41 Risk factors: a systematic review 2 Measurement outcome Risk factor Measurement risk factor Results Risk of bias: QUIPS domains Corticosteroid symptom inventory Age (4-5 / 7-10 / 12-16) Patient record Trend of more behavioral symptoms in younger children (<7 years) 5/6 high Prospectively collected SAE Age (<16 / ≥16) Patient record <16 years: 0,4%, ≥16 years 2,2% (p<.05) 4/6 high Observation (collected retrospectively) Type of steroid Assigned by protocol Dex: 3 neuropsychiatric adverse events Pred: 0 events (p=.24) 4/6 high Collected retrospectively SNPs: - N363S - Bcl1 PCR-RFLP N363S: no SNP present Bcl1: depression symptoms more frequent among carriers (40.7% vs 11.8%, p=.040) 4/6 high Collected retrospectively Polymorphisms in - ABCB1 - NR3C1 - GST - IL-10 genes - PCR-RFLP - PCR-RFLP - PCR-ASO - PCR-RFLP No correlation between neuropsychiatric toxicity and genotype 4/6 high - CBCL - CDI - Conners Parent Questionnaire - Platelet MAO activity - Age - Sex -Radiochemical assay - Prior pred exposure - Patient record - Patient record MAO activity: correlated with steroid induced changes in CBCL and Connors, not CDI. Prior pred exposure: NS Age: NS Sex: NS 4/6 high Reported by clinician - Type of steroid - Age (<2 / 2–9 / ≥10) - Sex - Assigned by protocol - Patient record - Patient record Dex: 6% vs pred 1% (p<0.0001) Age: NS Sex: depression in girls, aggression in boys (both trend) 2/6 high CBCL - Type of steroid - Age (2-<6 / ≥6-17) - Sex -Cumulative steroid dose - Assigned by protocol - Patient record - Patient record - Patient record - Per protocol Dex vs pred: NS Age: 2-<6 years more problems than ≥6-17 years. Sex: NS Cumulative steroid dose: NS 1/6 high
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