{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T11:50:29Z","timestamp":1789473029542,"version":"build-2803163510"},"reference-count":26,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Skin rash during epidermal growth factor receptor tyrosine kinase inhibitor (EGFR\u2010TKI) therapy has been associated with better outcomes in non\u2010small cell lung cancer (NSCLC), but previous studies may have overestimated this association because of immortal time bias. We evaluated the association between EGFR\u2010TKI\u2013associated skin rash and mortality while accounting for rash timing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We identified patients with NSCLC who initiated first\u2010line EGFR\u2010TKIs between August 2018 and December 2024 using a Japanese claims database. EGFR\u2010TKI\u2013associated skin rash was defined using a qualifying diagnosis and rash\u2010related treatment recorded in the same calendar month. We performed time\u2010dependent propensity score sequential matching: each patient who newly developed skin rash was matched on the rash\u2010onset day to patients still at risk who had not yet developed skin rash; follow\u2010up started on the matched day. For comparison, we also performed an analysis that did not account for immortal time bias and landmark analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 11\u2009830 eligible patients, 560 developed incident skin rash. In the time\u2010dependent propensity score sequential matching analysis, 560 patients with skin rash were matched to 5600 patients without skin rash, and skin rash was associated with lower recorded mortality (HR, 0.621; 95% CI, 0.404\u20130.953). The estimate was stronger in the analysis not accounting for immortal time bias (HR, 0.410), whereas the association was attenuated in landmark analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>EGFR\u2010TKI\u2013associated skin rash was associated with lower recorded mortality, but the association was weaker after accounting for immortal time bias. Prior studies may have overestimated this association.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pds.70428","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T09:23:30Z","timestamp":1782897810000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Association Between\n                    <scp>EGFR<\/scp>\n                    \u2010\n                    <scp>TKI<\/scp>\n                    \u2013Associated Skin Rash and Recorded Mortality in Non\u2010Small Cell Lung Cancer: A Real\u2010World Analysis Accounting for Immortal Time Bias"],"prefix":"10.1002","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2538-6328","authenticated-orcid":false,"given":"Yasutaka","family":"Ihara","sequence":"first","affiliation":[{"name":"Clinical Research Promotion Unit, Clinical Therapeutic Trial Center Ehime University Hospital  Toon Ehime Japan"},{"name":"Center for Data Science Ehime University  Toon Ehime Japan"},{"name":"Integrated Medical and Agricultural School of Public Health Ehime University  Toon Ehime Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukihiro","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Pulmonology, Hypertension &amp; Nephrology, Graduate School of Medicine Ehime University  Toon Ehime Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoichiro","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Pulmonology, Hypertension &amp; Nephrology, Graduate School of Medicine Ehime University  Toon Ehime Japan"},{"name":"Department of Clinical Oncology Ehime University Graduate School of Medicine  Toon Ehime Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1713137"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0909530"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyv207"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdi157"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.3727\/096504017X14913452320194"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(12)70412-6"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2012.06.009"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.1357"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0055128"},{"key":"e_1_2_13_11_1","unstructured":"Medical Data Vision Co. 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