{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T21:03:32Z","timestamp":1784322212600,"version":"3.55.0"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2023,12,6]],"date-time":"2023-12-06T00:00:00Z","timestamp":1701820800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["111-2314-B-075 A-001-MY3"],"award-info":[{"award-number":["111-2314-B-075 A-001-MY3"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,4,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>In the era of biologic therapy, phototherapy and methotrexate (MTX) are still commonly used for treatment in patients with moderate-to-severe psoriasis. However, the skin cancer risk following a combination of MTX and narrowband ultraviolet B (NB-UVB) has rarely been explored.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To investigate whether MTX plus NB-UVB increases skin cancer risk in patients with psoriasis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a retrospective cohort study of data in the Taiwan National Health Insurance Research Database from 1997 to 2013. Cumulative incidences and multivariate analysis were investigated using a competing risk regression model, comparing skin cancer risk between cohorts of people having combination therapy and those using NB-UVB alone, matched for relative confounders. We further conducted a sensitivity analysis for those receiving a higher MTX dose. Standardized incidence ratios (SIRs) were calculated for skin cancer risk.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We enrolled 3203 participants in each cohort. No significant differences in skin cancers were noted between the two cohorts for the cumulative incidences (log-rank test, P = 0.28) and for the hazard ratio (HRs) [adjusted HR 0.50, 95% confidence interval (CI) 0.15\u20131.63, P = 0.247] in the competing risk regression model. There were also no significant differences between those receiving higher-dose MTX and UVB alone in the cumulative incidences of skin cancers (P = 0.23) and the HR (adjusted HR = 0.29, 95% CI 0.04\u20132.21, P = 0.23) in the multivariate analysis. There was no significant difference in the SIR between the two cohorts compared with the general population.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In the Taiwanese population, MTX does not increase skin cancer risk in patients with moderate-to-severe psoriasis receiving NB-UVB.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ced\/llad424","type":"journal-article","created":{"date-parts":[[2023,12,7]],"date-time":"2023-12-07T05:42:47Z","timestamp":1701927767000},"page":"459-465","source":"Crossref","is-referenced-by-count":3,"title":["Methotrexate did not add skin cancer risk in patients with psoriasis receiving narrowband ultraviolet B phototherapy: a nationwide retrospective cohort study"],"prefix":"10.1093","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2185-1340","authenticated-orcid":false,"given":"Chun-Hsien","family":"Chao","sequence":"first","affiliation":[{"name":"Department of Medicine Education"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Ying","family":"Wu","sequence":"additional","affiliation":[{"name":"Division of Translational Research"},{"name":"Institute of Biomedical Informatics and Research Center for Epidemic Prevention and"},{"name":"Faculty of Medicine and Institute of Clinical Medicine, National Yang Ming Chiao Tung University , Taipei , Taiwan"},{"name":"Department of Public Health, China Medical University , Taichung , Taiwan"},{"name":"National Institute of Cancer Research and Institute of Population Health Science, National Health Research Institutes , Miaoli , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fan-Ling","family":"Chou","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Taichung Veterans General Hospital , Taichung , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8932-5095","authenticated-orcid":false,"given":"Yi-Ju","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Taichung Veterans General Hospital , Taichung , Taiwan"},{"name":"Department of Post-Baccalaureate Medicine, National Chung Hsing University , Taichung , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,12,6]]},"reference":[{"key":"2024042316200121000_llad424-B1","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1056\/NEJMra0804595","article-title":"Psoriasis","volume":"361","author":"Nestle","year":"2009","journal-title":"N Engl J 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