{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T16:37:39Z","timestamp":1778863059792,"version":"3.51.4"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"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":["Int J of Urology"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The study quantifies the real\u2010world incidence of skin phototoxicity associated with oral 5\u2010aminolevulinic acid hydrochloride during photodynamic diagnosis\u2010assisted transurethral resection of bladder tumor. Furthermore, we assessed whether the Japanese regulatory revision in 2022 on the concomitant use with photosensitizing medications modified the risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 462 procedures performed at Toranomon Hospital between 2020 and 2024. The clinical data included demographics, laboratory results, medication history, and adverse reactions. Skin reactions were graded using the Common Terminology Criteria for Adverse Events, version 5.0. Logistic regression, including Firth's penalized likelihood, was used to identify independent predictors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Phototoxicity occurred in eleven procedures (all grade 1), and all patients recovered without complications. Skin phototoxicity occurred in one of 190 patients (0.5%) without photosensitizing agents and in 10 of 272 patients (3.7%) with the concomitant use of photosensitizing agents. The unadjusted relative risk was 7.0, and the absolute risk increase with photosensitizing drugs was 3.2% (number needed to harm, 32). Concomitant photosensitizing drugs and elevated preoperative alanine aminotransferase grade were independently associated with phototoxicity in univariate and multivariate analyses (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). The most frequently used concomitant medications included calcium\u2010channel blockers, angiotensin receptor blockers, statins, and thiazide diuretics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Skin phototoxicity related to oral 5\u2010aminolevulinic acid hydrochloride during photodynamic diagnosis\u2010assisted transurethral resection of bladder tumor is uncommon and mild. Although the continued use of photosensitizing medications and elevated alanine aminotransferase levels increased the risk of phototoxicity, careful medication review and standard light\u2010avoidance measures can support the safe use of 5\u2010aminolevulinic acid hydrochloride.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/iju.70448","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T10:07:03Z","timestamp":1774865223000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Skin Phototoxicity With Aminolevulinic Acid Hydrochloride in Patients With Non\u2010Muscle Invasive Bladder Cancer: Real\u2010World Incidence and Concomitant Medication Effects"],"prefix":"10.1111","volume":"33","author":[{"given":"Asami","family":"Usui","sequence":"first","affiliation":[{"name":"Department of Urology Toranomon Hospital  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2668-6218","authenticated-orcid":false,"given":"Tomohiko","family":"Hara","sequence":"additional","affiliation":[{"name":"Department of Urology Toranomon Hospital  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suguru","family":"Oka","sequence":"additional","affiliation":[{"name":"Department of Urology Toranomon Hospital  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazushige","family":"Sakaguchi","sequence":"additional","affiliation":[{"name":"Department of Urology Toranomon Hospital  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinji","family":"Urakami","sequence":"additional","affiliation":[{"name":"Department of Urology Toranomon Hospital  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,30]]},"reference":[{"key":"e_1_2_12_2_1","volume-title":"Global Cancer Observatory\u2009: Cancer Today","author":"International Agency for Research on Cancer","year":"2024"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2023.03.029"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2005.12.031"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2020.12.033"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/iju.13718"},{"key":"e_1_2_12_7_1","volume-title":"National Database of Health Insurance. Claims and Specific Health Checkups of Japan (NDB)","author":"Ministry of Health Labour and Welfare","year":"2025"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/iju.13856"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pdpdt.2023.103707"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/iju.14099"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pdpdt.2024.104291"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pdpdt.2023.103294"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1562\/2006-02-03-IR-794"},{"key":"e_1_2_12_14_1","volume-title":"Risk Management Plan for Alaglio Granules 1.5 g and Alaglio Oral Powder 1.5 g","author":"SBI Pharmaceuticals Co. Ltd","year":"2024"},{"issue":"2","key":"e_1_2_12_15_1","article-title":"Photosensitivity Reaction From Operating Room Lights After Oral Administration of 5\u2010Aminolevulinic Acid for Fluorescence\u2010Guided Resection of a Malignant Glioma","volume":"13","author":"Yahanda A. T.","year":"2021","journal-title":"Cureus"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10147-024-02638-5"},{"key":"e_1_2_12_17_1","unstructured":"Pharmaceuticals and Medical Devices Agency \u201cRevision of Precautions \u2010 Aminolevulinic Acid Hydrochloride \u201d(2022) https:\/\/www.pmda.go.jp\/files\/000244342.pdf."},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0b013e3181577511"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyac034"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.2001.04186.x"},{"key":"e_1_2_12_21_1","volume-title":"Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0","author":"National Cancer Institute","year":"2017"},{"key":"e_1_2_12_22_1","volume-title":"PMDA Search: Prescription Drug Information","author":"Pharmaceuticals and Medical Devices Agency","year":"2025"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.3390\/pharmaceutics12111104"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pharmthera.2023.108487"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40264-019-00806-5"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.3389\/falgy.2022.876695"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms24108964"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1989.01670220051006"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjcvp\/pvac017"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41585-019-0184-4"}],"container-title":["International Journal of Urology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iju.70448","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/iju.70448","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iju.70448","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T10:52:17Z","timestamp":1777027937000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/iju.70448"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,30]]},"references-count":29,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1111\/iju.70448"],"URL":"https:\/\/doi.org\/10.1111\/iju.70448","archive":["Portico"],"relation":{},"ISSN":["0919-8172","1442-2042"],"issn-type":[{"value":"0919-8172","type":"print"},{"value":"1442-2042","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,30]]},"assertion":[{"value":"2025-11-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70448"}}