{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T11:52:37Z","timestamp":1789732357153,"version":"4.0.1"},"reference-count":39,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T00:00:00Z","timestamp":1693267200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012331","name":"LEO Fondet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100012331","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006477","name":"National Taiwan University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006477","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The risks of serious infections that lead to hospitalization and mortality in patients with psoriasis in Asia have not been comprehensively studied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We examined the incidence of serious infection and infection mortality in patients with psoriasis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This population\u2010based retrospective cohort study used the Taiwan National Health Insurance claims database from 2000 to 2017. Adult patients with psoriasis were identified by a relevant International Classification of Diseases (ICD) code and matched to six comparators without psoriasis on age and sex. Psoriasis patients were categorized as having moderate\u2010to\u2010severe disease once exposed to systemic therapies, phototherapy or biologic therapies. The incidence of serious infection and infection mortality were identified by ICD codes from inpatient hospitalization and death registration. Cox proportional hazard models were used to compare the risk, and the results were adjusted for covariates and presented as adjusted hazard ratios (aHR) and 95% confidence interval (95% CI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 185,434 psoriasis patients and 1,112,581 comparators were included. A higher rate of serious infection (aHR: 1.21, 95% CI: 1.19\u20131.22) was found in patients with psoriasis compared to matched comparators without psoriasis, and the risk was enhanced when patients had moderate\u2010to\u2010severe psoriasis (aHR: 1.30, 95% CI: 1.27\u20131.34). Specifically, there was an increased risk of serious infection due to respiratory infections (aHR: 1.11, 95% CI: 1.09\u20131.13), skin\/soft\u2010tissue infections (aHR: 1.57, 95% CI: 1.52\u20131.62), sepsis (aHR: 1.23, 95% CI: 1.19\u20131.27), urinary tract infections (aHR: 1.11, 95% CI: 1.08\u20131.14), hepatitis B (aHR: 1.18, 95% CI: 1.06\u20131.30) and hepatitis C (aHR: 1.49, 95% CI: 1.32\u20131.69). Furthermore, psoriasis patients were associated with a higher risk of infection\u2010related mortality (aHR: 1.15, 95% CI: 1.11\u20131.18) compared to matched comparators.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients with psoriasis had a higher risk of serious infection and infection mortality, which was enhanced by moderate\u2010to\u2010severe psoriasis. Practitioners should be aware of the increased risk in patients with psoriasis, but it should not be a barrier to offering effective treatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.19466","type":"journal-article","created":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T21:06:26Z","timestamp":1692824786000},"page":"136-144","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Risk of serious infection and infection mortality in patients with psoriasis: A nationwide cohort study using the Taiwan National Health Insurance claims database"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9491-0421","authenticated-orcid":false,"given":"Teng\u2010Chou","family":"Chen","sequence":"first","affiliation":[{"name":"Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health University of Manchester  Manchester UK"},{"name":"Department of Pharmacy School of Pharmaceutical Sciences National Yang Ming Chiao Tung University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting\u2010Chun","family":"Wang","sequence":"additional","affiliation":[{"name":"Health Data Research Center National Taiwan University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1831-074X","authenticated-orcid":false,"given":"Zenas Z. N.","family":"Yiu","sequence":"additional","affiliation":[{"name":"Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng\u2010Sui","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Dermatology Taipei City Hospital  Taipei Taiwan"},{"name":"Department of Dermatology National Yang\u2010Ming Chiao Tung University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li\u2010Chia","family":"Chen","sequence":"additional","affiliation":[{"name":"Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. Arnold","family":"Chan","sequence":"additional","affiliation":[{"name":"Health Data Research Center National Taiwan University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5371-4427","authenticated-orcid":false,"given":"Christopher E. M.","family":"Griffiths","sequence":"additional","affiliation":[{"name":"Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre University of Manchester  Manchester UK"},{"name":"NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science\u00a0Centre University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren M.","family":"Ashcroft","sequence":"additional","affiliation":[{"name":"Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health University of Manchester  Manchester UK"},{"name":"NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science\u00a0Centre University of Manchester  Manchester UK"},{"name":"NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester Academic Health Science Centre University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Global Psoriasis Atlas (GPA)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,29]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.296.14.1735"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2010.01.050"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1346-8138.2011.01401.x"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2013.06.053"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2012.08.015"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2014.01.008"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.19052"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.21595"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/ng.2007.48"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4632.2008.03470.x"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2008.11.906"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jid.2018.01.039"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2011.10688.x"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.16083"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(85)70188-0"},{"key":"e_1_2_10_17_1","unstructured":"World Health Organization.Global TB Rep.2021[cited 2022 Aug 15]. 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