Patient with Severe Crohnʼs Disease Became a Father While on Methotrexate and Infliximab Therapy

Lamboglia, Francesca; D’Incà, R.; Oliva, L.; Bertomoro, P.; Sturniolo, Giacomo Carlo

doi:10.1002/ibd.20722

Cited by 18 publications

(7 citation statements)

References 13 publications

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“…Three case reports from before 2000 reported only healthy liveborn children ( Perry, 1983 ; Griggs and Schwartz, 2006 ; Lamboglia et al , 2009 ). More recent case series and cohort studies (169 pregnancies and 193 liveborn children) found no increased risk of birth defects associated with paternal MTX exposure ( Beghin et al , 2011 ; Engeland et al , 2013 ; Weber-schoendorfer et al , 2014 ; Winter et al , 2017 ; Drenches et al , 2018 ).…”

Section: Discussionmentioning

confidence: 99%

“…Eight small studies and one large population-based cohort were identified ( Lamboglia et al , 2009 ; Paschou et al , 2009 ; Saougou et al , 2013 ; Clowse et al , 2015 ; Larsen et al , 2016 ; Hoxha et al , 2017 ; Uyaroglu et al , 2017 ; Lichtenstein et al , 2018 ; Micu et al , 2019 ). In total, 61 males, 121 pregnancies and 372 children were included.…”

Section: Discussionmentioning

confidence: 99%

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The effect of paternal exposure to immunosuppressive drugs on sexual function, reproductive hormones, fertility, pregnancy and offspring outcomes: a systematic review

Perez-Garcia

Dolhain

Vorstenbosch

et al. 2020

Human Reproduction Update

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BACKGROUND Information regarding the possible influence of immunosuppressive drugs on male sexual function and reproductive outcomes is scarce. Men diagnosed with immune-mediated diseases and a wish to become a father represent an important neglected population since they lack vital information to make balanced decisions about their treatment. OBJECTIVE AND RATIONALE The aim of this research was to systematically review the literature for the influence of paternal immunosuppressive drug use on many aspects of male sexual health, such as sexual function, fertility, pregnancy outcomes and offspring health outcomes. SEARCH METHODS A systematic literature search was performed in the bibliographic databases: Embase (via Elsevier embase.com), MEDLINE ALL via Ovid, Cochrane Central Register of Trials (via Wiley) and Web of Science Core Collection. Additionally, Google Scholar and the Clinical trial registries of Europe and the USA were searched. The databases were searched from inception until 31 August 2019. The searches combined keywords regarding male sexual function and fertility, pregnancy outcomes and offspring health with a list of immunosuppressive drugs. Studies were included if they were published in English and if they included original data on male human exposure to immunosuppressive drugs. A meta-analysis was not possible to perform due to the heterogeneity of the data. OUTCOMES A total of 5867 references were identified, amongst which we identified 161 articles fulfilling the eligibility criteria. Amongst these articles, 50 included pregnancy and offspring outcomes and 130 included sexual health outcomes. Except for large Scandinavian cohorts, most of the identified articles included a small number of participants. While a clear negative effect on sperm quality was evident for sulfasalazine and cyclophosphamide, a dubious effect was identified for colchicine, methotrexate and sirolimus. In three articles, exposure to tumour necrosis factor-α inhibitors in patients diagnosed with ankylosing spondylitis resulted in improved sperm quality. The information regarding pregnancy and offspring outcomes was scant but no large negative effect associated with paternal immunosuppressive drug exposure was reported. WIDER IMPLICATIONS Evidence regarding the safety of immunosuppressive drugs in men with a wish to become a father is inconclusive. The lack of standardisation on how to evaluate and report male sexual function, fertility and reproduction as study outcomes in men exposed to immunosuppressive drugs is an important contributor to this result. Future research on this topic is needed and should be preferably done using standardised methods.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The effect of paternal exposure to immunosuppressive drugs on sexual function, reproductive hormones, fertility, pregnancy and offspring outcomes: a systematic review

Perez-Garcia

Dolhain

Vorstenbosch

et al. 2020

Human Reproduction Update

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“…Twenty‐six articles were included for data extraction: 9 studies on AZA, 10 on MTX, 2 on MPA/MMF and 5 on different oral immunosuppressive drugs . These included six retrospective questionnaire‐based studies, six prospective observational studies, six retrospective medical chart reviews, one review with original data and seven case reports.…”

Section: Resultsmentioning

confidence: 99%

Pregnancy and fetal outcomes after paternal exposure to azathioprine, methotrexate or mycophenolic acid: a critically appraised topic

et al. 2017

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“…Although the effect of MTX on fertility is well documented, French and Koren in collaboration with the Motherisk Programme at the University of Toronto report that there have been ‘no reports of adverse pregnancy outcomes among men exposed to methotrexate before conception’ . In addition, there is one report of a 41‐year‐old male taking MTX and infliximab at the time of conception resulting in a healthy 2.8 kg foetus . A prospective observational study by Weber‐Shoendorfer et al .…”

Section: Resultsmentioning

confidence: 99%

Review article: the safety of therapeutic drugs in male inflammatory bowel disease patients wishing to conceive

Sands

Jansen

Zaslau

et al. 2015

Aliment Pharmacol Ther

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Patient with Severe Crohnʼs Disease Became a Father While on Methotrexate and Infliximab Therapy

Cited by 18 publications

References 13 publications

The effect of paternal exposure to immunosuppressive drugs on sexual function, reproductive hormones, fertility, pregnancy and offspring outcomes: a systematic review

The effect of paternal exposure to immunosuppressive drugs on sexual function, reproductive hormones, fertility, pregnancy and offspring outcomes: a systematic review

Pregnancy and fetal outcomes after paternal exposure to azathioprine, methotrexate or mycophenolic acid: a critically appraised topic

Review article: the safety of therapeutic drugs in male inflammatory bowel disease patients wishing to conceive

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