Sexual function and reproduction can be impaired in men with rheumatic diseases: A systematic review

Perez-Garcia, L. F.; Winkel, Bernke te; Carrizales, Juan; Bramer, Wichor M.; Vorstenbosch, Saskia; Puijenbroek, Eugene van; Hazes, J. M. W.; Dolhain, Radboud J E M

doi:10.1016/j.semarthrit.2020.02.002

Cited by 44 publications

(41 citation statements)

References 91 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Recently, it has been shown that disease activity can also impair fertility in men with rheumatic diseases ( Villiger et al , 2010 ; Ganatra et al , 2018 ; Kaya Aksoy et al , 2019 ; Perez-Garcia et al , 2020 ). In consequence, it is very important to start focusing on developing well-designed epidemiological studies where study design and data analysis consider how diseases and drugs together can affect sexual health and reproduction.…”

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

View full text Add to dashboard Cite

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.

show abstract

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

View full text Add to dashboard Cite

show abstract

“…Previous studies have shown that PsA (9,10,12) and psoriatic disease activity (36)(37)(38) are both risk factors for ED in men with psoriasis, a population known to have an increased risk of sexual dysfunction. However, unlike sexual dysfunction, and despite this implied association, the incidence of ED in men with PsA has not been previously analyzed in a population-based cohort and has been minimally analyzed by other methods (39). By defining the incidence of ED in men with PsA, we can begin to explore the relationship between vascular ED and cardiovascular risk within this population of men with a heightened risk of cardiovascular morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

Erectile Dysfunction in Men With Psoriatic Arthritis: A Population-based Cohort Study

et al. 2020

View full text Add to dashboard Cite

Objective To define the incidence of erectile dysfunction (ED) in a population-based cohort of men with psoriatic arthritis (PsA). Methods Data pertaining to demographics, ED, and potential confounding diagnosis were extracted from a comprehensive medical record system for a population-based cohort of men with PsA and an age-matched male comparator cohort. Cumulative incidence of ED adjusted for competing risk of death was compared between the two cohorts. Results There were 128 age-matched pairs of men with PsA and without PsA in the described cohorts. At baseline there was a 7% prevalence of ED in men with PsA prior to diagnosis compared to a 3% prevalence of ED in the comparator cohort (p=0.16). After PsA diagnosis / index date, diagnosis with PsA was associated with an increased risk of ED (age-adjusted HR 1.45, 95%CI: 0.79-2.68), but this association did not reach statistical significance. This was based on 24 cases of ED in the men with PsA and 18 cases within the comparator cohort. No confounding factors or ED treatment strategies differed significantly between men with PsA and ED and comparators with ED. Conclusion Men with PsA may have an increased risk of ED, which was detected, but likely underpowered in this study. Whether this difference is secondary to higher prevalence of traditional risk factors of ED in men with PsA compared to general population will require further study.

show abstract

“…This study describes a case of sJIA associated with hypogonadotropic hypogonadism. This association has been the subject of limited research in the literature [4,5].…”

Section: Discussionmentioning

confidence: 99%

“…A few studies have reported that low serum testosterone is predictive of seronegative arthritis [5]. However, the association between hypogonadotropic hypogonadism and juvenile chronic arthritis is rare [4,5]. Here we report an untreated case of systemic juvenile idiopathic arthritis (sJIA) in a young African male who also presents hypogonadotropic hypogonadism.…”

Section: Introductionmentioning

confidence: 87%

See 1 more Smart Citation

Hypogonadotropic Hypogonadism and Juvenile Idiopathic Arthritis in an African Boy: What is the Pathophysiological Link?

Diack¹,

Ndiaye²,

Mbaye

et al. 2020

Cureus

View full text Add to dashboard Cite

The association between hypogonadotropic hypogonadism and juvenile chronic arthritis has rarely been reported in the literature. We report an untreated case of systemic juvenile idiopathic arthritis in a young African male with co-presentation of hypogonadotropic hypogonadism. Possible pathophysiological and etiological links are discussed. A 16-year-old boy was received in our outpatient department for chronic arthritis with temporomandibular involvement and fever. There was no family history of rheumatic diseases or psoriasis. Body temperature was 39.5°C at admission. The clinical examination found synovitis of wrists and knees and inflammatory lymphadenopathy. This polyarthritis occurred in a context of hypogonadism marked by impuberism of Tanner classification stage P2G2. Laboratory tests showed biological inflammatory syndrome and hyperferritinemia with collapsed glycosylated ferritin at 11%. Hormonal testing found low blood testosterone (0.08 mg/L) and pituitary hormone levels attesting to hypogonadotropic hypogonadism. Screening for infections was negative. The immunological assessment for antinuclear antibodies, rheumatoid factor, and anti-cyclic citrullinated peptide antibodies were negative. Standard radiography showed bilateral wrist carpitis. The olfactory bulb was present and normal by cerebral magnetic resonance imaging. The diagnosis of systemic juvenile idiopathic arthritis associated with hypogonadotropic hypogonadism, probably related to delayed puberty, was retained. A therapy combining corticosteroid, methotrexate for arthritis, and hormone replacement with testosterone led to regression of arthritis, biological inflammatory syndrome, and hypogonadism. The presence of rheumatic disease in this context of hypogonadism, regardless of its cause, is mainly associated with very low testosterone levels and the presentation of arthritis in these patients tends to be more severe.

show abstract

Sexual function and reproduction can be impaired in men with rheumatic diseases: A systematic review

Cited by 44 publications

References 91 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

Erectile Dysfunction in Men With Psoriatic Arthritis: A Population-based Cohort Study

Hypogonadotropic Hypogonadism and Juvenile Idiopathic Arthritis in an African Boy: What is the Pathophysiological Link?

Contact Info

Product

Resources

About