Systemic therapy associates with a lower incidence of male infertility among psoriasis patients

Summary: Abstract Body: Psoriasis is a chronic inflammatory skin disease with severe consequences on quality of life. Existing research indicates systemic inflammation may impair fertility, yet data on whether systemic medications used in the management of psoriasis associate with male infertility remain scarce. We conducted a population-based retrospective cohort study utilizing de-identified data from the TriNetX Global Collaborative Network, between 2004-2024. Male patients diagnosed with psoriasis were included in the analysis. Individuals with a prior history of infertility or known hormonal, genetic, inflammatory or structural causes of infertility were excluded. Using the greedy nearest neighbor algorithm, male psoriasis patients managed with systemic therapy for psoriasis (biologics and non-biologics) were propensity score matched (1:1) to a control cohort of male psoriasis patients managed without systemic therapy. Covariates included demographics, overweight and obesity status, smoking, alcohol use, and body mass index. Male infertility was measured at any time after the index event for up to 20 years or until withdrawal from the TriNetX database. Odds Ratios (OR) with 95% confidence intervals (CIs) were calculated. We identified 26,907 psoriasis patients managed with systemic therapy and 95,305 psoriasis patients managed without, who met the study criteria. Propensity score matching resulted in cohorts of 26,165 patients. The mean age of patients receiving systemic therapy was 48.5 ± 16.8 years, while the mean age of those not receiving systemic therapy was 48.4 ± 17.1 years. Within a 20-year observation window, psoriasis patients managed with systemic therapy were 45% less likely to be diagnosed with male infertility compared to controls (26 vs 47, OR 0.55; 95% CIs: 0.34-0.89). Findings from this large, population-based study suggest male psoriasis patients receiving systemic therapy are less likely to experience infertility compared to those not on systemic therapy. Ana J. Ormaza Vera¹, Madison P. Olexson¹, Chunghwan Ro¹, Clinton W. Enos¹ 1. Dermatology, Macon & Joan Brock Virginia Health Sciences at Old Dominion University, Norfolk, VA, United States. Clinical Research: Epidemiology and Observational Research