POS1388 SEMEN ANALYSIS OF PATIENTS WITH PSORIATIC ARTHRITIS, AXIAL SPONDYLOARTHRITIS AND HEALTHY CONTROLS

Background:

Psoriatic arthritis (PsA) and axial spondyloarthritis (AxSpA) are commonly diagnosed in young males in their reproductive years. However, only a few studies have investigated male fertility in patients with spondyloarthritis (SpA).

Objectives:

We aimed to evaluate the sperm quality in male patients with PsA and AxSpA compared to healthy controls (HC) and to investigate the effects of disease activity and anti-rheumatic drugs on sperm quality.

Methods:

Consecutive PsA and AxSpA patients (age range 18-50 years), who fulfilled the classification criteria for PsA (CASPAR) and AxSpA (ASAS) were recruited prospectively. HC were recruited from candidate sperm donors at the male fertility clinic. Each patient was evaluated by a comprehensive clinical assessment that included measurement of disease activity scores (MDA, DAPSA, CPDAI & PASDAS for PsA and ASDAS for AxSpA). Treatments ranged from no treatment to conventional and biologic DMARDs. Sperm collection and analysis were performed on the day of clinical assessment. Sperm analysis was performed according to the World Health Organization 2010 guidelines. In addition, sperm DNA-fragmentation test was performed. Continuous variables were compared using a t-test or Anova for normally distributed data, otherwise, a non-parametric test was applied. Fisher's exact test was used to compare categorical variables.

Results:

93 patients (51 PsA and 42 AxSpA) and 32 HC were included. Demographics and clinical characteristics are presented in Table 1. Semen parameters analysis, including morphology, concentration, motility, vitality and DNA fragmentation, of PsA and AxSpA patients were similar to those of HC (p>0.05) (Table 2). In addition, no differences were observed in semen analysis in the different disease activity states (remission/low and moderate/high disease activity) for PsA and for AxSpA (p>0.05). Finally, a comparison of the different treatment options (no treatment, conventional and biologic DMARDs) showed no differences in most parameters, including volume, concentration, vitality, morphology and total DNA fragments. However, motility was lower in patients treated with conventional synthetic and biologic monotherapy (54.7±16.2 and 52.8±11.0, respectively), compared to no treatment and conventional synthetic DMARDs+biologic therapy (62.4±7.4 and 59.2±4.4, respectively), p<0.01. Nevertheless, motility values for all groups were within the normal range (>40%).

Conclusion:

In this relatively large study evaluating semen analysis in spondyloarthropathies, the semen quality of PsA and AxSpA patients was comparable to HC in all parameters. In addition, neither disease activity nor antirheumatic drugs substantially affected sperm quality. Our results do not support cryopreservation of semen before treatment initiation nor a drug free interval prior to conception. Further longitudinal large studies are needed. Table 1. Demographic and clinical characteristics of patients with PsA, AxSpA and healthy controls # P-Value<0.05 *CsDMARDs= conventional synthetic DMARDs: Methotrexate, Leflunomide **Biologic therapy= TNFi (Infliximab+Etanercept+Adalimumab+Golimumab), Anti-IL17 (Secukinumab+ Ixekizumab), Anti-IL23 (Guselkumab), Anti-IL12/23 (Ustekinumab)

REFERENCES:

NIL.

Acknowledgements:

NIL.

Disclosure of Interests:

None declared.