REVIEW   

Minerva Endocrinology 2021 September;46(3):350-62

DOI: 10.23736/S2724-6507.20.03236-8

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Impact of current antipsoriatic systemic treatments on male and female fertility: what endocrinologists need to know

Sara CACCIAPUOTI ¹ ✉, Emanuele SCALA ¹, Matteo MEGNA ¹, Lucia GALLO ¹, Giuseppina FONTANELLA ¹, Angelo RUGGIERO ¹, Silvia SAVASTANO ², Gabriella FABBROCINI ¹

¹ Section of Dermatology, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy; ² Unit of Endocrinology, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy

Fertility is a function of the body that is often overlooked as a site for the expression of the side effects of certain drugs. With the approval of new drugs with a totally innovative mechanism of action, the risk assessment on fertility both in male and female is more difficult. This is particularly true in psoriasis, an invalidating inflammatory skin disease. The estimated prevalence of psoriasis in adults ranged from 0.51% to 11.43%, and in children from 0% to 1.37%, with frequent diagnosis in young patients of childbearing age. With the increasing use of new, predominantly immunosuppressive or biologic drugs for psoriasis, questions frequently arise in clinical practice as to their safety in men and women wishing to procreate. Both psoriatic patients and their physicians are concerned about adverse effects of the disease and its treatment on their future fertility, causing additional concerns in the therapeutic management of these patients. Among antipsoriatic drugs, conventional therapies are mainly involved in the onset of infertility in both sexes, exerting in some cases toxic effects against reproductive organs. Conversely, biologic agents appear to improve male and female fertility especially when gonadal impairment is related to inflammatory phenomena. There is a lack of review articles of commonly used medications in psoriasis with respect to their potential effects on fertility. The aim of this paper was to provide a practical guide for both dermatologist and endocrinologist in therapeutic management of psoriatic patients of childbearing age, considering the impact of prescribed drugs on their current and future fertility.

KEY WORDS: Fertility; Psoriasis; Therapy; Biological factors