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Abstract：
OBJECTIVE: Male fertility is an emergent issue that should be considered in clinical practice, when dealing with chronic inflammatory diseases in young men. As it is known, the chronic inflammation is the main pathophysiologic mechanism in some rheumatological conditions such as spondyloarthritis (SpA), Ankylosing Spondylitis (AS) and Psoriatic Arthritis (PsA). Therefore, it is paramount to be aware if these diseases could impair male fertility, both due to the inflammation or to the treatments needed: we reviewed the literature on the most relevant and recent evidence on male fertility in patients affected by SpA, AS and PsA.
RESULTS: Rheumatological inflammatory diseases (included SpA, AS and PsA) could impair the family planning in man life, especially when diagnosed at young age. Moreover, focusing on sperm quality, it seems that a link between sperm quality impairment and a higher disease activity exist. Focusing on therapies, Tumor Necrosis Factor inhibitors showed a safety profile on human male fertility in clinical studies. Recently, a prospective study and two double-blind placebo-controlled trials assessed the impact of methotrexate and Filgotinib on semen parameters, respectively, showing a safety profile of these drugs on human semen quality. However, there are no clinical data on the impact of Interleukin (IL)17 inhibitors(i), IL12-23i and IL23i. Concerning male fertility in SpA, AS and PsA, an unmet clinical need is still present and new studies are needed to understand the association between these diseases and male fertility, and the implication of the therapies used for these diseases. This narrative review provides an overview of the available data on male fertility in patients affected by SpA, AS and PsA.
RESULTS: Rheumatological inflammatory diseases (included SpA, AS and PsA) could impair the family planning in man life, especially when diagnosed at young age. Moreover, focusing on sperm quality, it seems that a link between sperm quality impairment and a higher disease activity exist. Focusing on therapies, Tumor Necrosis Factor inhibitors showed a safety profile on human male fertility in clinical studies. Recently, a prospective study and two double-blind placebo-controlled trials assessed the impact of methotrexate and Filgotinib on semen parameters, respectively, showing a safety profile of these drugs on human semen quality. However, there are no clinical data on the impact of Interleukin (IL)17 inhibitors(i), IL12-23i and IL23i. Concerning male fertility in SpA, AS and PsA, an unmet clinical need is still present and new studies are needed to understand the association between these diseases and male fertility, and the implication of the therapies used for these diseases. This narrative review provides an overview of the available data on male fertility in patients affected by SpA, AS and PsA.
摘要：
目的：男性生育力是临床实践中应该考虑的紧急问题，在处理年轻男性的慢性炎症性疾病时。众所周知,慢性炎症是一些风湿性疾病如脊柱关节炎（SpA）的主要病理生理机制，强直性脊柱炎（AS）和银屑病关节炎（PsA）。因此,最重要的是要意识到这些疾病是否会损害男性的生育能力，由于炎症或所需的治疗：我们回顾了有关SpA患者男性生育能力的最相关和最新证据的文献，AS和PSA。
结果：风湿病（包括SpA，AS和PsA）可能会损害人类生活中的计划生育，尤其是在年轻时被诊断。此外，关注精子质量，似乎精子质量受损和较高的疾病活动之间存在联系。专注于治疗，肿瘤坏死因子抑制剂在临床研究中显示了对人类男性生育能力的安全性。最近,一项前瞻性研究和两项双盲安慰剂对照试验评估了甲氨蝶呤和Filgotinib对精液参数的影响,分别,显示这些药物对人类精液质量的安全性。然而,没有关于白细胞介素（IL）17抑制剂（I）的影响的临床数据，IL12-23i和IL23i。关于SpA中的男性生育能力，AS和PsA，仍存在未满足的临床需求，需要新的研究来了解这些疾病与男性生育能力之间的关系，以及用于这些疾病的疗法的含义。这篇叙述性综述概述了受SpA影响的患者男性生育能力的现有数据，AS和PSA。
结果：风湿病（包括SpA，AS和PsA）可能会损害人类生活中的计划生育，尤其是在年轻时被诊断。此外，关注精子质量，似乎精子质量受损和较高的疾病活动之间存在联系。专注于治疗，肿瘤坏死因子抑制剂在临床研究中显示了对人类男性生育能力的安全性。最近,一项前瞻性研究和两项双盲安慰剂对照试验评估了甲氨蝶呤和Filgotinib对精液参数的影响,分别,显示这些药物对人类精液质量的安全性。然而,没有关于白细胞介素（IL）17抑制剂（I）的影响的临床数据，IL12-23i和IL23i。关于SpA中的男性生育能力，AS和PsA，仍存在未满足的临床需求，需要新的研究来了解这些疾病与男性生育能力之间的关系，以及用于这些疾病的疗法的含义。这篇叙述性综述概述了受SpA影响的患者男性生育能力的现有数据，AS和PSA。
