Ab0173 Male Patients With Psoriatic Arthritis, Rheumatoid Arthritis and Axial Spondyloarthritis Have More Children Than Matched Controls

Background: In the last couple of years, there has been increased awareness regarding possible effects of chronic inflammatory joint diseases (IJDs) on male fertility. The iFAME-fertility study [1] from The Netherlands in 2021 suggested an association between IJDs and reduced fertility. However, a recent extensive cohort study [2] showed that the proportion of childless men was lower in 11,000 Norwegian IJD patients than in matched controls. Further data are needed to improve our understanding of how male fertility is affected by various inflammatory joint diseases. Objectives: To examine the number of children per man and the proportion of childless men in patients with psoriatic arthritis (PsA), rheumatoid arthritis (RA) and spondyloarthritis (SpA), and to compare the number of children and proportion of childless men between the various diagnostic groups and between the different patients groups and their respective controls. Methods: This is a nationwide, population-based cohort study. Male patients aged 25–65 years, with PsA (n = 2,649), RA (n = 1,716), and SpA (n = 2,766) from the Norwegian Arthritis Registry were individually matched 1:5 on birth year and county of residence to men without IJDs, using data from the National Population Register (n = 35,655). Birth data were acquired from the Medical Birth Registry of Norway. We compared the mean number of children per man and the proportion of childless men in patients with PsA, RA and SpA with controls, and between the three patient groups. When analyzing age-adjusted differences in outcomes between the three diagnoses, a reference age of 50 years (in 2021) was used. Results: The mean number of children per man was significantly higher (p < 0.001) in all three diagnostic groups than in the controls (Table 1). Similarly, for all three groups, fewer men were childless compared with the control group (p < 0.001, Table 1). The age-adjusted number of children per man was largely similar for the three patient groups (Figure 1: PsA 1.86, RA 1.82, and SpA 1.77 for a man at age 50), but SpA patients had a statistically significant and slightly lower mean number of children compared to patients with PsA (difference: 0.10; 95% CI: 0.03–0.16; p < 0.001). The other group differences were not statically significant. Similar findings were found regarding the proportion of childless men with 17.1% of PsA patients, 18.7% of RA patients and 20.8% of SpA patients being childless at age 50 (p < 0.001 for PsA vs. SpA). Conclusion: In this large nationwide cohort study, we found that patients with PsA, RA and SpA all have a higher number of children per man and are less likely to be childless compared to controls from the general population, and that only small differences were observed between the diagnostic groups. Our results suggest that male fertility is not negatively altered in any of the IJD diagnostic groups. In our setting, factors associated with getting or having an IJD seem to improve fertility or the motivation and possibility to father children. REFERENCES: [1] Perez-Garcia LF, et al. Impaired fertility in men diagnosed with inflammatory arthritis: Ann Rheum Dis. 2021;80(12):1545-52. [2] Sigmo GD, et al. Male patients with inflammatory joint diseases are less likely to be childless compared to controls. Results from a Norwegian population-based cohort study of 10,865 patients. Ann Rheum Dis. 2024; Accepted for publication (25.11.23). Table 1. Mean number of children per man and proportion of childless men in 2021, in patients with PsA, RA and SpA compared to age-matched controls*. * When comparing patients to controls, we did not adjust for the father's age, since the patients and controls are already matched by year of birth. Due to the different average age in the various diagnostic groups, the total number of children and proportion of childless men cannot be directly compared across the groups. † P value <0.001 in all groups Acknowledgements: NIL. Disclosure of Interests: None declared.