Association Between Psoriasis and Erectile Dysfunction: A Meta-Analysis.

Background: Several studies have shown a relationship between psoriasis and erectile dysfunction (ED), but a meta-analysis of the data has not been performed.

Aim: To conduct a comprehensive meta-analysis of existing evidence to quantify and compare the risk of ED with psoriasis.

Methods: A systematic literature search was conducted using MEDLINE, EMBASE, Cochrane databases, and Google Scholar. We calculated pooled odds ratios (OR), standardized mean difference (SMD), and 95% CI.

Outcomes: Outcome measures included characteristics of included studies, association between psoriasis and ED risk, and association for adjusted-for-covariates studies between psoriasis and ED risk.

Results: In total, 9 studies with 36,242 psoriasis patients and 1,657,711 controls (participants without psoriasis) met inclusion criteria and showed that there was statistically significant association between psoriasis and ED risk (OR 1.35; 95% CI 1.29-1.41; P < .00001; I = 44%). A significant association for adjusted-for-covariates studies between psoriasis and ED risk was also observed (OR 1.22; 95% CI 1.08-1.37; P = .002; I = 43.8%). It revealed the International Index of Erectile Function-5 score was statistically significantly lower in the psoriasis group than controls (SMD -3.09; 95% CI -4.81 to -1.37; P = .0004; I = 77%). A subgroup analysis was performed to potentially explain heterogeneity. It examined the main potential sources of inter-study variance including variance sample sizes and different assessment tools for ED.

Clinical Translation: The risk of ED in psoriasis patients should also be assessed by physicians.

Conclusions: This study is a well-designed and comprehensive meta-analysis to examine the relationship between psoriasis and risk of ED. However, the included studies are mostly cross-sectional or have small sample cohorts, which could bring bias and heterogeneity into the analysis. Our findings support the hypothesis that psoriasis is associated with an increased risk of ED. Furthermore, additional prospective cohort studies are needed to elucidate these relationships and to advance knowledge in this field. Wu T, Duan X, Chen S, et al. Association Between Psoriasis and Erectile Dysfunction: A Meta-analysis. J Sex Med 2018;15:839-847.