High prevalence of erectile dysfunction in men with psoriasis: evidence from a systematic review and meta-analysis

Psoriasis is a common skin disease with the global prevalence of about 2%. Mounting evidence has emerged indicating that there was an association between psoriasis and increased susceptibility to erectile dysfunction (ED). We aimed to assess whether psoriasis was a risk factor for ED through a comprehensive literature review and meta-analysis. The MEDLINE (PubMed), EMBASE, and the Cochrane Library were systematically searched for all studies investigating the erectile function in psoriatic patients. The association between psoriasis and risk of ED was summarized using the odds ratios (OR) with a 95% confidence interval (CI). The protocol for this meta-analysis is available from PROSPERO (CRD42018093025). Overall, 1829449 participants (the mean age ranged from 44 years to 56.3 years) were included from 8 studies (6 cross-sectional, 1 cohort, and 1 case-control study); 39490 of whom were patients with psoriasis, with the mean disease duration from 6 months to 19.9 years. The methodological quality of the 8 included studies was considered to be either moderate or high quality. Synthesis results from the included studies revealed that psoriasis was significantly associated with an increased risk of ED in psoriatic patients (OR = 1.62, 95%CI: 1.37-1.91, P < 0.001; heterogeneity: I² = 62.6%, P = 0.009). The results were consistent after multivariable adjustment (6 studies; combined OR = 1.5, 95%CI: 1.31-1.72, P < 0.001; heterogeneity: I² = 53.5%, P = 0.056). Evidence from this meta-analysis indicates that patients with psoriasis have a significantly elevated risk of ED.