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E096 Sexual function in axial spondyloarthritis: a systematic review and meta-analysis

Somer, Max; Battista, Simone; Grange, Jake; Prior, Yeliz; Parsons, Helen; Packham, Jon; Haywood, Kirstie; Prior, James

Authors

Max Somer

Jake Grange

Helen Parsons

Jon Packham

Kirstie Haywood

James Prior



Abstract

Background/Aims Sexual function is crucial for fostering intimate relationships and enhancing quality of life. The impact of axial spondyloarthritis (axSpA) on sexual function remains unclear despite existing research, which has typically focused on men. This systematic review examines the role of axSpA on sexual function in both genders and explores whether features of axSpA, such as disease activity, have a role. Methods The medical literature databases PsycINFO, CINAHL, MEDLINE, Embase, and Cochrane Central were searched from inception to February 2024, focusing on adults diagnosed with axSpA. Measures of sexual function, assessed through established patient-reported outcome measures (PROMs) and other methods, were extracted along with disease activity, laboratory, and demographic data. Narrative synthesis of included studies was followed by the pooling of a subset of studies using random-effects meta-analysis. Results Initially, 325 records were identified across the five databases. The review ultimately included 37 studies: 22 case-control, 14 cross-sectional, and one cohort, all conducted between 1983 and 2023, spanning 14 countries. Most reports originated from Turkey (n = 15), while three were from the UK. Nineteen studies focused on men, 13 included both sexes, four examined women only, and one did not report the gender ratio. Various sexual function measures were used, with the International Index of Erectile Function (IIEF) and the Female Sexual Function Index (FSFI) being the most common PROMs for men and women, respectively. Eleven studies assessed the impact of axSpA on male sexual function using the IIEF. Seven reports compared men with axSpA to healthy controls, with five reporting significant differences. When pooled (n = 4), all IIEF domain scores, except sexual desire, were significantly lower in those with axSpA. The pooled mean difference in erectile function was -3.46 (95% CI: -4.54 to -2.38), although this small degree of change is unlikely to reflect symptoms clinically important to patients. Four studies examined the effect of axSpA on female sexual function using the FSFI. Three compared women with axSpA to controls, with two reporting significant differences in total FSFI scores. Moreover, domain scores for sexual arousal and lubrication were significantly lower in women with axSpA. However, meta-analysis revealed no significant difference in total scores between cases and controls (mean difference: -4.55, 95% CI: -9.82 to 0.73). Conclusion Men with axSpA show statistically higher rates of sexual dysfunction compared to controls, although the effects appear small, with minimal clinical impact. Research on the impact of axSpA on women’s sexual function is scarce and inconsistent, with available evidence indicating minimal overall contribution. Further studies, especially in the UK and using established PROMs, are needed to clarify the role of axSpA in sexual health. Disclosure M. Somer: None. S. Battista: None. J. Grange: None. Y. Prior: None. H. Parsons: None. J. Packham: None. K. Haywood: None. J. Prior: None.

Presentation Conference Type Conference Abstract
Conference Name British Society for Rheumatology
Start Date Apr 28, 2025
End Date Apr 30, 2025
Acceptance Date Apr 1, 2025
Online Publication Date Apr 28, 2025
Publication Date Apr 1, 2025
Deposit Date Jun 23, 2025
Journal Rheumatology
Print ISSN 1462-0324
Electronic ISSN 1462-0332
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
Volume 64
Issue Supplement_3
DOI https://doi.org/10.1093/rheumatology/keaf142.331