AB1016 ERECTILE DYSFUNCTION IN ANKYLOSING SPONDYLITIS: ASSOCIATIONS WITH DISEASE-RELATED PARAMETERS

Abstract

BackgroundAnkylosing spondylitis (AS) is a chronic, inflammatory, autoimmune disease that dominantly affects younger men. (1) Patients with AS often experience chronic musculoskeletal pain, fatigue and stiffness, which may contribute to psychological distress and sexual dysfunction (SD). (2)ObjectivesThe study aimed to assess prevalence of ED in patients with AS and identify potential associations between clinical parameters related to AS and the presence of ED.MethodsThis observational cross-sectional study was approved by the local Ethics Committee. Forty consecutive male patients with the AS (mean age 42.8 ± 8.9 years) and 60 healthy men (mean age 38.9 ± 10.9 years) were included. All subjects filled-in the International Index of Erectile Function (IIEF) questionnaire, as well as the Beck anxiety inventory (BAI) and the Beck depression inventory (BDI). In patients with AS disease activity was evaluated using the Ankylosing Spondylitis Disease Activity Score (ASDAS) and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), functional ability using the Bath Ankylosing Spondylitis Functional Index (BASFI), and quality of life using the Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire.ResultsED was significantly more frequent in patients with AS (21/40, 52.5%) compared to controls (52.5%: 25%, p=0.049). Moreover, the mean value of IIEF score was significantly (p=0.035) lower in AS patients (22.3 ± 8,9) than in the control group (25.7 ± 7.5). There was no significant difference in BAI and BDI scores between patients with AS and ED and patients with ED in the control group. Parameters reflecting disease activity (ASDAS, BASDAI, CRP) and functionality (BASFI) were somewhat higher in the patients with AS and ED in comparison to patients without ED. However, these findings were not statistically significant. According to ASQoL scores, patients with AS and ED had a worse quality of life compared to patients with AS but without ED (p=0.022). AS patients with ED had more severe symptoms of depression than AS patients without ED (p=0.034). Univariate logistic regression showed that BDI and ASQoL scores were associated with the presence of ED. However, multivariate logistic regression analysis showed that ASQoL was an independent prognostic factor for the presence of ED in patients with AS. The increase in one unit of ASQoL score increased the risk of having ED for 17.5% (p=0.035).ConclusionThe prevalence of ED in patients with AS was higher than in healthy controls. Poor quality of life (according to ASQoL) was the only parameter, independently associated with the presence of ED. It is necessary to raise awareness of ED in patients with AS.