Abstract
ABSTRACTBackground Rheumatic diseases such as ankylosing spondylitis (AS) may be associated with sexual dysfunction.Aim To study erectile function of a group of Brazilian AS patients comparing them with controls.Materials and Methods This was a cross sectional study approved by the local Committee of Ethics in Research. The questionnaire IIEF (International Index of Erectile Function) was applied to 40 AS patients and 40 healthy controls. AS patients had determination of disease activity (through BASDAI or Bath Ankylosing Spondylitis Disease activity index), ASDAS (Ankylosing Spondylitis Disease Activity Score, MASES or Maastricht Ankylosing Spondylitis Score and SPARCC or Spondyloarthritis Research Consortium of Canada), function (through BASFI or Bath Ankylosing Spondylitis Functional Index and HAQ or Health Assessment Questionnaire) and BASMI (Bath Ankylosing Spondylitis Metrological Index).Results AS patients had a median score on IIEF of 22.0 (IQR=18-25) while controls had 29 (IQR=27-30) with p<0.0001 Only 17.5% of the AS patients had no erectile dysfunction, in opposite to 87.5% of controls (p<0.0001). IIEF scores had a negative association with BASDAI (p<0.0001), HAQ (p=0.05), body mass index (P=0.03), MASES (P=0.02) and SPARCC (P=0.02) in a univariate analysis. Multiple regression showed that BASDAI was the only variable independently associated with IIEF.Conclusion There is a high prevalence of erectile dysfunction among AS patients that is associated with disease activity measured by BASDAI.
Highlights
Ankylosing spondylitis (AS) is a chronic rheumatic disease that affects mainly young males and belongs to the group of Spondyloarthritis (SpA) [1]
In the ankylosing spondylitis (AS) group, 90% had lumbar pain; 77.5% had peripheral arthritis; 45% had anterior uveitis, 37.5% had enthesitis; 12.5% had coxalgia; 12.5% had dactylitis; 70.5% were human leukocyte antigen (HLA) B27 positive; 32.5% were on treatment with sulphasalazine; 7.5% were on non-steroidal anti-inflammatory drugs and 7.5% on anti-TNF medications. b) Study of Index of Erectile Function (IIEF) among AS patients
Table-3 displays the scores of studied patients and controls according to IIEF classification and shows a significant difference between the two groups
Summary
Ankylosing spondylitis (AS) is a chronic rheumatic disease that affects mainly young males and belongs to the group of Spondyloarthritis (SpA) [1]. The diagnosis of AS, as in others SpA, can be done by the ASAS (Assessment of SpondyloArthritis International Society) classification criteria that includes a set of clinical findings such as inflammatory back pain, ibju | Erectile dysfunction in ankylosing spondylitis arthritis, enthesitis etc., presence of HLA B27 and image findings of sacroiliitis [1] (Table-1). Its treatment varies according to presenting clinical features but in patients with axial predominance it is based mainly on AINH (anti-inflammatory non-steroidal drugs) and biological medication such as anti-TNF alpha (TNF-α). When it affects peripheral joints or has an extra-articular involvement, sulphasalazine, methotrexate and leflunomide may be used [1].
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