S911 Sexual Dysfunction Improves With Biologic Therapy in Men and Women With IBD

Abstract

Introduction: Patients with inflammatory bowel disease (IBD) have a high degree of sexual dysfunction (SD). Few studies have tracked SD longitudinally or with IBD-specific scales. We aimed to correlate SD with clinical and psychosocial IBD indices and track SD longitudinally using the IBD- Female and Male Sexual Dysfunction Scales (IBD-FSDS and MSDS). Methods: We surveyed patients with Crohn’s disease (CD) and ulcerative colitis (UC) starting a new biologic or small molecule therapy (anti-TNF, anti-integrin, anti-IL12/23, JAK inhibitor) at start of induction and 2- and 6-months. Surveys also included the PROMIS Brief Sexual Function and Satisfaction Profile, disease activity indices [Harvey-Bradshaw index (HBI), partial Mayo score], and psychosocial scales [Patient Health Questionnaire-9 (PHQ-9), Short IBD Questionnaire (SIBDQ), and IBD-Disability Index (IBDDI)]. Clinical data included endoscopic scores, inflammatory biomarkers (ESR, CRP, calprotectin), and IBD history. Therapy response was defined as a reduction in HBI, pMayo, SCCAI ≥3 or total HBI ≤ 4, pMayo < 2, SCCAI ≤2 at survey 3. Results: 123 patients (68 males and 53 females) completed survey 1, 89 completed survey 2, and 74 completed survey 3. The median age was 31 years. 58% had CD, 42% had UC, and 31% were non-white. At induction, the median MSDS score was 6 out of 40 (IQR 2.5-13.5) and FSDS was 12 out of 60 (3-27.5); (Table 1Table 1.: Median Sexual Dysfunction, Clinical Disease Activity and Psychosocial Scores Stratified by Therapeutic Response.). SD scores strongly correlated with PROMIS scores (r=-0.75, p< 0.001), Mayo endoscopic score (r=0.71, p< 0.001), and moderately correlated with HBI (r=0.49, p=0.002) and pMayo scores (0.44, p=0.03), but not with inflammatory biomarkers. SD also correlated with SIBDQ (r=0.55, p< 0.001), PHQ-9 (r=0.42, p< 0.001), and IBD-DI (r=0.47, p< 0.001). MSDS scores significantly improved from survey 1 to survey 3 (p= 0.039). FSDS scores numerically improved but did not reach significance. Over 50% of patients had a significant response to therapy. When stratified by treatment response, MSDS and FSDS scores improved significantly among therapy responders (p=0.006 and p= 0.041, respectively) as did Male-PROMIS scores. This improvement was not observed in non-responders (p=0.27). HBI, SCCAI, pMayo, SIBDQ and IBD-DI also improved among responders. Conclusion: In this longitudinal cohort, there was a strong correlation between SD, disease activity, and psychosocial indices. Among therapy responders, there was a significant improvement in SD. These findings further clarify the relationship between SD and therapeutic response in IBD.