POS0991 THE IMPACT OF AXIAL SPONDYLOARTHRITIS ON PATIENTS’ SEXUAL LIFE: RESULTS FROM THE SPANISH ATLAS
Authors: M. Garrido-Cumbrera, J. Gratacos-Masmitja, E. Collantes-Estevez, P. Zarco-Montejo, C. Sastré, S. Sanz-Gómez, P. Plazuelo-Ramos, V. Navarro-Compán
Journal: Annals of the Rheumatic Diseases (2021)

Background: Axial Spondyloarthritis (axSpA) can impact patients’ sexual life. Objectives: The aim is to assess the prevalence of functional limitation in sexual activity in axSpA patients in Spain and its associated factors. Methods: Data from an online survey of 680 unselected axSpA patients pertaining to the Atlas of Axial Spondyloarthritis in Spain were collected. Functional limitation in intimate relations was assessed through a 3-point Likert scale (low, medium, and high) and the sample was divided into 1) low-medium and 2) high. Mann-Whitney and χ 2 tests were used to analyse relations between sociodemographic, employment, lifestyle, patient-reported outcomes, and comorbidities with respect to functional limitation in intimate relations. Univariate and multivariate binary logistic regression was used to analyse its associated factors. Results: 605 axSpA patients were included: the mean age was 45.5 years, 51.4% were female, 38.3% had a university degree, and 70.7% were married. A total of 57.7%, 28.9%, and 13.4% participants presented high, medium, and low limitation in intimate relations, respectively. Patient with high functional limitation in intimate relations were younger (44.6 vs 46.7, p=0.032), female (67.2% vs 47.6% of male, p&lt;0.001), did not belong to a patient organisation (62.7% vs 51.5% of members, p=0.006), were on sick leave (73.3% vs 51.9% of employed, p&lt;0.001) and smoked more (67.3% vs 52.6%, p&lt;0.001). The high limitation group presented higher disease activity (6.3 vs 4.9), functional limitation (48.2 vs 34.4) and spinal stiffness (7.9 vs 6.9, all p&lt;0.001), worse mental health (7.0 vs 4.1, p&lt;0.001), longer diagnostic delay (9.2 vs 7.6, p=0.019), and more comorbidities such as anxiety (73.3% vs 53.2%), depression (80.0% vs 53.3%) and sleep disorders (70.9% vs 53.9%, all p&lt;0.001). In addition, 80.3% of patients with decreased frequency of intimate relations presented high functional limitation in intimate relations (vs 10.0% with more frequency) and 81.4% had experienced a worsening relationship with their spouse (vs 55.6% with better relation, all p&lt;0.001). In the multivariate binary logistic regression, the qualitative factors associated with high functional limitation in intimate relations were a reduction in the frequency of intimate relations (OR= 18.66) and smoking (OR= 2.89), while the quantitative factor associated with high functional limitation in the intimate relation was higher overall functional limitation (B= 0.292; Table 1). Table 1. Logistic regression to analyse factor associated with high functional limitation in intimate relation (N= 302) Univariate logistic analysis Multivariate logistic analysis OR p-value 1 OR p-value 1 Qualitative factors Gender. Female 2.254 &lt;0.001 1.311 0.569 Patient Organization. Member 0.632 0.006 0.515 0.171 Employment. Sick leave 2.354 &lt;0.001 1.060 0.910 Smoking. Yes 1.852 0.001 2.885 0.020 Anxiety diagnosis. Yes 2.420 &lt;0.001 0.569 0.306 Depression diagnosis. Yes 3.509 &lt;0.001 1.665 0.408 Sleep disorder diagnosis. Yes 2.081 0.001 0.625 0.381 Frequency of intimate relation. Less than before vs same or more than before 12.605 &lt;0.001 18.655 &lt;0.001 Relation with spouse. Worse than before 5.480 &lt;0.001 1.256 0.636 Quantitative factors B p-value 2 B p-value 2 Age -0.018 0.021 0.010 0.718 BASDAI (0-10) 0.398 &lt;0.001 -0.155 0.284 GHQ-12 (0-12) 0.154 &lt;0.001 0.003 0.952 Functional Limitation (0-54) 0.237 &lt;0.001 0.292 &lt;0.001 Spinal Stiffness (3-12) 0.131 &lt;0.001 -0.116 0.226 Diagnostic Delay 0.030 0.013 0.020 0.474 1 p-value for test H 0 : OR = 1 2 p-value for test H 0 : B = 0 Conclusion: More than half of patients with axSpA in Spain presented high functional limitation in intimate relations, who more likely presented decreased frequency of relations. This may indicate that avoidance of sexual encounters is a common coping mechanism for the functional limitation accompanying this disease. Healthcare providers can play a key role in the sexual health of axSpA patients by improving patient-physician communication and raising awareness about the benefits of counselling on a healthy sexual life. Acknowledgements: This study was supported by Novartis Spain. The authors would like to thank all patients who participated in this study. Disclosure of Interests: Marco Garrido-Cumbrera: None declared, Jordi Gratacos-Masmitja Grant/research support from: Abbvie, BMS, Lilly, MSD, Novartis, Pfizer, Roche, and UCB, Eduardo Collantes-Estevez Grant/research support from: Abbvie, BMS, Lilly, MSD, Novartis, Pfizer, Roche, and UCB, Pedro Zarco-Montejo: None declared, Carlos Sastré Employee of: Novartis Farmacéutica Spain, Sergio Sanz-Gómez: None declared, Pedro Plazuelo-Ramos: None declared, Victoria Navarro-Compán Grant/research support from: Abbvie, BMS, Lilly, MSD, Novartis, Pfizer, Roche, and UCB.