POS0846 SEXUAL FUNCTION IS IMPAIRED IN WOMEN WITH SYSTEMIC SCLEROSIS COMPARED TO HEALTHY CONTROLS
Authors: B. Heřmánková, M. Špiritović, S. Oreska, H. Štorkánová, H. Smucrova, K. Pavelka, J. Vencovský, L. Šenolt, R. Bečvář, M. Tomčík
Journal: Annals of the Rheumatic Diseases (2021)

Background: Systemic sclerosis (SSc) is a multisystem, connective tissue disorder characterized by fibrosis of the skin and internal organ involvement, which can influence all aspects of life, including sexual life. Objectives: This study aimed to compare sexual function in patients with SSc to age-/sex-matched healthy controls (HC) and determine the potential impact of clinical features on sexual function. Methods: In total, 90 women with SSc (mean age: 49.1, disease duration: 6.1 years, lcSSc/dcSSc: 62/28, mRSS: 9.3, ESSG activity index: 2.1), who fulfilled the ACR/EULAR 2013 criteria, and 90 healthy controls (mean age: 49.1) without rheumatic diseases filled in 12 well-established and validated questionnaires assessing sexual function (FSFI, BISF-W, SFQ-28, SQoL-F), pelvic floor function (PISQ-12, PFIQ-7), fatigue (FIS, Fatigue Impact Scale), physical activity (HAP, Human Activity Profile), disability (HAQ, Health Assessment Questionnaire), depression (BDI-II, Beck’s Depression Inventory-II) and quality of life (SF-36, Medical outcomes study Short Form 36 – PCS, Physical Component Summary; MCS, Mental Component Summary). A routine laboratory testing was performed. Data are presented as median (IQR). Results: Patients with SSc reported significantly greater prevalence and severity of sexual dysfunction (FSFI, BISF-W, SFQ28 – in all subscales as well as total scores), worse sexual quality of life (SQoL-F) and pelvic floor dysfunction (PISQ-12, PFIQ-7) compared to HC (table 1). The prevalence of sexual dysfunction in patients with SSc according to the FSFI cut-off score was 77%. Worse scores in SSc patients were associated with longer disease duration [BISF-W-total (r=-0.243,p=0.026), FSFI-lubrication (r=-0.229,p=0.035)], higher disease activity [ESSG activity index: BISF-W-total (r=-0.291,p=0.010), FSFI-arousal (r=-0.299,p=0.007)], increased inflammation [CRP: BISF-W-receptivity/initiation (r=-0.301,p=0.007)], more pronounced fatigue [FIS-total: BISF-W-total (r=-0.412,p&lt;0.0001)], more severe depression [BDI-II: FSFI-total (r=-0.506,p&lt;0.0001), SQoL-F (r=-0.369, p&lt;0.0001)], worse functional disability [HAQ: FSFI-total (r=-0.394,p&lt;0.0001)], reduced physical activity [HAP: FSFI-total (r=0.535,p&lt;0.0001)], and decreased overall quality of life [SF-36 PCS: FSFI-total (r=0.428,p&lt;0.0001), SF-36 MCS: SQoL-F (r=0.472, p&lt;0.0001)]. Conclusion: Women with SSc reported significantly impaired sexual function and pelvic floor function compared to age-/sex-matched healthy controls. Worse scores in SSc were associated with disease-related features. Table 1. Sexual function and pelvic floor function in women with SSc and healthy controls Questionnaire: score range (meaning ) SSc (n=90 ) HC (n=90 ) p-value FSFI: Female sexual function index: 2 (worst) - 36 (best) 19.4 (3.9-26.8) 30.1 (23.1-32.9) p&lt;0.0001 BISF-W : Brief Index of Sexual Function for Women: -16 (worst) - 75 (best) 14.3 (2.1-35.1) 38.2 (19.3-46.2) p&lt;0.0001 SQoL-F: Sexual Quality of Life Questionnaire-Female: 0 (worst) - 100 (best) 61.1 (34.4-81.1) 91.1 (70.0-96.7) p&lt;0.0001 PISQ-12: Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire short form: 0 (best) - 48 (worst) 13.0 (9.0-17.0) 7.0 (5.0-12.0) p&lt;0.0001 PFIQ-7: Pelvic Floor Distress Inventory Questionnaire: 0 (best) - 300 (worst) 9.5 (0.0-48.8) 0.0 (0.0-8.3) p&lt;0.0001 SFQ-28: Sexual Functioning Questionnaire-28 desire: 5 (worst) - 31 (best) 17.0 (12.0-20.0) 21.0 (17.0-23.0) p&lt;0.0001 SFQ-28 arousal sensation: 4 (worst) - 20 (best) 10.0 (8.0-13.0) 12.0 (9.0-15.0) p=0.0031 SFQ-28 arousal lubrication: 2 (worst) - 10 (best) 5.0 (4.0-7.0) 8.0 (5.2-9.0) p&lt;0.0001 SFQ-28 arousal cognitive: 2 (worst) - 10 (best) 5.0 (4.0-6.0) 7.0 (5.0-8.0) p&lt;0.0001 SFQ-28 orgasm: 1 (worst) - 15 (best) 10.0 (6.5-12.0) 12.0 (10.0-13.0) p&lt;0.0001 SFQ-28 pain: 2 (worst) - 15 (best) 12.0 (9.5-15.0) 15.0 (13.0-15.0) p&lt;0.0001 SFQ-28 enjoyment: 6 (worst) - 30 (best) 19.0 (12.5-24.0) 24.0 (20.0-25.8) p&lt;0.0001 SFQ-28 partner: 2 (worst) - 10 (best) 9.0 (8.0-10.0) 10. (9.0-10.0) p=0.0182 Acknowledgements: Supported by MHCR 023728, GA UK 1578119, and SVV 260373. Disclosure of Interests: None declared