AB0945 THE IMPACT OF AXIAL SPONDYLOARTHRITIS ON PATIENTS’ SEXUAL LIFE. RESULTS FROM THE INTERNATIONAL MAP OF AXIAL SPONDYLOARTHRITIS (IMAS)
Authors: M. Garrido-Cumbrera, D. Poddubnyy, F. Sommerfleck, C. Bundy, S. Makri, J. Correa-Fernández, S. M. Akerkar, J. Lowe, E. Karam, V. Navarro-Compán
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> The physical and mental burden suffered by patients with axial spondyloarthritis (axSpA) can lead to a worsening of their self-perception and sexual health. Despite this, research on the impact of axSpA on intimate relationships is very scarce. <h3>Objectives:</h3> To study the change and determinants of frequency of sexual activity and intimacy since disease onset in a large sample of patients from the International Map of Axial Spondyloarthritis (IMAS) study from around the world. <h3>Methods:</h3> IMAS is a cross-sectional online survey (2017-2022) including 5,557 unselected axSpA patients worldwide from Europe, North America, Latin America, Asia, and South Africa. The impact of axSpA on patients' sexual life was evaluated in 3,783 patients by a question assessing changes in the frequency of intimate relations since the onset of axSpA on a five-point Likert scale from "much more than before" to "much less than before". Impact of axSpA on the partner's relationship since disease onset was also assessed using 5-point Likert scale from "much better than before" to "much worse than before". The region of South Africa was excluded from this analysis due to intimate relationships in that region not being included in the questionnaire. Independent factors evaluated were sociodemographic, lifestyles, patient-reported outcomes (disease activity using BASDAI scale [0-10], spinal stiffness [3-12] and mental health using GHQ-12 scale [0-12]), mental comorbidities, relationship with spouse, functional limitation on intimate relations, and treatments. Mann-Whitney test, Pearson's correlation, simple and multivariable regression analysis were used to evaluate the possible association of the investigated factors with less frequency of intimate relations. <h3>Results:</h3> Of the 3,783 participants who reported on the frequency of intimate relations since disease onset, 56.7% declared that it was less or much less than before, this proportion being the highest in Asia (59.1%) and the lowest in Latin America (52.7%; <b>Map 1</b>). Furthermore, 43.0% declared high or medium functional limitation in intimate relations and 31.3% reported worsening relations with their partner since disease onset. A lower frequency of intimate relations was more common in older age, female gender, overweight or obesity patients, smokers, those with lack of physical activity, higher BASDAI, greater spinal stiffness, poorer mental health, self-reported diagnosis of anxiety, depression and sleep disorders, higher functional limitation in intimate relations, worsening relationship with spouse since disease onset, and lack of biologics use. In the multivariable linear regression analysis, the factors associated variables with lower frequency of intimate relations were older age (b= 0.009), female gender (b= 0.115), overweight or obesity (b= 0.071), lack of physical activity (b= 0.115), higher disease activity (b= 0.030), poorer mental health (b= 0.025), higher functional limitation in intimate relation (b= 0.224) and worse relationship with spouse (b= 0.224; <b>Table 1</b>). <h3>Conclusion:</h3> More than half of the patients had decreased frequency of intimate relations due to axSpA. Furthermore, this decreased frequency of intimate relationships was associated with patients who were older, female, overweight or obese, not physically active, with higher disease activity, poorer mental health, greater functional limitation in intimate relationships, and poorer relationship with spouse. These results highlight the need to address sexual life in a holistic approach to axSpA management, aiming to reduce functional limitation in intimate relations, monitor partner relationships and promote physical activity to contribute to a better sexual life. <h3>REFERENCES:</h3> <b>NIL.</b> <b>Table 1.</b> Univariable and multivariable linear regression of factors associated with less frequency of intimate relation (N= 2,176) <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> This study was supported by Novartis Pharma AG. The authors would like to thank all patients who participated in the study. <h3>Disclosure of Interests:</h3> Marco Garrido-Cumbrera Novartis, Denis Poddubnyy AbbVie, BMS, Celgene, Janssen, Lilly, MSD, Novartis, Pfizer, Roche, UCB, AbbVie, MSD, Novartis, Pfizer, Fernando Sommerfleck Abbvie, Eli Lilly, Janssen, Novartis, Abbvie, Novartis, Janssen, Christine Bundy AbbVie, Celgene, Janssen, Lilly, Novartis, Pfizer, Souzi Makri Novartis, GSK, Bayer, José Correa-Fernández: None declared, Shashank Murlidhar Akerkar Pfizer, Novartis, Eli Lilly, Jansen, Jo Lowe No personal funding, but ASIF has received funding from Novartis, UCB, Lilly, Abbvie, Boehringer Ingleheim, Pfizer, Janssen, Elie Karam: None declared, Victoria Navarro-Compán AbbVie, Eli Lilly, Janssen, MSD, Novartis, Pfizer, UCB Pharma, AbbVie, Eli Lilly, Galapagos, MoonLake, MSD, Novartis, Pfizer, UCB Pharma, AbbVie, Novartis.