Sexual Dysfunction More Common in Rheumatoid Arthritis, Psoriatic Arthritis

Data from a cross-sectional observational study of patients from outpatient rheumatology clinics at a pair of university health systems provides an overview of the prevalence of sexual dysfunction among patients with rheumatic disease.

Presented at the Annual European Congress of Rheumatology (EULAR 2022), results of the study, which assessed sexual dysfunction using a 14-item version of the Changes in Sexual Functioning Questionnaire (CSFQ-14), suggest sexual dysfunction was prevalent among 48% of patients with rheumatoid arthritis, 30% of patients with psoriatic arthritis, and just 6% of those without rheumatic disease in the study’s control group.

“Both chronic inflammatory joint diseases have a deteriorated sexual life when compared to a healthy population. All the domains of the sexual sphere were functionally deteriorated,” said lead investigator Carlos Valera-Ribera, of the Doctor Peset University Hospital in València, Spain, during his presentation at EULAR 2022.

Although previous studies have examined the prevalence of sexual dysfunction among patients with rheumatic diseases, Valera-Ribera and colleagues noted most of these studies have been limited by design, including lack of a healthy control population for comparison. With this in mind, investigators sought to describe the prevalence of sexual dysfunction among patients with rheumatoid arthritis and psoriatic arthritis and to compare these results to a healthy population of patients from the same region.

Using patients from a pair of university hospital outpatient facilities, investigators identified 188 patients for inclusion in their analyses. Of the 188 patients identified for inclusion, 89 were healthy controls, 72 were diagnosed with psoriatic arthritis using CASPAR criteria, and 27 were diagnosed with rheumatoid arthritis using EULAR/ACR 2010 criteria. Investigators pointed out 30.43% of those with psoriatic arthritis, 48.15% of those with rheumatoid arthritis, and 5.88% of the control group had scores in the sexual dysfunction range on the CSFQ-14.

The overall study cohort was 52.7% female, 47.3% male, and had a mean age of 48±12.5 years. When discussing characteristics of participants, Valera-Ribera pointed out more than half of the study population assessed their own health as “good” or “very good” and 77.7% had a personal history of depression, with 18.6% needing psychological treatment and 18.1% receiving pharmacologic treatment. For the purpose of analysis, investigators collected information related to multiple variables for inclusion in their regression models, including age, gender, year of diagnosis, perceived health, marital status, level of education, employment situation, annual level of income, history of depression, and active treatment of mental health disease.

Upon analysis, investigators found sexual dysfunction was associated with a diagnosis of psoriatic arthritis and rheumatoid arthritis (P <.001), age (P <.001), employment status (P <.001), and annual level of income (P=.002). When assessing CSFQ-14 scores, results suggested men had a mean score that was 7.5 points higher than women, but this score decreased to 6.15 in men with psoriatic arthritis. Further analysis suggested with psoriatic arthritis and rheumatoid arthritis had a mean score 8.2 points lower compared to their counterparts in the healthy control groups.

Additionally, results indicated all domains of the CSFQ-14 questionnaire were negatively impacted by having psoriatic arthritis or rheumatoid arthritis (P <.001). When assessing the odds ratio of sexual dysfunction, the observed results suggested patients diagnosed with psoriatic arthritis were at an 8.7-times greater risk of having sexual dysfunction and those with a diagnosis of rheumatoid arthritis had a 10-times greater risk of having sexual dysfunction when compared to healthy controls.

“Age, sex, perceived health, employment situation, and economic status are related to the risk for suffering sexual dysfunction and must be considered in daily practice when evaluating this aspect of our patient,” Valera-Ribera added.

References:

1. Vilera-Ribera C. Annual European Congress of Rheumatology (EULAR 2022). IMPACT OF CHRONIC JOINT DISEASES ON THE SEXUAL SPHERE WITH REGARDS TO A HEALTHY POPULATION: A MULTICENTER STUDY.