Axial Spondyloarthritis Inflammation Linked to Low Sexual Quality of Life

A team of investigators sought to examine the relationship between disease variables and sexual quality of life in individuals with axial spondyloarthritis.

Among individuals with axial spondyloarthritis, inflammation negatively affects sexual quality of life (SQOL), according to a study published in The Journal of Rheumatology.

This cross-sectional study included 360 participants with a mean axial spondyloarthritis disease duration of 13.9 years; two-thirds were men and the mean age was 45.5 years. Among this population 26.7% reported being current smokers, 78% were either married or living with a partner, and 86.0% exercised for ≥1 hour per week. Data collected on participants included disease severity measures and treatment, demographic, and quality-of-life characteristics; the SQOL-Female (SQOL-F) questionnaire was used to assess SQOL among both women and men. Multiple linear regression analysis was used to investigate the correlation between SQOL-F score and independent variables. The relationship between disease- and demographic-related variables was analyzed using linear regression analysis.

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The mean C-reactive protein level was 8.5 mg/L, the mean Bath Ankylosing Spondylitis Disease Activity Index score was 3.1 (range, 0-10), the mean Bath Ankylosing Spondylitis Global Score was 3.8 (range, 0-10), the mean Bath Ankylosing Spondylitis Functional Index score was 2.7 (range, 0-10), and the mean Health Assessment Questionnaire score was 0.6 (range, 0-3). Nonsteroidal anti-inflammatory drugs were used by 44% of participants, while.0% used synthetic disease-modifying antirheumatic drugs (DMARDs) and 24% used biologic DMARDs (bDMARDS). A mean SQOL score of 76.6 (range, 18-108) was reported, and a lower SQOL score was associated with female gender, higher body mass index (BMI), disease activity, and current mode of biologic treatment.

Limitations to this study include data collection from 2 hospitals, a cross-sectional study design and subsequent lack of causal interpretation, recruitment from a hospital population, a lack of healthy controls, the need for more metrics for sexual activity and enjoyment, and a lack of data on factors like radiologic damage, fibromyalgia, and hip involvement.

The study authors conclude that “SQOL is lower in females and in [axial spondyloarthritis] patients with active disease shown by elevated BAS-G and [C-reactive protein]. The use of bDMARD was also independently associated with a lower SQOL score, possibly reflecting bDMARD treatment in this cross-sectional study as a marker of [axial spondyloarthritis] disease activity and not causality between bDMARD use and impaired SQOL. Thus, we believe that our data indicate that good disease control suppressing inflammation may improve SQOL in patients with [axial spondyloarthritis]. The association between increased BMI and low SQOL should encourage patients to change their lifestyle, which then may improve SQOL.”


Berg KH, Rohde GE, Prøven A, Benestad EEP, Østensen M, Haugeberg G. Sexual quality of life in patients with axial spondyloarthritis in the biologic treatment era [published online February 15, 2019]. J Rheumatol. doi: 10.3899/jrheum.18041