Increased proportion of comorbidities but no deterioration of sexual quality of life during a 5-year follow-up in patients with axial spondyloarthritis in the biologic treatment era

Objective To explore patient perception of sexual quality of life (SQOL), an important category of QOL, in male and female patients with axial SpA (axSpA) after a 5year follow-up. Methods A broad spectrum of demographic, disease-related, treatment and SQOL data was collected at baseline and at the 5year follow-up. SQOL was assessed by the SQOL-Female (SQOL-F) questionnaire. For statistical analysis, McNemar's tests, paired t-tests and multiple regression analyses were applied. Results A total of 245 axSpA patients (168 men and 77 women) from outpatient clinics were examined (mean age 46years, mean disease duration 11.9years at baseline). Compared with baseline, the patients had lower CRP, lower Maastricht Ankylosing Spondylitis Enthesitis Scores, lower BASFI scores, less use of smoking and significantly more patients were treated with biologic DMARDs at the 5year follow-up. Patient perception of SQOL was basically unchanged at the 5year follow-up despite a significantly increased proportion of comorbidities, including cardiovascular, endocrine and gastrointestinal disease. A decrease in SQOL after 5years was observed only in patients exercising <1h/week at baseline (P=0.048) and in patients >65years old. Conclusion In our axSpA patients, no statistically significant changes in SQOL were observed over 5years, despite a significant increase in comorbidities. Overall disease symptoms decreased, indicating better disease control. Increased use of biologic drugs at the 5year follow-up may have contributed to this favourable outcome.