Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Applying the New Classification Criteria for Rheumatoid Arthritis to Patients (pts) with Early Rheumatoid Arthritis Treated with Abatacept Plus MTXInsights From AGREE (Abatacept study to Gauge Remission and joint damage progression in MTX nave patients with Early Erosive Rheumatoid Arthritis).
Ngcozana1, Tanaka, Chighizola2, Cecilia B., Parker1, Louise, DBE1, Carol M. Black, Ong3, Voon, Denton4, Christopher D.
Sexual dysfunction is a great concern for many patients with scleroderma. Previous studies suggest that the prevalence of erectile dysfunction (ED) in male scleroderma (SSc) patients ranges from 12 to 81%. The objectives of this study were to (a) determine the prevalence of sexual dysfunction (b) evaluate its psychological impact on relationships (c) explore the interaction of these patients with key health professionals in sexual health.
100 men with limited (lcSSc) or diffuse cutaneous scleroderma (dcSSc) were invited to complete a validated International Index of Erectile Function Questionnaire (IIEF). The questionnaire was expanded to evaluate the psychological effects of sexual difficulties in SSc patients' relationships and interaction with health professionals. IIEF assesses five domains of sexual function: erectile function, orgasmic function, sexual desire, intercourse satisfaction and overall satisfaction. Potential confounding factors including smoking were analysed with logistic and linear regression.
62 patients responded to the questionnaire of which the mean age (mean ±SD, year) was 54 ±11.1. The mean disease duration (mean ±SD, years) was 8.4 ± 8.0 and 11.4 ± 7.3 for patients with dcSSc and lcSSc respectively. 71% of the respondents reported sexual difficulties in at least one of the domains. 39% of this cohort were considered as severe in all 5 domains of which half had diffuse disease. Interestingly, 34% developed sexual difficulties before they were diagnosed with SSc. For those who developed ED after the onset of SSc, the mean duration (mean±SD, years) from disease onset to emergence of ED was 4.0 ±3.1. As shown in the table below, intercourse satisfaction fared the worst of all the five domains with a score of 45% in the severe dysfunction category. Past or present smoking did not predict ED or severity of ED.
|Domain||Severe Dysfunction n (%)||Moderate n (%)||Mild-Moderate Dysfunction n (%)||Mild Dysfunction n (%)||No Dysfunction n (%)|
|Erectile Function||23 (37)||4 (6)||3 (5)||11 (18)||16 (26)|
|Orgasmic Function||22 (35)||8 (13)||5 (8)||1 (2)||21 (34)|
|Sexual Desire||6 (10)||11 (18)||10 (16)||16 (26)||6 (10)|
|Intercourse Satisfaction||28 (45)||5 (8)||11(18)||3 (5)||10 (16)|
|Overall Satisfaction||24 (39)||3 (5)||5 (8)||16 (26)||9 (15)|
55% of the respondents reported that their sexual difficulties had caused a significant strain on their relationships with their partner and 48% of these individuals did not discuss the difficulties with their partners. 45% of the patients reported that they had never been asked about their sexual health by a health professional. However 65% of the men would have discussed these issues had they been given the opportunity to do so.
ED is a common yet unexplored complication in scleroderma. It is a difficult subject to discuss, yet our results suggest that sexual functioning is an integral parameter in the assessment of quality of life for the affected men. Our results suggest that ED may occur even before diagnosis of SSc, implying that it could be an early feature especially in diffuse subset. Therefore multidisciplinary teams treating scleroderma patients should be aware of and actively enquire about sexual dysfunction.
To cite this abstract, please use the following information:
Ngcozana, Tanaka, Chighizola, Cecilia B., Parker, Louise, DBE, Carol M. Black, Ong, Voon, Denton, Christopher D.; Applying the New Classification Criteria for Rheumatoid Arthritis to Patients (pts) with Early Rheumatoid Arthritis Treated with Abatacept Plus MTXInsights From AGREE (Abatacept study to Gauge Remission and joint damage progression in MTX nave patients with Early Erosive Rheumatoid Arthritis). [abstract]. Arthritis Rheum 2011;63 Suppl 10 :1573