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 quality of life, in male and female patients with axial spondyloarthritis (axSpA) after a five-year follow-up. METHODS A broad spectrum of demographic, disease-related, treatment and SQOL data was collected at baseline and at 5-year 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 was 46 years and mean disease duration was 11.9 years at baseline. Compared with baseline, the patients had lower C-reactive protein (CRP), lower Maastricht Ankylosing Spondylitis Enthesitis score (MASES), lower Bath Ankylosing Spondylitis Functional Index (BAS-G), less use of smoking, and significantly more patients were treated with biologic DMARDs at 5-year follow-up. Patient perception of SQOL was basically unchanged at the 5-year follow-up despite a significantly increased Proportion of comorbidities including cardiovascular, endocrine, and gastrointestinal disease. A decrease in SQOL after 5 years was observed only in patients exercising 65 years old. CONCLUSION In our axSpA patients, no statistically significant changes in SQOL were observed over 5 years, despite a significant increase in comorbidities. Overall disease symptoms decreased indicating better disease control. Increased use of biologic drugs at 5 years follow-up may have contributed to this favorable outcome.