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Zhang Y, Wu X, Zhang W, Liu G, Feng X, Jiang H, Zhang X. Erectile dysfunction in ankylosing spondylitis: a systematic review and meta-analysis. Sex Med 2023; 11:qfad025. [PMID: 37256218 PMCID: PMC10226813 DOI: 10.1093/sexmed/qfad025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/23/2023] [Accepted: 04/25/2023] [Indexed: 06/01/2023] Open
Abstract
Background The prevalence of erectile dysfunction (ED) in ankylosing spondylitis (AS) patients was reported rarely and with small sample. Aim The study sought to explore the prevalence of ED in men with AS and to determine whether AS is a risk factor for ED. Methods A systematic search was conducted in the China National Knowledge Infrastructure, Wanfang, VIP Database, CBM, PubMed, Web of Science, and Cochrane Library. The search was restricted to the articles published up to October 2022. Assessment tools adapted for prevalence studies were used to evaluate the quality of cross-sectional studies, and the quality of case-control studies was assessed by Newcastle-Ottawa scale. The relative risk (RR) and the standard mean difference (SMD) were used to evaluate the association between AS and ED. The subgroup analyses were conducted to identify the resources of heterogeneity. The sensitivity analysis was performed to assess the stability of the pooled estimates. Data were analyzed and graphed using STATA 16.0. Outcomes The pooled prevalence of ED in AS patients was calculated and the RR and the SMD were used to evaluate the association between AS and ED. Results A total of 393 AS patients, enrolled in the 8 included studies, were assessed for the prevalence of ED. The pooled ED prevalence estimate was 44% (95% confidence interval [CI], 25% to 63%, P < .001) with the statistical heterogeneity (I2 = 95.1%, P < .001). After pooling the data for RR, the results showed that men with AS were at a significantly higher risk for ED when compared with the general population without AS (RR, 2.04; 95% CI, 1.28 to 3.25, P = .003; heterogeneity: I2 = 72.6%, P = .003). The pooled results of 5 studies, which provided the International Index of Erectile Function (IIEF) score, demonstrated that patients with AS had significantly lower values in the IIEF erectile function domain as compared with the healthy control subjects (SMD, -0.60; 95% CI, -0.80 to -0.41; P < .001; heterogeneity: I2 = 34.4%, P = .192). Additionally, the other domain of the IIEF also showed lower values when compared with the general population without AS (P < .05). Clinical Implications The present meta-analysis provides evidence of the management of ED in men with AS. Strengths and Limitations This is the first meta-analysis to provide the prevalence of ED in AS patients and to demonstrate that AS is a risk factor for ED. However, the results after pooling the included studies showed significant heterogeneity. Conclusion Our meta-analysis demonstrated the high prevalence of ED in men with AS and that AS is a potential risk factor for ED.
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Affiliation(s)
| | | | | | - Guodong Liu
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230031, China
- Institute of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230031, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, 230031, China
| | - Xingliang Feng
- Corresponding author: Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China. ; Department of Urology, Peking University First Hospital; Institute of Urology, Peking University Andrology Center, Beijing, China. ; The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China.
| | - Hui Jiang
- Corresponding author: Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China. ; Department of Urology, Peking University First Hospital; Institute of Urology, Peking University Andrology Center, Beijing, China. ; The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China.
| | - Xiansheng Zhang
- Corresponding author: Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China. ; Department of Urology, Peking University First Hospital; Institute of Urology, Peking University Andrology Center, Beijing, China. ; The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China.
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Minopoulou I, Pyrgidis N, Tishukov M, Sokolakis I, Baniotopoulos P, Kefas A, Doumas M, Hatzichristodoulou G, Dimitroulas T. Sexual dysfunction in women with systemic autoimmune rheumatic disorders: a systematic review and meta-analysis. Rheumatology (Oxford) 2023; 62:1021-1030. [PMID: 35951753 DOI: 10.1093/rheumatology/keac457] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 07/28/2022] [Accepted: 08/03/2022] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES In women with systemic autoimmune rheumatic diseases (SARDs), female sexual dysfunction (SD) remains underestimated. We aimed to explore the prevalence and correlates of SD in females with SARDs. METHODS We performed a systematic review and meta-analysis of studies assessing the prevalence of SD and the pooled Female Sexual Function Index (FSFI) scores in this setting (PROSPERO: CRD42021287346). We searched PubMed, EMBASE and Cochrane Central Register of Controlled Trials (CENTRAL) databases and grey literature until February 2022. We evaluated the quality of the selected records using the Hoy Risk of Bias tool. A random-effects meta-analysis of proportions with the double arcsine transformation was conducted. Subgroup and sensitivity analyses, as well as meta-regression of important correlates, were conducted. RESULTS We included 68 studies with 5457 females diagnosed with a SARD (mean age: 43.7 [12.9] years). The overall SD prevalence was 63% (95% CI: 56, 69%, I2 = 94%) and the overall FSFI total score was 19.7 points (95% CI: 18.4, 21, I2 = 97%). Including only sexually active females, the SD prevalence was estimated as 60% (95% CI: 53, 67%, I2 = 88%), whereas the FSFI total score was 22 points (95% CI: 20.8, 23.1, I2 = 93%). Across the different SARDs, women with Sjögren's syndrome and systemic sclerosis reported the highest levels of SD (74%, 95% CI: 58, 87%, I2 = 84% and 69%, 95% CI: 54, 83%, I2 = 94%, respectively). CONCLUSION Sexual function in females with SARDs seems to be severely impaired, irrespective of the type of SARD. Screening and treatment of SD in females with SARDs should become an integral part of healthcare clinical practice.
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Affiliation(s)
- Ioanna Minopoulou
- Fourth Department of Internal Medicine, Medical School, Hippokration General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nikolaos Pyrgidis
- Department of Urology, 'Martha-Maria' Hospital Nuremberg, Nuremberg, Germany
| | - Maksim Tishukov
- Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Sokolakis
- Department of Urology, 'Martha-Maria' Hospital Nuremberg, Nuremberg, Germany
| | | | - Aristeidis Kefas
- Second Propedeutic Department of Internal Medicine, Medical School, Hippokration General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Michael Doumas
- Second Propedeutic Department of Internal Medicine, Medical School, Hippokration General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Theodoros Dimitroulas
- Fourth Department of Internal Medicine, Medical School, Hippokration General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Romanowska-Próchnicka K, Felis-Giemza A, Olesińska M, Wojdasiewicz P, Paradowska-Gorycka A, Szukiewicz D. The Role of TNF-α and Anti-TNF-α Agents during Preconception, Pregnancy, and Breastfeeding. Int J Mol Sci 2021; 22:ijms22062922. [PMID: 33805757 PMCID: PMC7998738 DOI: 10.3390/ijms22062922] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 03/11/2021] [Indexed: 12/15/2022] Open
Abstract
Tumor necrosis factor-alpha (TNF-α) is a multifunctional Th1 cytokine and one of the most important inflammatory cytokines. In pregnancy, TNF-α influences hormone synthesis, placental architecture, and embryonic development. It was also shown that increased levels of TNF-α are associated with pregnancy loss and preeclampsia. Increased TNF-α levels in complicated pregnancy draw attention to trophoblast biology, especially migratory activity, syncytialisation, and endocrine function. Additionally, elevated TNF-α levels may affect the maternal-fetal relationship by altering the secretory profile of placental immunomodulatory factors, which in turn affects maternal immune cells. There is growing evidence that metabolic/pro-inflammatory cytokines can program early placental functions and growth in the first trimester of pregnancy. Furthermore, early pregnancy placenta has a direct impact on fetal development and maternal immune system diseases that release inflammatory (e.g., TNF-α) and immunomodulatory factors, such as chronic inflammatory rheumatic, gastroenterological, or dermatological diseases, and may result in an abnormal release of cytokines and chemokines in syncytiotrophoblasts. Pregnancy poses a challenge in the treatment of chronic disease in patients who plan to have children. The activity of the disease, the impact of pregnancy on the course of the disease, and the safety of pharmacotherapy, including anti-rheumatic agents, in pregnancy should be considered.
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Affiliation(s)
- Katarzyna Romanowska-Próchnicka
- Department of Biophysics and Human Physiology, Faculty of Health Sciences, Warsaw Medical University, 02-091 Warsaw, Poland; (K.R.-P.); (P.W.); (D.S.)
- Department of Connective Tissue Diseases, National Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, Poland;
| | - Anna Felis-Giemza
- Department of Connective Tissue Diseases, National Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, Poland;
- Correspondence:
| | - Marzena Olesińska
- Department of Connective Tissue Diseases, National Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, Poland;
| | - Piotr Wojdasiewicz
- Department of Biophysics and Human Physiology, Faculty of Health Sciences, Warsaw Medical University, 02-091 Warsaw, Poland; (K.R.-P.); (P.W.); (D.S.)
| | - Agnieszka Paradowska-Gorycka
- Department of Molecular Biology, National Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, Poland;
| | - Dariusz Szukiewicz
- Department of Biophysics and Human Physiology, Faculty of Health Sciences, Warsaw Medical University, 02-091 Warsaw, Poland; (K.R.-P.); (P.W.); (D.S.)
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Ayan A, Cetin SY. Investigation of Sexual Dysfunction in Partner of Patients with Ankylosing Spondylitis. SEXUALITY AND DISABILITY 2021. [DOI: 10.1007/s11195-021-09682-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Nisihara R, Heil Junior LJ, Fagundes FG, Sobreiro B, Campos APB, Simioni J, Skare TL. Erectile Dysfunction, Testosterone Levels and Disease Activity in Ankylosing Spondylitis Patients. Urology 2021; 153:210-214. [PMID: 33476603 DOI: 10.1016/j.urology.2021.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/14/2020] [Accepted: 01/05/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To study erectile function in male patients with Ankylosing Spondylitis (AS) trying to correlate it with sexual hormonal profile and disease activity. METHODS We included 35 AS patients and 104 controls. Patients and controls answered the IIEF (International Index of Erectile Dysfunction) and had dosing of total testosterone, free testosterone (FT), bioavailable testosterone (BT), SHBG (serum hormone binding globulin), albumin and LH (luteinizing hormone). AS patients had epidemiological, clinical and treatment data obtained from the charts. AS disease activity was measured simultaneously with blood collection through Bath AS Disease Activity Index, ASDAS (AS Disease Activity Score) -ESR (using erythrocyte sedimentation rate) and ASDAS-CRP (using C reactive protein). RESULTS The IIEF results were worse in AS patients than controls (P = .02). Total testosterone and SHBG were higher in AS (with P = .01 and P <.0001 respectively). Between the 2 groups, no differences in LH, FT, BT levels (all with P = ns) were found. In AS patients, the IIEF results did not correlate with total testosterone, SHBG, LH, FT, and BT but a negative association was found with Bath AS Disease Activity Index (P = .001) and ASDAS-CRP (P = .02). CONCLUSION AS patients had worst sexual performance than controls that was linked to disease activity but not to male sexual hormonal profile.
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Affiliation(s)
- Renato Nisihara
- Mackenzie Evangelical School of Medicine Paraná, Curitiba, Brazil; Department of Medicine, Positivo University, Curitiba, Brazil.
| | - L J Heil Junior
- Mackenzie Evangelical School of Medicine Paraná, Curitiba, Brazil
| | | | | | - Ana P B Campos
- Mackenzie Evangelical School of Medicine Paraná, Curitiba, Brazil
| | - Juliana Simioni
- Mackenzie Evangelical School of Medicine Paraná, Curitiba, Brazil
| | - Thelma L Skare
- Mackenzie Evangelical School of Medicine Paraná, Curitiba, Brazil
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Cooley LF, Wren J, Keeter MK, Lam I, Bennett N, Brannigan RE. Anti-TNF agents and potential effects on male fertility: are men being counseled? BMC Urol 2020; 20:111. [PMID: 32718310 PMCID: PMC7385975 DOI: 10.1186/s12894-020-00658-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Accepted: 06/22/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Adult men with autoimmune conditions are commonly prescribed anti-tumor necrosis factor (anti-TNF) agents; however, there is a paucity of quality evidence as to their effect on male fertility (e.g. semen parameters and sperm quality). Our objective was to determine if men with autoimmune conditions are being counseled regarding the unknown reproductive effects of anti-TNF agents prior to initiation of therapy. METHODS A retrospective analysis of 1010 male patients age 18-45 who were prescribed an anti-TNF agent were assessed for (1) receipt of counseling regarding potential reproductive effects; (2) screening for anatomic or laboratory abnormalities associated with infertility; (3) election for sperm cryopreservation. RESULTS Only 10.3% of men received counseling, and this was not associated with age (p = 0.77). Those who received counseling were significantly more likely to have a genitourinary exam performed, be assessed for presence of a varicocele, be asked about or endorse low libido or erectile dysfunction, have a testosterone, LH, FSH, or prolactin level checked, and have a semen analysis performed (all, p < 0.0001). Rates of sperm cryopreservation were low, but statistically higher in men who received counseling (5.77% (+) counseling, 1.10% (-) counseling) (p = 0.002). CONCLUSIONS The limited current literature lacks a consensus regarding the short- and long-term male reproductive effects of anti-TNF therapy. Despite this lack of clarity, rates of pre-initiation counseling were low. Rates of sperm cryopreservation, while improved in the counseled group remained low, suggesting prescribing physicians may be unaware of this option for patients.
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Affiliation(s)
- Lauren Folgosa Cooley
- Department of Urology, Northwestern University Feinberg School of Medicine, 676 N. St. Clair St. Arkes 23-015, Chicago, IL, 60611, USA
| | - James Wren
- Department of Urology, Northwestern University Feinberg School of Medicine, 676 N. St. Clair St. Arkes 23-015, Chicago, IL, 60611, USA
| | - Mary Kate Keeter
- Department of Urology, Northwestern University Feinberg School of Medicine, 676 N. St. Clair St. Arkes 23-015, Chicago, IL, 60611, USA
| | - Isaac Lam
- Department of Urology, Northwestern University Feinberg School of Medicine, 676 N. St. Clair St. Arkes 23-015, Chicago, IL, 60611, USA
| | - Nelson Bennett
- Department of Urology, Northwestern University Feinberg School of Medicine, 676 N. St. Clair St. Arkes 23-015, Chicago, IL, 60611, USA
| | - Robert E Brannigan
- Department of Urology, Northwestern University Feinberg School of Medicine, 676 N. St. Clair St. Arkes 23-015, Chicago, IL, 60611, USA.
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Effects of Ankylosing Spondylitis on Erectile Function. MEDICAL BULLETIN OF SISLI ETFAL HOSPITAL 2020; 54:188-192. [PMID: 32617056 PMCID: PMC7326678 DOI: 10.14744/semb.2018.49358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 07/27/2018] [Indexed: 12/27/2022]
Abstract
Objectives: Ankylosing spondylitis (AS), which is a chronic rheumatologic disorder, may be associated with erectile dysfunction (ED). This study aims to investigate the incidence of erectile dysfunction in patients with AS with a control group and to investigate the risk factors for ED. Methods: All demographic data were recorded. Participants in both groups filled in the IIEF-5 (International Index of Erectile Function), Beck Depression Index (BDI) and Beck Anxiety Index (BAI) questionnaires, whereas patients with AS additionally filled in Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrological Index (BASMI) and Ankylosing Spondylitis Quality of Life (ASQoL) questionnaires. Patients were compared concerning erectile function and predictive factors. Fifty patients with the AS diagnosis and fifty healthy males were included in this study. Results: ED of all degrees was present in 38% and 30% of males in the AS group and control group, respectively, with no statistical difference. However, the mean IIEF-EF domain score of the AS group (22.3±7.0) was significantly lower than the control group (25.7±4.3) (p=0.004). In addition, BDI and BAI scores were significantly higher in the AS group. When we have divided patients in the AS group into two, according to the presence or absence of the ED, the mean IIEF-EF domain score of patients with ED was lower than AS patients without ED. No difference was detected in both groups concerning age and the duration of the disease. Patients who had ED in the AS group had significantly higher scores in BASDAI, BASFI, depression and anxiety; however, no significant difference was detected among groups regarding BASMI scores. Mean IIEF score was lower in patients with AS, and this had a negative correlation with BASDAI, BASFI, ASQoL, BDI and BAI scores. Conclusion: Erectile function scores were slightly lower in the AS group than the control group in our study. ED risk factors were shown as disease activity and psychological status.
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Restoux LJ, Dasariraju SR, Ackerman IN, Van Doornum S, Romero L, Briggs AM. Systematic Review of the Impact of Inflammatory Arthritis on Intimate Relationships and Sexual Function. Arthritis Care Res (Hoboken) 2020; 72:41-62. [PMID: 30941870 DOI: 10.1002/acr.23857] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 02/12/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To systematically review evidence of the impact of inflammatory arthritis on, or association of inflammatory arthritis with, intimate relationships and sexual function. METHODS Ovid Medline, Ovid PsycINFO, Ovid Embase, and EBSCO CINAHL databases were searched. Two independent reviewers selected articles, extracted data, and conducted manual searches of reference lists from included studies and previous reviews. The quality of evidence was assessed using standard risk-of-bias tools. RESULTS Fifty-five eligible studies were reviewed. Of these, 49 (89%) were quantitative, 5 (9.1%) were qualitative, and 1 (1.8%) used a mixed-method design. Few quantitative studies were rated as low risk of bias (n = 7 [14%]), many were rated as moderate (n = 37 [74%]) or high risk (n = 6 [12%]). Quantitative study sample sizes ranged from 10 to 1,272 participants, with a reported age range 32-63 years. Qualitative study sample sizes ranged from 8 to 57 participants, with a reported age range 20-69 years. In studies reporting the Female Sexual Function Index, all inflammatory arthritis groups demonstrated mean scores ≤26.55 (range of mean ± SD scores: 14.2 ± 7.8 to 25.7 ± 4.7), indicating sexual dysfunction. In studies reporting the International Index of Erectile Function, all inflammatory arthritis groups reported mean scores ≤25 (range of mean ± SD scores: 16.0 ± 5.3 to 23.8 ± 7.0), indicating erectile dysfunction. Key qualitative themes were impaired sexual function and compromised intimate relationships; prominent subthemes included inflammatory arthritis-related pain and fatigue, erectile dysfunction, diminished sexual desire, and sexual function fluctuations according to disease activity. CONCLUSION Sexual dysfunction appears highly prevalent among men and women with inflammatory arthritis, and increased clinician awareness of this impairment may guide provision of tailored education and support.
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Affiliation(s)
| | | | | | | | - Lorena Romero
- Alfred Medical Research and Education Precinct, Melbourne, Victoria, Australia
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Aykurt Karlıbel İ, Dülger S, Kasapoğlu Aksoy M, Güzelsoy M, Türkoğlu AR, Altan L, Yıldız T. Effect of cigarette smoking on sexual functions, psychological factors, and disease activity in male patients with ankylosing spondylitis. Aging Male 2019; 22:109-115. [PMID: 29863428 DOI: 10.1080/13685538.2018.1477935] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE This study aims to investigate the effect of smoking on sexual functions in AS patients. PATIENTS AND METHODS A total of 67 male AS patients with a median age of 34 years (range: 18-57) reporting sexual activity at least for the past 4 weeks period were included. Patients were divided into smokers (Group 1, n = 47) and non-smokers (Group 2, n = 20). Fagerström test for nicotine dependence, smoking history, exhaled carbon monoxide test were recorded for smoking AS patients. Visual analogue scale (VAS), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Metrology Index (BASMI), Bath Ankylosing Spondylitis Functional Index (BASFI), Ankylosing Spondylitis Quality of Life (ASQoL), International Index of Erectile Function (IIEF), Beck Depression Inventory (BDI) were filled for both groups. RESULTS There was no significant difference between smokers and non-smokers in all evaluation parameters. BASMI scores were significantly lower in the mild dependency subgroup as compared to those with moderate or severe dependency (p = .005 and p = .007, respectively). Total IIEF score and IIEF categories correlated significantly with BASDAI, BASFI, BASMI, ASQoL, pain, fatigue, and cumulative smoking. BDI showed an inverse correlation with the IIEF score and IIEF category (p < .001 r = -0.520, p < .001 r = -0.508, respectively). CONCLUSIONS Sexual function in AS patients is associated with the pain, fatigue, disease activity, functional status, quality of life, depression as well as the cumulative exposure to smoking, and that sexual functions tend to decline with increasing degree of cigarette dependency.
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Affiliation(s)
- İlknur Aykurt Karlıbel
- a Department of Physical Medicine and Rehabilitation , University of Health Sciences Bursa Yüksek İhtisas Training and Research Hospital , Bursa , Turkey
| | - Seyhan Dülger
- b Department of Pulmonology , University of Health Sciences Bursa Yüksek İhtisas Training and Research Hospital , Bursa , Turkey
| | - Meliha Kasapoğlu Aksoy
- a Department of Physical Medicine and Rehabilitation , University of Health Sciences Bursa Yüksek İhtisas Training and Research Hospital , Bursa , Turkey
| | - Muhammet Güzelsoy
- c Department of Urology , University of Health Sciences Bursa Yüksek İhtisas Training and Research Hospital , Bursa , Turkey
| | - Ali Rıza Türkoğlu
- c Department of Urology , University of Health Sciences Bursa Yüksek İhtisas Training and Research Hospital , Bursa , Turkey
| | - Lale Altan
- a Department of Physical Medicine and Rehabilitation , University of Health Sciences Bursa Yüksek İhtisas Training and Research Hospital , Bursa , Turkey
- d Department of Physical Medicine and Rehabilitation , Uludağ University Medicine Faculty , Bursa , Turkey
| | - Tekin Yıldız
- b Department of Pulmonology , University of Health Sciences Bursa Yüksek İhtisas Training and Research Hospital , Bursa , Turkey
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Sommerfleck FA, Schneeberger EE, Orozco MC, Zamora N, Landi M, Citera G. Validation and cultural adaptation of the qualisex questionnaire in patients with axial spondyloarthritis in Argentina. Rheumatol Int 2018; 38:2103-2109. [DOI: 10.1007/s00296-018-4148-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 08/23/2018] [Indexed: 01/22/2023]
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Satisfaction and discontent of Polish patients with biological therapy of rheumatic diseases: results of a multi-center questionnaire study. Reumatologia 2018; 56:140-148. [PMID: 30042601 PMCID: PMC6052366 DOI: 10.5114/reum.2018.76901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 06/11/2018] [Indexed: 01/17/2023] Open
Abstract
Objectives Biologics are medications widely applied in the management of inflammatory rheumatic diseases. The drugs were found to be effective but their application is associated with some disadvantages. Medication with biologics is relatively expensive, and in Poland, it is carried out in specialized centers. The study was designed to evaluate various aspects of satisfaction and dissatisfaction of Polish patients treated with biologics. Material and methods An anonymous questionnaire was distributed in 23 Polish rheumatological centers involved in the treatment; 1212 returned questionnaires were used for analysis. Responses were received from 606 patients with rheumatoid arthritis, 427 with ankylosing spondylitis, 117 psoriatic arthritis, and 62 adult patients with juvenile idiopathic arthritis (in whom administration of the drugs had been introduced before they were 18 years old). The investigated group constituted about one-fifth of all rheumatic patients on biologics in Poland. Results A beneficial or very beneficial influence of the medication on the state of physical health was found mostly in patients with rheumatoid arthritis (51.3 and 30.5%) and ankylosing spondylitis (51.0 and 36.8%). Family life was improved by the treatment especially in patients with ankylosing spondylitis (40.7 and 35.6% beneficial and very beneficial, respectively), sleep quality and sexual life mostly in those with ankylosing spondylitis (beneficial/very beneficial influence 41.5/38.4, and 38.7/23.9, respectively). There was a rather small influence of biological treatment on the financial situation of the patients. In general, satisfaction with the treatment was evaluated as positive or very positive in 88% of all investigated patients. In a significant part of the patients, transportation to the medical center was considered as a disadvantage of the treatment. About one-third of the patients considered laboratory and imaging tests to be done before initiation of the medication as a difficulty, and for about 40% waiting time for qualification for the medication was a significant disadvantage. The route of drug administration was without importance for 4/5 of the patients. Conclusions Summing up, the results were similar in the patients suffering from various diseases although those with psoriatic arthritis felt the highest satisfaction (possibly due to the positive aesthetic effect), and those with ankylosing spondylitis had significant improvement in sexual life (probably due to younger age). Relatively low satisfaction was found in patients with juvenile idiopathic arthritis. There was a small influence of medication on financial status of the patients. Application of biologics has few disadvantages and most of them are associated with the organization of health services (waiting time for the tests, transportation to the medical centers).
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Santana T, Skare T, Delboni VS, Simione J, Campos APB, Nisihara R. Erectile dysfunction in ankylosing spondylitis patients. Int Braz J Urol 2017; 43:730-735. [PMID: 28379663 PMCID: PMC5557450 DOI: 10.1590/s1677-5538.ibju.2016.0378] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 01/11/2017] [Indexed: 01/07/2023] Open
Abstract
Background Rheumatic diseases such as ankylosing spondylitis (AS) may be associated with sexual dysfunction. Aim To study erectile function of a group of Brazilian AS patients comparing them with controls. Materials and Methods This was a cross sectional study approved by the local Committee of Ethics in Research. The questionnaire IIEF (International Index of Erectile Function) was applied to 40 AS patients and 40 healthy controls. AS patients had determination of disease activity (through BASDAI or Bath Ankylosing Spondylitis Disease activity index), ASDAS (Ankylosing Spondylitis Disease Activity Score, MASES or Maastricht Ankylosing Spondylitis Score and SPARCC or Spondyloarthritis Research Consortium of Canada), function (through BASFI or Bath Ankylosing Spondylitis Functional Index and HAQ or Health Assessment Questionnaire) and BASMI (Bath Ankylosing Spondylitis Metrological Index). Results AS patients had a median score on IIEF of 22.0 (IQR=18-25) while controls had 29 (IQR=27-30) with p<0.0001 Only 17.5% of the AS patients had no erectile dysfunction, in opposite to 87.5% of controls (p<0.0001). IIEF scores had a negative association with BASDAI (p<0.0001), HAQ (p=0.05), body mass index (P=0.03), MASES (P=0.02) and SPARCC (P=0.02) in a univariate analysis. Multiple regression showed that BASDAI was the only variable independently associated with IIEF. Conclusion There is a high prevalence of erectile dysfunction among AS patients that is associated with disease activity measured by BASDAI.
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Affiliation(s)
- Thiago Santana
- Unidade de Reumatologia, Hospital Evangélico, Padre Anchieta, Curitiba, PR, Brasil
| | - Thelma Skare
- Unidade de Reumatologia, Hospital Evangélico, Padre Anchieta, Curitiba, PR, Brasil
| | - Vitor Steil Delboni
- Unidade de Reumatologia, Hospital Evangélico, Padre Anchieta, Curitiba, PR, Brasil
| | - Juliana Simione
- Unidade de Reumatologia, Hospital Evangélico, Padre Anchieta, Curitiba, PR, Brasil
| | - Ana Paula B Campos
- Unidade de Reumatologia, Hospital Evangélico, Padre Anchieta, Curitiba, PR, Brasil
| | - Renato Nisihara
- Unidade de Reumatologia, Hospital Evangélico, Padre Anchieta, Curitiba, PR, Brasil.,Departamento de Medicina, Universidade Positivo, Curitiba, PR, Brasil
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Blasco-Blasco M, Ruiz-Cantero MT, Juárez-Herrera Y Cairo LA, Jovaní V, Pascual E. Sex and Gender Interactions in the Lives of Patients with Spondyloarthritis in Spain: A Quantitative-qualitative Study. J Rheumatol 2017; 44:1429-1435. [PMID: 28668807 DOI: 10.3899/jrheum.170128] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To illustrate the experiences and contextual support perceived by men and women with spondyloarthritis (SpA) in relation to their demanding productive and reproductive roles. METHODS A quantitative-qualitative study of 96 men and 54 women with SpA was conducted at the Alicante University General Hospital, in a Spanish Mediterranean city, from March 2013 to February 2014. Descriptive and qualitative content analyses compared working lives and family/partner relationships of male and female patients. RESULTS Working life: both women (55.6%) and men (51.04%) were similarly affected, but women had worse disease activity (5.4 vs 4.0, p = 0.01) and less antitumor necrosis factor-α therapy (56.7% vs 77.6%, p < 0.05). Different patterns were found by gender: women mostly practiced presenteeism whereas men practiced absenteeism, women took antiinflammatories prior to work and men after work, employers suggested more frequently the beneficial actions for men, and some women withdrew permanently from the labor market. Family/partner relationships: women were more affected (57.4%) than men (41.7%), with worse results for diagnostic delay (11.2 vs 6.4 yrs, p = 0.02), disease activity (5.8 vs 3.6, p < 0.001), and physical function (5.2 vs 3.8, p = 0.02). Gender role conflicts emerged, with women developing strategies to face compulsory housework whereas men avoided them; women regretted neglecting their children and men not sharing leisure activities with them. CONCLUSION Our study highlights the vital complexity in which patients with SpA are immersed, especially for women in a country where a mix of new and traditional gender roles coexist. Awareness of its existence is crucial when professionals strive to provide healthcare focused on their well-being in addition to medical therapy.
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Affiliation(s)
- Mar Blasco-Blasco
- From the Public Health Department, Alicante University; Rheumatology Department, Alicante University General Hospital; Miguel Hernandez University, Alicante, Spain.,M. Blasco-Blasco, MPH, Public Health Department, University of Alicante; M.T. Ruiz-Cantero, MPH, PhD, Public Health Department, University of Alicante, and CIBERESP; L.A. Juárez-Herrera y Cairo, PhD, Public Health Department, University of Alicante; V. Jovaní, MD, Rheumatology Department, Alicante University General Hospital; E. Pascual, Professor of Medicine (Rheumatology), Miguel Hernandez University
| | - María Teresa Ruiz-Cantero
- From the Public Health Department, Alicante University; Rheumatology Department, Alicante University General Hospital; Miguel Hernandez University, Alicante, Spain. .,M. Blasco-Blasco, MPH, Public Health Department, University of Alicante; M.T. Ruiz-Cantero, MPH, PhD, Public Health Department, University of Alicante, and CIBERESP; L.A. Juárez-Herrera y Cairo, PhD, Public Health Department, University of Alicante; V. Jovaní, MD, Rheumatology Department, Alicante University General Hospital; E. Pascual, Professor of Medicine (Rheumatology), Miguel Hernandez University.
| | - Lucero Aida Juárez-Herrera Y Cairo
- From the Public Health Department, Alicante University; Rheumatology Department, Alicante University General Hospital; Miguel Hernandez University, Alicante, Spain.,M. Blasco-Blasco, MPH, Public Health Department, University of Alicante; M.T. Ruiz-Cantero, MPH, PhD, Public Health Department, University of Alicante, and CIBERESP; L.A. Juárez-Herrera y Cairo, PhD, Public Health Department, University of Alicante; V. Jovaní, MD, Rheumatology Department, Alicante University General Hospital; E. Pascual, Professor of Medicine (Rheumatology), Miguel Hernandez University
| | - Vega Jovaní
- From the Public Health Department, Alicante University; Rheumatology Department, Alicante University General Hospital; Miguel Hernandez University, Alicante, Spain.,M. Blasco-Blasco, MPH, Public Health Department, University of Alicante; M.T. Ruiz-Cantero, MPH, PhD, Public Health Department, University of Alicante, and CIBERESP; L.A. Juárez-Herrera y Cairo, PhD, Public Health Department, University of Alicante; V. Jovaní, MD, Rheumatology Department, Alicante University General Hospital; E. Pascual, Professor of Medicine (Rheumatology), Miguel Hernandez University
| | - Eliseo Pascual
- From the Public Health Department, Alicante University; Rheumatology Department, Alicante University General Hospital; Miguel Hernandez University, Alicante, Spain.,M. Blasco-Blasco, MPH, Public Health Department, University of Alicante; M.T. Ruiz-Cantero, MPH, PhD, Public Health Department, University of Alicante, and CIBERESP; L.A. Juárez-Herrera y Cairo, PhD, Public Health Department, University of Alicante; V. Jovaní, MD, Rheumatology Department, Alicante University General Hospital; E. Pascual, Professor of Medicine (Rheumatology), Miguel Hernandez University
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Liu YF, Wen CYZ, Tu SH. On the Relationship of Male Sexual Dysfunction and Ankylosing Spondylitis. J Rheumatol 2015; 42:2513. [PMID: 26628711 DOI: 10.3899/jrheum.150517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Ya-Fei Liu
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, and Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China;
| | | | - Sheng-Hao Tu
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave., Wuhan, Hubei 430030, China.
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