Sexual Quality of Life in Patients with Axial Spondyloarthritis in the Biologic Treatment Era

J Rheumatol. 2019 Sep;46(9):1075-1083. doi: 10.3899/jrheum.180413. Epub 2019 Feb 15.


Objective: To examine the relationship between demographics, disease-related variables, treatment, and sexual quality of life (SQOL) in men and women with axial spondyloarthritis (axSpA).

Methods: AxSpA patients were consecutively recruited from 2 rheumatology outpatient clinics in southern Norway. A broad spectrum of demographics, disease, treatment, and QOL data were systematically collected. SQOL was assessed using the SQOL-Female (SQOL-F) questionnaire (score range 18-108). Appropriate statistical tests were applied for group comparison, and the association between independent variables and SQOL-F was examined using multiple linear regression analysis.

Results: A total of 360 (240 men, 120 women) axSpA patients with mean age 45.5 years and disease duration 13.9 years were included. Seventy-eight percent were married/cohabiting, 26.7% were current smokers, 71.0% were employed, 86.0% performed > 1-h exercise per week, and 88.0% were HLA-B27-positive. Mean (SD) values for disease measures were C-reactive protein (CRP) 8.5 (12.1) mg/l, Bath Ankylosing Spondylitis Disease Activity Index 3.1 (2.1), Bath Ankylosing Spondylitis Global Score (BAS-G) 3.8 (2.5), Bath Ankylosing Spondylitis Functional Index 2.7 (2.2), and Health Assessment Questionnaire 0.6 (0.5). The proportion of patients using nonsteroidal antiinflammatory drugs was 44.0%, synthetic disease-modifying antirheumatic drugs (DMARD) 5.0%, and biologic DMARD 24.0%. Mean (SD) total sum score for SQOL was 76.6 (11.3). In multivariate analysis, female sex, increased body mass index, measures reflecting disease activity (BAS-G and CRP), and current biologic treatment were independently associated with a lower SQOL.

Conclusion: Our data suggest that inflammation in patients with axSpA even in the biologic treatment era reduces SQOL.


Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antirheumatic Agents / therapeutic use*
  • Biological Products / therapeutic use*
  • Body Mass Index
  • Female
  • Humans
  • Male
  • Middle Aged
  • Personal Satisfaction*
  • Quality of Life / psychology*
  • Severity of Illness Index
  • Sex Factors
  • Sexual Behavior / psychology*
  • Spondylarthritis / diagnosis
  • Spondylarthritis / drug therapy
  • Spondylarthritis / psychology*
  • Surveys and Questionnaires


  • Antirheumatic Agents
  • Biological Products