Background/Purpose: Although systemic lupus erythematosus (SLE) has a higher prevalence in women, the disease usually has a more aggressive course in men. Information regarding erectile function in men with SLE is quite scant. Therefore, the aim of this study was to describe the prevalence of erectile dysfunction (ED) as well as associated demographic and clinical features in men with SLE, by means of a systematic, standardized evaluation.

Methods: We performed a transversal study in five tertiary care centers in Latin America (3 in Mexico, one in El Salvador and one in Nicaragua). We included male patients older than 16 years who fulfilled ≥4 ACR criteria for SLE, and who had reported regular sexual activity in the previous 6 months. Patients with other rheumatic diseases (except for APS), chronic viral infections, concomitant diagnosis of benign prostate hyperplasia, and late-onset SLE (≥50 years of age) were excluded. All patients answered the self-administered International Index of Erectile Function-5 Questionnaire (IIEF-5), which has been validated in Spanish. Other relevant demographic, clinical and serological characteristics were documented from the clinical records.

Results: We included 118 subjects. The prevalence of ED in our study population was 67.7% (80/118), the majority were classified as mild to moderate (17.5±3.8 points; normal score: 22-25 points). The mean age of patients with ED was 35.6±11, while in patients without ED it was 32.3±9 (p=0.11). There were no significant differences in most of the demographic and clinical variables between both groups, either (Table 1). There was a trend regarding current prednisone intake in patients with ED (67 vs 48%, p=0.066). Furthermore, patients with ED had a higher MMF dose (1461±989 vs 860±1011 mg p=0.036) and a lower lymphocyte count (1398±634 vs 1717±814 cells/µl, p=0.022) than controls. Complement levels, anti-dsDNA antibodies and serum creatinine did not differ between groups. Also, both SLEDAI (p=0.16) and SLICC (p=0.13) scores were similar between groups.

Conclusion: Regardless of acute disease activity, accrual damage, type of previous SLE activity and comorbidities, men with SLE have a high prevalence of ED, considering most are young patients. Interestingly, prednisone dose was not associated with this condition, and the only difference in immunosuppressive drugs between groups was a higher dose of MMF in the patients with ED. Besides, lymphopenia could play a physiopathogenic role, associated with microvascular damage. The high prevalence of ED could potentially be associated to diminished quality of life, which must be addressed by prospective studies. Table 1. Demographic features and comorbidities of patient with and without ED and SLE

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/epidemiologic-profile-of-erectile-dysfunction-in-sle-a-multi-center-study-in-latin-american-patients/