Background/Purpose: Patients with SLE present with greater sexual dysfunction (SxD) than patients with other chronic diseases [1]. These patients tend to be younger compared to the rest of the population when presenting with SxD; hence, their screening is not routinely performed. The SLICC Frailty Index (SLICC-FI) was recently developed as a predictor of adverse health outcomes in SLE patients [2]. This study aims to examine the possible association between frailty and SxD in SLE patients.

Methods: We performed a 12-month transversal study in a tertiary care center. Male and female patients ≥ 18 years old who fulfilled EULAR/ACR criteria for SLE were included. Patients with other autoimmune or chronic degenerative diseases were excluded. Sexual function was assessed by CSFQ-14 questionnaire (SxD was defined as ≤ 47 and ≤ 41 points, in male and female subjects, respectively). Frailty was assessed by the SLICC-FI score, in which patients were classified as non-frail (SLICC-FI ≤ 0.21) or frail (SLICC-FI >0.21). Disease activity was measured by SLEDAI and SLICC damage index. We used univariate and multivariate analysis to assess association between frailty and SxD. Relevant demographic, clinical, and serological characteristics were recorded.

Results: We included 309 patients (excluded n=36, final analysis n=273) with a mean age of 37 (± 11) years; most of them being female (90%). SxD was found in 69% of all subjects. The mean baseline SLICC-FI score was 0.11 (±0.06), with 21 patients (7.6%) classified as frail. SxD was prevalent in 95% of all frail patients. The univariate analysis showed that the variables associated with frailty were shorter immunosuppressive exposure time, lower CFSQ-14 scores and lower C4 leves (table 1). Multivariate analysis indicated that SxD and disease activity (SLEDAI) at the time of inclusion were independent risk factors for frailty (OR 11.63, 95%CI 1.5-89.9, p= 0.019 and OR 1.19, 95%CI 1.05-1.35 p= 0.006, respectively).

Conclusion: According to our study, the presence of SxD, which has a high prevalence in SLE patients, is an independent risk factor for frailty. Assessing for SxD during frailty evaluation may lead to more comprehensive interventions, helping to improve the quality of life of SLE patients.

Reference: [1] Daleboudt GMN, et al. J Psychosom Res 2013. [2] Legge A, et al. J Rheumatol. 2020.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/measuring-sexual-dysfunction-as-an-indicator-of-frailty-in-systemic-lupus-erythematosus-population/