－S 336 －
― F-427 ―
The effect of anti-TNF agents on sexual dysfunction in male patients with ankylosing spondylitis
Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
*Ji Seon Oh, Hyun-Mi Heo, Yong Gil Kim, Chang-Keun Lee, Bin Yoo
Background: Ankylosing spondylitis (AS), a chronic inflammatory disease involving axial spine and peripheral joints, mainly affects young males. It has been shown that male patients with AS frequently have a sexual dysfunction compared with healthy males. Purpose: To assess the improvement of sexual dysfunction in male patients with AS and to identify the different responses between anti-TNF-αagents and conventional drugs. Methods: We conducted a survey prospectively in 30 male patients with AS who visited rheumatology clinic in one tertiary hospital with the age of 30 to 50 years. We measured Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) to assess disease activity.
The patients fulfilled the questionnaire of International Index of Erectile Function (IIEF) that is self-administered measure of sexual dysfunction comprising the 5 domains such as erectile function (EF), intercourse satisfaction (IS), organic function (OF), sexual desire (SD), and overall satisfaction (OS). These data were measured before and after 3-month treatment, and compared between anti-TNF-αtreatment group and conventional drugs treatment group. Results: Among 30 patients, 22 patients were treated with anti-TNF-α agents and 8 patients were treated with conventional drugs (sulfasalazine and NSAIDs). There was significant improvement in BASDAI after treatment in both anti-TNF-α treated patients (p<0.001) and conventional drugs treated patients (p=0.02). In comparison of IIEF score, anti-TNF-α treated patients showed significant improvement in 4 (EF, p<0.001; IS, p<0.001; SD, p<0.01; OS, p=0.03) of 5 domains. However, conventional drugs treated patients showed no improvement in all domains. Some domains of IIEF showed significant correlations with BASDAI: EF, r (partial correlation coefficient adjusted by age)=-0.495 (p<0.01); IS, r=-0.512 (p<0.01); OS, r=-0.460 (p<0.05). Conclusion: This study suggest that anti-TNF-α therpay could improve sexual dysfunction in male AS patients as well as their disease activities. The improvement of EF, IS, and OS might be partially related with the control of disease activity.
― F-428 ―
The Prevalence of Extraintestinal manifestations in Korean pateints with Inflammatory bowel disease
Division of Rheumatology, Department of Internal Medicine, Kangnam St. Mary’s Hospital, College of Medicine, The Catholic University
*Ho Sung Yoon, Hyun Ok Kim, Ji Hyeon Ju, Kwi Young Kang1, Sung-Hwan Park1, Ho-Youn Kim1,
Objectives: Inflammatory bowel disease(IBD), which is composed of Crohn's disease(CD) and ulcerative colitis(UC), is associated with extraintestinal manifestations(EIM). The racial difference exists in EIM, but there are few studies about korean IBD patients. The aim of this study was to evaluate the prevalence of major EIM in Korean patients with IBD and the association between EIM and diverse clinical variables. Methods: EIM in 190 patients diagnosed with IBD (CD: 84, f/m: 32/52, meam age at presentation: 35.8 years, average disease duration 55months; UC: 106, f/m: 52/54, meam age at presentation: 46.9 years, average disease duration 61months) in Kangnam St. Mary's Hospital were retrospectively studied. the χ2 test was used to compare groups and odds ratios were calculated. Results: A total of 22.1% of patients with IBD developed EIM (CD: 23.8%, UC 20.8%). No relationship was found between EIM and disease behaviour and location according to the Vienna Classification. Musculoskeletal manifestations were seen in 15.5% of the patients with CD and 14.2% of the patients with UC. There was a increased frequency of Musculoskeletal complications in women with UC (OR: 2.0) and CD (OR: 1.89). But axial arthritis was more frequent in men. Ocular manifestation were present in 1.2% in CD and 1.9% in UC. The most frequent manifestations were anterior uveitis and conjunctivitis. Mucocutaneous manifestations were apparent in approximately 9.5% of CD and UC patients. Mucocutaneous manifestations were more frequent in women in UC (11.5% vs 7.4%, OR: 1.55 95% CI: 0.46-5.02), Erythema nodosum, keratoderma blenorrhagica were the most frequent manifestations. The rate of hepatobiliary manifestations were in 3.6% in CD and 6.6% in UC.
hepatobiliary manifestations were more frequent in UC patients with a disease duration for more than 120 months (p<0.05). Conclusion: The prevalence of EIM in Korean IBD patients is simillar to Western data. In contrast, there are discrepancies between EIM and clinical features.
There are need to study the larger population.
