S841 Biologic Therapy Response Improves Sexual Dysfunction in Patients With Inflammatory Bowel Disease

Introduction: Patients with IBD have a high degree of sexual dysfunction (SD) which has been correlated with depression, disease activity, and past medication use such as steroids and biologic therapy. We aimed to track SD longitudinally and assess the impact of biologic therapy, using IBD-specific scales. Methods: Patients with Crohn’s disease (CD) and ulcerative colitis (UC) starting a new biologic therapy (anti-TNF, anti-integrin, anti-IL12/23, JAK inhibitor) were surveyed at start of induction therapy and at 6-months. Surveys included the IBD- FSDS and MSDS, PROMIS Brief Sexual Function and Satisfaction Profile, clinical disease activity indices [Harvey-Bradshaw index (HBI), partial Mayo (pMayo) score] and scales that assessed depression [Patient Health Questionnaire-9 (PHQ-9)], and quality of life [Short IBD Questionnaire (SIBDQ)]. Clinical data included inflammatory markers and prior IBD therapies. Therapy response was defined as a reduction in HBI, pMayo, SCCAI ≥3 or total HBI ≤ 4, pMayo < 2, SCCAI ≤2 at 6 months. Results: 158 patients (86 males and 72 females) completed surveys at induction, and 101 completed at 6 months. The median age was 31 years, 58% had CD, 42% had UC, and 32% were non-white. At induction, the median MSDS score was 5.5 out of 40 (IQR 2-13) and FSDS was 12 out of 60 (3-27; Table). SD correlated with the SIBDQ (r=0.56, p< 0.001), and PHQ-9 (r=0.51, p< 0.001). MSDS and FSDS scores strongly correlated with PROMIS scores (r= 0.70, p< 0.001), and moderately correlated with the HBI (r=0.49, p=0.002), pMayo and SCCAI score (0.44, p=0.02). SD did not correlate with markers of inflammation. MSDS scores significantly improved at 6 months among all participants (p= 0.048). FSDS and PROMIS scores numerically improved among all participants, but did not reach significance. Both MSDS and FSDS scores significantly improved among therapy responders (p=0.004 and p= 0.042, respectively) as did PROMIS scores. Both patients with prior biologic use and biologic naïve patients experienced improvement in sexual function among therapy responders (p=0.02, 0.04). Conclusion: There was a strong correlation between SD, disease activity, depression, and quality of life indices. Biologic therapy improves sexual function in therapy responders, which is again evidenced in this updated cohort. Despite prior data correlating prior biologic use with SD, our new findings in this longitudinal study show improvement in SD in patients who are both biologic naïve and those with prior use. Table 1. - This Table shows the median sexual dysfunction and clinical disease activity scores stratified by therapeutic response and prior biologic use Induction 6 months p- value (survey 1-3) All Participants MSDS (out of 40) 5.5 (2- 13) 2.5 (0-9) 0.048* FSDS (out of 60) 12 (3-27) 9 (3-19) 0.477 PROMIS 31 (20-38) 29.5 (22-35) 0.682 HBI 5 (3-7) 3 (1-6) 0.003* pMayo 3 (2-5) 2 (1-4) 0.052 SCCAI 6 (4-8) 4 (3-6) 0.003* Therapy responders All MSDS (out of 40) 5 (1-10) 1 (0-3) 0.004* FSDS (out of 60) 13 (3-30) 8 (3, 10) 0.042* PROMIS 32 (26-38) 27 (20-32) 0.039* HBI 5 (2-6) 2 (1-3) < 0.001* pMayo 4 (2-6) 1 (0-3) < 0.001* SCCAI 7 (5-9) 3 (1-4) < 0.001* Therapy non-responders MSDS 6 (4-16) 8 (3- 12) 0.472 FSDS 12 (8.5-29) 11.5 (3.5- 22) 0.610 PROMIS 34 (2-40.5) 32 (16- 35.5) 0.656 HBI 6 (3-7) 6 (4.5-7.5) 0.285 pMayo 5 (3-6) 4 (1-7) 0.310 SCCAI 6 (5-7) 5 (4-7) 0.441 Biologic naïve MSDS 6 (3-14) 2 (0-7) 0.020* FSDS 12 (3-26) 8 (3-10) 0.089 PROMIS 30 (20-33.5) 26 (2-32) 0.022* Prior biologic use MSDS 6.5 (3-14) 2 (0.5-0.5) 0.039* FSDS 16 (3.5-30) 4 (1.5-14) 0.044* PROMIS 30.5 (10-38) 26 (5-35) 0.045* Therapy response= Reduction in HBI, pMayo, SCCAI ≥3 or HBI ≤ 4, pMayo < 2, or SCCAI ≤2 at survey 3.Therapy non-response= Reduction in HBI < 3, pMayo < 3 points or SCCAI < 3.