背景:多发性硬化症(MS)是一种中枢神经系统自身免疫性疾病,主要影响年轻人,在女性中更普遍,可能导致MS男性和女性的性功能障碍(SD)。女性性功能障碍可以定义为性交困难,缺乏性欲,觉醒和高潮阶段的障碍,和性疼痛障碍。这项研究的目的是调查MS女性的性功能变化,这些女性在六个月后将治疗从一线注射药物转换为其他药物。并评估SD的所有三个域的变化。
方法:在这项纵向研究中,诊断为MS的女性,年龄在18至50岁之间,并且是从干扰素β-1a(肌肉内和皮下)转换治疗的候选人,和醋酸格拉替雷(GA),芬戈莫德,富马酸二甲酯(DMF),或纳他珠单抗(NTZ)由于患者的便利性和耐受性以及不良事件被包括在内。使用“多发性硬化症亲密关系和性行为问卷-19”评估新疗法开始前和六个月后的SD变化。采用SPSSV.24软件进行统计学分析。直方图和Shapiro-Wilk检验用于评估变量的正态性;由于定量变量的非正态分布(年龄除外),使用Wilcoxon符号秩检验来比较分数,用药前和用药后六个月。显著性水平被认为小于0.05。
结果:在107名女性参与者中(平均年龄:35.09±5.61),MSISQ-19总得分的平均值,用药前和用药后6个月无显著性差异(p值=0.091).然而,考虑到子域,药物改变仅影响MSISQ-19的第三亚结构域(p值=0.017).尽管如此,其他子域的评分没有显著变化(原发性SD的p值=0.761,继发性SD的p值=0.479).此外,药物改变前后EDSS无显著差异(p值=0.461)。
结论:据我们所知,这是第一项研究,评估MS药物改变对患者SD改善的影响。根据提出的横断面研究的结果,我们发现在六个月的时间里,MSISQ-19症状的第三亚域明显改善,而其他SD域的变化不显著。
BACKGROUND: Multiple Sclerosis (MS) a central nervous system autoimmune disorder, mainly affecting young adults and more prevalent among women, can lead to sexual dysfunction (SD) among both males and females with MS. Female sexual dysfunction can be defined as dyspareunia, a lack of sexual desire, disorders in the arousal and orgasm phases, and sexual pain disorders. The purpose of this study is to investigate the changes in sexual function among females with MS whose treatment was switched from first-line injectable medications to other agents after a six-month duration. And assess the changes in all three domains of SD.
METHODS: In this longitudinal study females diagnosed with MS, aged between 18 and 50 years old, and were candidates for switching their treatment from interferon beta-1a (intra-muscular and subcutaneous), and Glatiramer Acetate (GA), to Fingolimod, Dimethyl Fumarate (DMF), or
Natalizumab (NTZ) due to patients\' convenience and tolerability and adverse events were included. \"Multiple Sclerosis Intimacy and Sexuality Questionnaire-19\" was used to evaluate the SD changes before and six months after the new treatment initiation. Statistical analysis was conducted using SPSS V.24 software. Histograms and the Shapiro-Wilk test were used to assess the normality of the variables; due to the non-normal distribution of quantitative variables (except for age), the Wilcoxon signed-rank test was used to compare the scores, before and six months after the medication change. The level of significance was considered less than 0.05.
RESULTS: Out of 107 female participants (average age: 35.09 ± 5.61), The mean of overall MSISQ-19 scores, before and six months after the medication change were not significant (p-value = 0.091). However, considering the subdomains, the medication changes only affected the tertiary subdomain of MSISQ-19 (p-value = 0.017). Still, the scores of other subdomains did not change significantly (p-value = 0.761 for primary SD and 0.479 for secondary SD). Also, there wasn\'t any significant difference between EDSS before and after the medication change (p-value = 0.461).
CONCLUSIONS: To our knowledge, this was the first study, assessing the effect of MS medication change on the improvement of SD among patients. According to the results of the presented cross-sectional study, we found that during a six-month period, the tertiary subdomain of MSISQ-19 symptoms improved significantly, while the changes in other SD domains were not significant.