Shedding light on sexuality in psoriatic arthritis: a 5-year prospective follow-up of an outpatient cohort.

To assess sexual quality of life over 5 years in patients with psoriatic arthritis, focusing on gender differences, specific domains, and the impact of health status. Patients were recruited during baseline visits in 2013. Data collection included demographics, disease activity, treatment, and patient-reported outcome measures. Sexuality was assessed using SQoL-Female (SQoL-F) questionnaire, with detailed and composite scores calculated. Item 15 of the 15D quality of life questionnaire evaluated the influence of health on sexual activity. After 5 years, patients were reinvited for follow-up with the same clinical and questionnaire data collected. Eighty-four patients with PsA with baseline and 5-year follow-up data were included (42.9% women; mean age 49.8 years; disease duration 8.9 years; 81.9% married/cohabiting). At baseline, mean DAPSA was 15.5, PASI 2.5, mean comorbidities 0.8, and 40.5% received biologic DMARDs. Over 5 years, comorbidities increased (1.0; p < 0.01), disease activity decreased (DAPSA 12.4; p = 0.03), and biologic use increased (51.2%; p = 0.04). Most men and women reported little or no impact of health on sexual activity; severe limitations were rare. Overall SQoL-F score remained stable, though women reported worse scores on items reflecting emotional concerns and sexual avoidance; total and domain scores did not differ by gender. Fatigue was the only consistent correlate of poorer SQoL-F, exceeding pain, disability, and inflammation. Over 5 years, overall SQoL in patients with PsA remained largely stable despite aging and increasing comorbidities. Women reported higher emotional and avoidance-related concerns. Fatigue, rather than pain, disability, or inflammation, consistently associated with poorer sexual well-being.