title: Erectile dysfunction is frequent in systemic sclerosis and associated with severe disease: a study of the EULAR Scleroderma Trial and Research group.
abstract: BACKGROUND
  Erectile dysfunction (ED) is common in men with systemic sclerosis (SSc) but the demographics, risk factors and treatment coverage for ED are not well known.
  
  
  METHODS
  This study was carried out prospectively in the multinational EULAR Scleroderma Trial and Research database by amending the electronic data-entry system with the International Index of Erectile Function-5 and items related to ED risk factors and treatment. Centres participating in this EULAR Scleroderma Trial and Research substudy were asked to recruit patients consecutively.
  
  
  RESULTS
  Of the 130 men studied, only 23 (17.7%) had a normal International Index of Erectile Function-5 score. Thirty-eight per cent of all participants had severe ED (International Index of Erectile Function-5 score ≤ 7). Men with ED were significantly older than subjects without ED (54.8 years vs. 43.3 years, P < 0.001) and more frequently had simultaneous non-SSc-related risk factors such as alcohol consumption. In 82% of SSc patients, the onset of ED was after the manifestation of the first non-Raynaud's symptom (median delay 4.1 years). ED was associated with severe cutaneous, muscular or renal involvement of SSc, elevated pulmonary pressures and restrictive lung disease. ED was treated in only 27.8% of men. The most common treatment was sildenafil, whose efficacy is not established in ED of SSc patients.
  
  
  CONCLUSIONS
  Severe ED is a common and early problem in men with SSc. Physicians should address modifiable risk factors actively. More research into the pathophysiology, longitudinal development, treatment and psychosocial impact of ED is needed.
authors.affiliation: Department of Rheumatology, Basel University, Burgfelderstrasse 101, Basel 4012, Switzerland.
authors.forename: Chingching
authors.initials: C
authors.lastname: Foocharoen
authors.forename: Alan
authors.initials: A
authors.lastname: Tyndall
authors.forename: Eric
authors.initials: E
authors.lastname: Hachulla
authors.forename: Edoardo
authors.initials: E
authors.lastname: Rosato
authors.forename: Yannick
authors.initials: Y
authors.lastname: Allanore
authors.forename: Dominique
authors.initials: D
authors.lastname: Farge-Bancel
authors.forename: Paola
authors.initials: P
authors.lastname: Caramaschi
authors.forename: Paolo
authors.initials: P
authors.lastname: Airó
authors.forename: Starovojtova M
authors.initials: SM
authors.lastname: Nikolaevna
authors.forename: José António
authors.initials: JA
authors.lastname: Pereira da Silva
authors.forename: Bojana
authors.initials: B
authors.lastname: Stamenkovic
authors.forename: Gabriela
authors.initials: G
authors.lastname: Riemekasten
authors.forename: Simona
authors.initials: S
authors.lastname: Rednic
authors.forename: Jean
authors.initials: J
authors.lastname: Sibilia
authors.forename: Piotr
authors.initials: P
authors.lastname: Wiland
authors.forename: Ingo
authors.initials: I
authors.lastname: Tarner
authors.forename: Vanessa
authors.initials: V
authors.lastname: Smith
authors.forename: Anna T
authors.initials: AT
authors.lastname: Onken
authors.forename: Walid Ahmed
authors.initials: WA
authors.lastname: Abdel Atty Mohamed
authors.forename: Oliver
authors.initials: O
authors.lastname: Distler
authors.forename: Jadranka
authors.initials: J
authors.lastname: Morović-Vergles
authors.forename: Andrea
authors.initials: A
authors.lastname: Himsel
authors.forename: Paloma Garcia
authors.initials: PG
authors.lastname: de la Peña Lefebvre
authors.forename: Thomas
authors.initials: T
authors.lastname: Hügle
authors.forename: Ulrich A
authors.initials: UA
authors.lastname: Walker
mesh_terms: D000328:Adult; D016208:Databases, Factual / Q000706:statistics & numerical data; D007172:Erectile Dysfunction / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D007674:Kidney Diseases / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009135:Muscular Diseases / Q000150:complications / Q000503:physiopathology*; D010879:Piperazines / Q000627:therapeutic use; D011446:Prospective Studies; D011687:Purines / Q000627:therapeutic use; D012595:Scleroderma, Systemic / Q000150:complications / Q000503:physiopathology*; D012720:Severity of Illness Index; D000068677:Sildenafil Citrate; D012871:Skin Diseases / Q000150:complications / Q000503:physiopathology*; D013450:Sulfones / Q000627:therapeutic use; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D010879:Piperazines; D011687:Purines; D013450:Sulfones; D014665:Vasodilator Agents; D000068677:Sildenafil Citrate