Study: Severity of rheumatoid arthritis may affect driving

A UNMC study funded by the Rheumatology Research Foundation found an association between driving and arthritis severity.

Internal medicine faculty members, Ted Mikuls, MD, and Kaleb Michaud, PhD, were co-principal investigators of the two-year study. Matthew Rizzo, MD, Frances & Edgar Reynolds Chair & Professor, UNMC Department of Neurological Sciences, is senior author of the paper.

Matthew Rizzo, MD	Kaleb Michaud, PhD

In the study, published online recently in Arthritis Care & Research, the team put sensors and instrumentation in the cars of 33 patients with rheumatoid arthritis (RA) and 23 healthy controls and collected data over an extended period of time as they drove their vehicles.

They wanted to know if rheumatoid arthritis might adversely impact vehicle control — related to acceleration, breaking or steering — and wanted to see if changes in arthritis severity over time led to changes in vehicle control.

They found RA patients appeared to have adverse consequences in terms of vehicle control and at least some of this appeared to be modifiable (vehicle control improved with improved arthritis symptoms).

"This is really the first time we are aware of that anyone has used in-car instrumentation such as this to quantify vehicle control in the context of rheumatoid arthritis," said Dr. Mikuls, first author of the paper. "Our results suggest that effective treatment of RA could have positive dividends on driving. This is important since, as driving is an instrumental activity of daily living, it could help to inform conversations between patients and providers about RA and its impact on driving.

"It also suggests that in-car instrumentation like this could be used as a new way of measuring how someone is doing with their arthritis in real time, for example, between office visits," Dr. Mikuls said. "This does not mean it’s unsafe to drive if you have RA. It simply means that there are differences in how RA patients drive and that these differences might be reduced with effective arthritis treatment."

He said larger studies need to examine whether RA treatments can improve driving further.

"We need to know exactly how the measures we used in this study translate in terms of actual outcomes such as motor vehicle crashes," Dr. Mikuls said.