Nerve Stimulation Reduces Rheumatoid Arthritis Symptoms

Vagus nerve stimulation may prove an effective RA treatment strategy.

Data from a clinical trial published in the Proceedings of the National Academy of Sciences (PNAS) found that vagus nerve stimulation significantly reduced rheumatoid arthritis (RA) symptoms.

To reduce RA symptoms, cytokine levels, and inflammation, researchers implanted a stimulation device on the vagus nerve during a surgical procedure. The device was activated and deactivated based on a set schedule.

A standard disease activity composite score for RA called DAS28-CRP was used to measure response over 84 days, with primary endpoints measured at day 42. The results of the study showed that out of 17 RA patients, there were several who demonstrated robust responses, despite not having responded to multiple therapies that included biologics with different mechanisms of action.

This indicates that active stimulation of the vagus nerve inhibits TNF production, resulting in the significant reduction of the severity of RA.

“This is the first study to evaluate whether stimulating the inflammatory reflex directly with an implanted electronic device can treat RA in humans,” said Paul-Peter Tak, MD, PhD, FMedSci. “We have previously shown that targeting the inflammatory reflex may reduce inflammation in animal models and in vitro models of RA. The direct correlation between vagus nerve stimulation and the suppression of several key cytokines like TNF as well as reduced RA signs and symptoms demonstrates proof of mechanism, which might be relevant for other immune-mediated inflammatory disease as well.”

There were also some patients who reported significant improvements, including some patients who had previously failed to respond to any other form of pharmaceutical treatment. Furthermore, there were no serious adverse events reported.

“This is a real breakthrough in our ability to help people suffering from inflammatory diseases,” said study co-author Kevin J. Tracey, MD. “While we’ve previously studied animal models of inflammation, until now we had no proof that electrical stimulation of the vagus nerve can indeed inhibit cytokine production and reduce disease severity in humans. I believe this study will change the way we see modern medicine, helping us understand that our nerves can, with a little help, make the drugs that we need to help our body heal itself.”

Although RA was the primary focus of the study, the results may have implications for Crohn’s disease, Parkinson’s disease, Alzheimer’s disease, and other inflammatory diseases.

Currently, SetPoint Medical is developing a novel proprietary bioelectronic medicine platform by using an implanted device that stimulates the vagus nerve in order to treat different immune-mediated inflammatory diseases.

Bioelectronic medicine is an emerging field that looks to target disorders by using advanced neuromodulation devices instead of using drugs for treatment that may offer significant advantages.

“Our findings suggest a new approach of fighting diseases with bioelectronics medicines, which use electronical pulses to treat diseases currently treated with potent and relatively expensive drugs,” said Anthony Arnold, chief executive officer of SetPoint Medical. “These results support our ongoing development of bioelectronics medicines designed to improve the lives of people suffering from chronic inflammatory diseases and give health care providers new and potentially safer treatment alternatives at a much lower total cost for the health care system.”