Stimulating Vagus Nerve Proves to Reduce Rheumatoid Arthritis Symptoms


A pilot study presented this weekend at EULAR suggests that electro stimulation of the vagus nerve reduces rheumatoid arthritis symptoms.

A pilot study presented this weekend at the European Congress of Rheumatology (EULAR) annual meeting in Madrid, suggests that electro stimulation of the vagus nerve reduces rheumatoid arthritis symptoms.

“This is a really exciting development. For many patients suffering from rheumatoid arthritis, current treatments don’t work or aren’t tolerated,” said Thomas Dörner, M.D., the Scientific Programme Committee chairman. “These results open the door to a novel approach to treating not only rheumatoid arthritis, but other chronic inflammatory diseases. This is certainly an area for further study.”

Recent advances in neuroscience and immunology have mapped circuits in the brain that regulate immune responses. In one of the circuits, signals are transmitted in the vagus nerve that inhibit the production of cytokines including that of the tumor necrosis factor (TNF), a rheumatoid arthritis treatment target.

This was a pilot study of 14 rheumatoid arthritis patients in which a novel miniature neurostimulator was implanted into the vagus nerve of each patient. Previously, they had failed at least two biologics or oral therapies. Patients were randomized into three groups:  placebo, stimulated once daily, or stimulated four times a day for 12 weeks.

By the study’s end, patients who received once-daily stimulation were shown to have a better response than those receiving four-times-daily stimulation with two-thirds meeting the EULAR good or moderate response criteria and a mean change in DAS28-CRP of -1.24. The mean change in DAS28-CRP in the placebo group was 0.16.

“Our pilot study suggests this novel device (MicroRegulator) is well tolerated and reduces signs and symptoms of rheumatoid arthritis,” said Mark Genovese, M.D., of Stanford University. “These data support the study of this device in a larger placebo-controlled study as a novel treatment approach for rheumatoid arthritis and possibly other chronic inflammatory diseases.”

Mark C. Genovese, Norman Gaylis, David Sikes, et al. "First-in-human study of novel implanted vagus nerve stimulation device to treat rheumatoid arthritis." EULAR 2019. Abstract: LB0009

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