How tiny electrical implants could treat rheumatoid arthritis – New Atlas

Could the future of rheumatoid arthritis treatment be a small implant designed to deliver bursts of electrical stimulation to a key nerve that can regulate the body’s inflammatory reflex? A flurry of research around the world is investigating this compelling idea, with large-scale clinical trials underway testing several kinds of novel implants.

Running from the brainstem down to the abdomen through the neck and chest, the vagus nerve is a large conduit that communicates signals between the brain and the body. Electrically stimulating this nerve using small implants is already approved by the US Food and Drug Administration (FDA) to treat some forms of epilepsy and depression.

Plus, a great deal of research has focused on how the vagus nerve mediates communication between the gut and the brain. This has led to the development of small devices designed to suppress a person’s appetite by gently stimulating the vagus nerve, tricking the brain into thinking the gut is full.

More recently, researchers have discovered yet another role of the vagus nerve – communicating to the brain when the body is experiencing inflammation. The research has revealed the vagus nerve can act as a brake for the immune system, sending signals to the spleen slowing down its release of inflammatory molecules.

Last year, the results of the first in-human pilot study testing a vagus nerve stimulation device for rheumatoid arthritis were published. The study was small but the results were promising, with no device-related or treatment-related serious adverse events. And, more importantly, the treatment reduced signs and symptoms of rheumatoid arthritis in the small cohort.

The world’s first large-scale Phase 3 trial testing this experimental arthritis therapy kicked off this year. Set to recruit 250 subjects, spanning 40 sites across the United States, the trial will be the first to robustly test whether vagus nerve stimulation can treat this common auto-immune disease.

Andrew Ko, a neurosurgeon from the University of Washington, says the device being tested in the trial is about the size of a vitamin tablet and it’s surgically inserted through a small incision in the neck. The implant can be recharged wirelessly by wearing a small collar-like device for an hour each week.

The trial will be blinded and placebo-controlled, with half the cohort randomly assigned to a placebo group that will receive the surgical implant but not be administered any electrical stimulation. And the stimulation being tested will only consist of one minute of activation per day.

“These low-voltage stimulations will be administered at night while patients are asleep, so they won’t even notice it,” explains Ko.

The trial is set to last around three years to account for long-term safety and efficacy data. However, the active intervention period will only span 12 weeks. Ko also …….

Source: https://newatlas.com/medical/rheumatoid-arthritis-electrical-stimulation-vagus-nerve/