Rheumatoid Arthritis is an autoimmune condition affecting nearly 18 million people worldwide. The treatment of Rheumatoid Arthritis involves various drugs which have numerous side effects.
Recently, US FDA approved Vagus Nerve Stimulation (VNS) as a new treatment for rheumatoid arthritis.
What is vagus nerve stimulation ?
Vagus nerve is the longest nerve of our body which helps control heart rate, digestion, respiration and immune response. It plays a crucial role in regulating how our body fights infection or manages inflammation. This is the key when it comes to treating rheumatoid arthritis.
Vagus nerve stimulation uses an implanted device that delivers small electrical signals to the vagus nerve, thereby modifying how it works. In rheumatoid arthritis, these signals help in reducing inflammation. This technique isn’t new. Previously it has been used to treat epilepsy patients who did not respond to medicines.
How does VNS treat Rheumatoid arthritis?
Rheumatoid Arthritis is an autoimmune condition in which the body’s overactive immune system targets joint tissues causing pain, swelling, stiffness and eventually joint damage. Conventional treatment includes drugs that target the immune system thereby compromising immunity and rendering patients towards other infections.
On the other hand, VNS works differently. It acts through the inflammatory reflex to reduce the release of inflammatory markers like TNF and IL-6. Instead of suppressing the entire immune system, it helps the immune system to reset or calm down parts that are too active.
How is VNS performed?
A one inch long device is surgically implanted in the neck. It is positioned around the vagus nerve. Once the device is in place, it is programmed to stimulate the vagus nerve for one minute everyday. The device can be tuned and readjusted according to the patients needs without additional surgery.
Clinical outcomes and side effects
The VNS therapy has so far shown promising results in clinical trials with improvement in symptoms like pain and swelling.
The common side effects include hoarseness of voice which typically subsides in a few days or weeks. Surgical site infections have been rarely noted.
Final thought
Vagus nerve stimulation represents a paradigm shift in the management of rheumatoid arthritis. While long term results are needed to evaluate its efficacy, vagus nerve stimulation shows promising results for patients with moderate to severely active rheumatoid arthritis and particularly for those who demonstrate intolerance to medicines.
MBH/PS