Rock Creek Pharmaceuticals Inc. (fka RCPIQ)

[seek the light]

http://www.jwatch.org/na41776/2016/07/19/vagus-nerve-stimulation-improves-symptoms-and-signs?ijkey=L6No9EiLizDL6&keytype=ref&siteid=jwatch&variant=full-text

ON THE HORIZON
July 19, 2016
Vagus Nerve Stimulation Improves Symptoms and Signs in Rheumatoid Arthritis
Anthony L. Komaroff, MD reviewing Koopman FA et al. Proc Natl Acad Sci U S A 2016 Jul 5.
VNS devices diminish proinflammatory cytokine production.

Animal studies have indicated that vagus nerve stimulation (VNS) ? an established therapy for epilepsy ? diminishes proinflammatory cytokine production. Researchers tested the hypothesis that lower cytokine production also benefits patients with rheumatoid arthritis (RA).

European investigators first confirmed that VNS greatly reduced production of tumor necrosis factor (TNF), interleukin (IL)-6, and IL-1ß in 7 epilepsy patients with newly implanted VNS devices. Then, they implanted VNS devices in two cohorts of patients with RA: Cohort 1 was 7 patients with active disease, despite methotrexate therapy and no past treatment with biologics; cohort 2 was 10 patients with severe RA who had not responded to methotrexate plus biologics.

VNS devices were turned on and off for varying intervals during 84 days of follow-up. When on, inflammatory cytokine production dropped and RA activity improved; when off, the reverse happened. On day 42, 57% of patients in cohort 1 and 30% of patients in cohort 2 had achieved a 50% response (by American College of Rheumatology criteria). No serious adverse effects of VNS were reported.

COMMENT

Whether VNS devices eventually will become a treatment option for patients with RA is unclear. However, this finding likely will promote study of the mechanisms by which VNS improves RA and hopefully will lead to less-invasive treatments that can achieve the same result. Our growing understanding of the communication between the nervous and immune systems is pointing toward novel therapies.

EDITOR DISCLOSURES AT TIME OF PUBLICATION

Disclosures for Anthony L. Komaroff, MD at time of publication