Vagus Nerve Stimulation for Rheumatoid Arthritis and Beyond, Part 1

Dr. David Chernoff, Chief Medical Officer of Setpoint Medical, discusses electrically driven vagus nerve stimulation (VNS) as a “neuroimmune modulation” approach to autoimmune and inflammatory disease. Chernoff explains the vagus nerve’s sensory role in monitoring organs and signaling the brainstem and spleen to regulate immune responses, and how precise stimulation can reduce pro-inflammatory cytokines without immunosuppression. Setpoint’s miniaturized, wireless, MRI-compatible implant is placed in an outpatient 45-minute neck procedure and delivers one minute of daily stimulation titrated to an upper comfort level; long-term safety is supported by prior surgical experience and a 242-patient blinded RA study with two-year data, leading to FDA approval for rheumatoid arthritis. The discussion covers add-on use with medications, potential steroid tapering, reimbursement, and research in Crohn’s disease, relapsing MS (vision and remyelination), and other conditions, including psoriatic arthritis, lupus, and neurodegenerative diseases.