Rheumatoid arthritis is a debilitating autoimmune disease that causes chronic inflammation of the joints. Over time, painful swelling may destroy joints in the hands, feet and extremities, which can lead to disability.
There’s no cure for rheumatoid arthritis and current treatment options have big downsides. But help may soon be available for millions of sufferers in the form of an entirely new field of medicine known as bioelectronics.
Bioelectronics and anti-inflammatory medicine
A new approach in the fight against rheumatoid arthritis may come in the form of an implant known as a miniature neuromodulation device. During a 30-minute procedure the device is attached to a patient’s vagus nerve, which runs from the brain down the left side of the neck and into the chest and abdomen. The vagus nerve, comprised mostly of sensory nerve fibers, transmits important information about organ function to the brain and helps monitor the body’s inflammatory processes.
Early clinical trials show that by using the neuromodulation implant to send electronic impulses to the vagus nerve at precise intensities and intervals, it can mimic a drug’s anti-inflammatory benefits without the side effects.
For most patients in the study, arthritic pain began to subside after a week or two. In addition, participants’ swollen joints shrank and blood tests revealed significant declines in inflammatory markers. The implant is controlled, updated and recharged using an iPad app, which communicates with a wearable collar around the patient’s neck.
Current treatments
Today, doctors prescribe powerful drugs to treat rheumatoid arthritis. While these medications can reduce inflammation, relieve pain or prevent or slow damage to joints, they often come with serious side effects.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) can lead to heart problems or kidney or liver damage.
• Corticosteroid medications such as prednisone can provide even more relief but may lead to diabetes or thinning of bones.
• Newer drugs known as disease-modifying antirheumatic drugs (DMARDs) slow the progression of the disease but can open the door to lethal infections.
While physical therapy can teach people with rheumatoid arthritis how to protect their joints, it is of little use if the disease has already destroyed those joints. In those cases, the only remaining option may be surgery. Surgical procedures for rheumatoid arthritis include:
• Total joint replacement: A procedure in which the surgeon removes damaged parts of the joint and replaces them with a plastic or metal prosthesis.
• Tendon repair: Fixes tendons around joints that have been loosened or damaged by inflammation.
• Joint fusion: May be necessary when joint replacement isn’t an option. Fusing the joints can realign and stabilize them to reduce pain.
The future
If the field of bioelectronics takes off (it already has powerful backers including pharmaceutical giant GlaxoSmithKline), it could be used to treat other autoimmune diseases such as Crohn’s disease.
What once was considered science fiction might soon become a fact of life for millions of people suffering from chronic diseases.
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Michael Kerr writes about healthcare, technology and business for publications including Forbes.com, Portland Business Journal and Bplans, among many others.