Neck implant may treat rheumatoid arthritis

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A pacemaker-like chip implant may be the future treatment for rheumatoid arthritis. Starting in August, the Academic Medical Centre (AMC) in Amsterdam will study whether surgically implanting an electrical device in a patient’s neck can inhibit the inflammation of joints, a common side-effect of the disease.

“This is a whole new way of treating rheumatoid arthritis,” says study supervisor and AMC Professor of Rheumatology Paul-Peter Tak.

Joint inflammation
About one percent of the world population suffers from rheumatoid arthritis. In the Netherlands, there are 150,000 cases. The disease is a life-long condition that causes constant pain in joints. According to Professor Tak, the symptoms come from interactions between the nervous and immune systems.

Patients from several European countries will be involved in the study and have the chip implanted in the vagas nerve of their neck. The nerve is responsible for respiratory control and heart rate.

By sending electrical stimuli to the nerve for approximately one minute a day, inflammation can be inhibited, says Professor Tak. “As a result, there are fewer complaints of pain and swelling. But more impressive is that you put the brakes on the damage that occurs to the joints.”

The extent of that damage, he says, can ultimately determine whether or not a patient will be bound to a wheelchair.

Natural balance
The Dutch researchers are working with an American company in developing the chip. Indeed, much of the original research into the relationship between nerves and the immune system has been done in the United States. The method’s application in rheumatic fever, however, was discovered in the Netherlands.

Already, the device has been proven to work against rheumatism in rats and mice. “If it works just as well in patients with rheumatoid arthritis, then you can imagine that this approach can recover the natural balance that is disrupted in people with the disease,” Professor Tak says.

Furthermore, the approach involves the use of little or no medication at all.

Cautious optimism
The Dutch Arthritis Association is cautiously optimistic about the chip. According to Ingrid Lether, who works with the organisation, the method has a great advantage. Implanting the pacemaker-like device is a known technique, so it can be applied quickly. Something that isn’t possible when developing drug treatments that require lengthy clinical trials.

“That makes it something that can be applied very quickly in clinical practice. If this study shows evidence that it really works, then it can be used in the very near future,” she says.  

Ten patients from Amsterdam will be involved in the study, which will last for two months. Professor Tak hopes to publish the results next year.