

Treatment for Rheumatoid Arthritis is Evolving.
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The Essential Role of the Vagus Nerve
The nervous system and the immune system have close bidirectional communication to maintain homeostasis, or setpoint, of immune system. The vagus nerve plays a critical role in the modulation of inflammation through the inflammatory reflex.
The afferent vagus nerve responds to inflammatory mediators and sends signals to the brainstem, where a signal originates and is transmitted by the efferent vagus nerve to the splenic nerve causing the release of norepinephrine in the spleen. CD4+ T lymphocytes expressing the β2 adrenaline receptor uptake the norepinephrine and release acetylcholine, which inhibits the production of various proinflammatory cytokines in macrophages without systemic immunosuppression.


Neuromodulation to Regulate Inflammation
SetPoint Medical's microregulator is designed to deliver precise, targeted electrical pulses to activate the intrinsic inflammatory reflex. Based on prior clinical experience, this pathway has shown promise as a potential treatment alternative for chronic autoimmune diseases like rheumatoid arthritis.
CLINICAL RESEARCH STUDY
The RESET-RA study is designed to evaluate the safety and effectiveness of SetPoint's investigational vagus nerve stimulation device for treatment of adult patients with active, moderate-to-severe rheumatoid arthritis who have had an inadequate response or intolerance to at least one biologic DMARDs or JAK inhibitors.
Additional information about the study can be seen at Clinicaltrials.gov.

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KEY PUBLICATIONS
Vagus nerve stimulation inhibits cytokine production and attenuates disease severity in rheumatoid arthritis
Read MoreThe cholinergic anti-inflammatory pathway: towards innovative treatment of rheumatoid arthritis
Read More

The Inflammatory Reflex
Read MoreRethinking inflammation: neural circuits in the regulation of immunity
Read MoreNeural reflexes in inflammation and immunity
Read MoreCAUTION – Investigational device. Limited by United States law to investigational use.