Rheumatoid Arthritis (RA) is a chronic autoimmune disease caused by excessive inflammation. The immune system typically uses inflammation in the body to attack infections caused by bacteria and viruses; but in autoimmune diseases like RA, inflammation attacks healthy tissue in the body which causes joint pain and swelling. Untreated RA can cause permanent damage to the joints, which can result in physical disability.
There is currently no cure for RA but medications known as disease-modifying antirheumatic drugs — referred to as DMARDs — can improve joint pain and swelling, improve comfort and function in day-to-day activities and slow the progression of joint damage.
There are multiple types of DMARDS – conventional synthetic, biologic and targeted synthetic.
Conventional synthetic DMARDs include:
- Baricitinib (Olumiant)
- Hydroxychloroquine (Plaquenil)
- Leflunomide (Arava)
- Methotrexate (Rheumatrex, Trexall, Otrexup, Rasuvo)
- Sulfasalazine (Azulfidine)
If patients do not initially respond to or eventually stop responding to conventional synthetic DMARDs, biologic or targeted synthetic DMARDs can provide additional treatment options.
Biologic and targeted synthetic DMARDs include:
- Abatacept (Orencia)
- Adalimumab (Humira)
- Anakinra (Kineret)
- Certolizumab (Cimzia)
- Etanercept (Enbrel)
- Golimumab (Simponi)
- Infliximab (Remicade)
- Rituximab (Rituxan, MabThera)
- Sarilumab (Kevzara)
- Tocilizumab (Actemra)
- Tofacitiniib (Xeljanz, Xeljanz XR)
- Upadacitinib (Rinvoq)
Many RA patients are still not adequately treated with or are intolerant to biologic or targeted synthetic DMARDS. These therapies can have serious side effects and are expensive.
The research in the RESET-RA study will help determine if an investigational vagus nerve stimulation device is safe and can improve RA in patients who continue to experience symptoms even after having tried multiple medications.