Transcutaneous auricular vagus nerve stimulation (ta-VNS) is a safe and effective therapeutic option to improve symptoms in children and young adults with mild to moderate inflammatory bowel disease (IBD), according to new research presented at the Advances in Inflammatory Bowel Diseases (AIBD) 2021 Annual Meeting held in December last year.

The study enrolled 22 patients, aged 10-21 years, who had failed to achieve disease remission with standard treatment and had fecal calprotectin levels more than 200 µg/g within 4 weeks of study entry. Out of these,12 had ulcerative colitis and 10 had Crohn′s disease. The patients were initially treated with either ta-VNS using a cutaneous electrical nerve stimulator unit targeting the left ear or sham stimulation of the posterior lower leg every day for 5 minutes for a of period 2 weeks. The patients then interchanged to the alternative stimulation for 2 weeks. After the fourth week, all patients received active ta-VNS for 5 minutes twice daily until week 16. The weighted Pediatric Crohn Disease Activity Index (wPCDAI) or Pediatric Ulcerative Colitis Activity Index (PUCAI) were used to measure disease activity. The primary endpoint of the study was ≥50% reduction in levels of fecal calprotectin at the end of follow up at week 16 compared to baseline. The median baseline FC was 587 μg/g. Results showed that two (33%) out of the six patients with ulcerative colitis and baseline PUCAI score >10 achieved clinical remission at week 16. Three patients with Crohn’s disease also had remission of disease (wPCDAI ≤ 10) at week 16. No safety concerns were noted.

Vagal nerve stimulation (VNS) is an investigational Bioelectronic Medicine therapy, which acts on the nervous system. It has anti-inflammatory properties and exerts its beneficial effects by attenuating the inflammatory process in patients with IBD. There is only limited data available on its use in humans with cervically implanted VNS device in adults with Crohn disease. For the first time, this study has demonstrated that the noninvasive technique of ta-VNS reduced fecal calprotectin levels and improved symptoms in children with mild or moderate IBD. However, the authors suggest the need for more research to find out the optimum dose and settings to obtain the maximum anti-inflammatory activity.

Sahn B, et al. Am J Gastroenterol. 2021 Dec 1; 116(Suppl 1):S19.