Transcutaneous auricular vagus nerve stimulation beneficial in pediatric IBD

For pediatric patients with mild-to-moderate inflammatory bowel disease, transcutaneous auricular vagus nerve stimulation (ta-VNS) attenuates signs and symptoms of disease, according to a study published online Oct. 18 in Bioelectric Medicine.

Benjamin Sahn, M.D., from the Steven & Alexandra Cohen Children's Medical Center at Northwell Health in New Hyde Park, New York City, and colleagues randomly assigned patients aged 10 to 21 years with mild/moderate Crohn disease (CD) or ulcerative colitis (UC) and fecal calprotectin (FC) >200 µg/g within four weeks of study entry to receive either ta-VNS targeting the cymba conchae of the external left ear or sham stimulation of 5 minutes in duration once daily for two weeks, followed by crossover to the alternative stimulation.

All participants received a ta-VNS of 5 minutes in duration twice daily at week 4 until week 16.

Twenty-two patients were enrolled: 10 with CD and 12 with UC. The researchers found that among the 12 patients with active symptomatic disease indices at baseline, clinical remission was achieved in three of six (50 percent) and two of six (33 percent) with CD and UC, respectively, at week 16.

Five patients were excluded from the FC analysis due to FC levels <200 µg/g at baseline. Of the remaining 17 patients, 11 (64.7 percent) with baseline FC ≥200 µg/g had a ≥50 percent reduction in FC at week 16. The median reduction in FC versus baseline was 81 and 51 percent in the UC and CD patients, respectively, at 16 weeks. No safety concerns were reported.

"Neuromodulation therapies such as vagus nerve stimulation have the potential of becoming an important tool in the treatment toolbox for patients with IBD," the authors write.

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