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The Lancet Rheumatology Publishes Pilot Clinical Data Showing Promising Efficacy and Safety Profile for E-mmunotherapy in Rheumatoid Arthritis Patients

Fifty-three percent (53%) of patients receiving e-mmunotherapy, using the Nēsos earbud-shaped neural interface, had a meaningful reduction in disease activity after three months, while 37% of patients achieved low disease activity and 23% of patients achieved remission.


The Lancet Rheumatology published data from a pilot clinical study evaluating the Nēsos developed e-mmunotherapy treatment in a cohort of rheumatoid arthritis patients. Patients with moderately to severely active rheumatoid arthritis (RA) despite treatment with conventional synthetic disease-modifying antirheumatic drugs (csDMARD) received daily e-mmunotherapy. E-mmunotherapy provides engineered neural input, electrical pulse sequences delivered from purpose-designed earbuds to activate the cholinergic anti-inflammatory pathway.

The study demonstrated a meaningful reduction in the signs of symptoms of RA in 53% of the treated patients after three months based on the American College of Rheumatology (ACR) response criteria (ACR20). In addition, 37% of patients achieved low disease activity, while 23% achieved remission (as defined by the disease activity score cutoffs of DAS28-CRP less than or equal to 3.2 and DAS28-CRP less than 2.6 respectively). Significant improvement in patient-reported outcomes suggests that the device might help address key unmet needs for patients with rheumatoid arthritis, such as those concerning pain and sleep. Almost two-thirds of patients saw improvements in their ability to fall asleep at night, and 70% of patients had a reduction in the number of times pain woke them up at night.

“If this data is validated in further clinical testing, e-mmunotherapy can provide a viable new therapeutic option for rheumatoid arthritis patients. The potential for meaningful clinical benefit plus an improved side effect profile, compared to biologic therapies like TNF-alpha inhibitors or synthetic DMARDs like JAK inhibitors, drive future development efforts,” said Professor Sara Marsal MD, University Hospital Vall d’Hebron, Barcelona, Spain, and principal investigator in this first human multicenter study.

Eighty-five percent reported they were either satisfied or very satisfied with using the device and 93% of patients reported that they saw some level of improvement in activity, symptoms, emotions, and overall quality of life. One device-related adverse event, a superficial skin abrasion at the site where the earpiece contacted the ear, was resolved without intervention.

“We are very excited by the data thus far and think this approach could provide real benefit for patients in the future,” added Dr. Matthew Baker, MD Clinical Chief, Division of Immunology and Rheumatology, Stanford University, and an advisor to Nēsos. “The overwhelmingly positive feedback we have received from patients has been great to see. We look forward to taking the next steps in further understanding the potential this device has to offer.” 

Based on the pilot study results, Nēsos has initiated an upcoming double-blind, randomized, sham-controlled trial at multiple study sites in the United States. 

Full results published in The Lancet Rheumatology available online here

About Nēsos
Leveraging neuroscience research, Nēsos aims to treat diseases by restoring neurological pathways that control immune function. Neuroplasticity altering electrical fields, delivered by a noninvasive brain interface, are used to activate target brain pathways. Nēsos is guided and supported by clinical and scientific collaborators from top academic institutions, including Stanford, Vall d’Hebron, Harvard, Mount Sinai, Feinstein Institute, University of California, San Diego, and the University of California, San Francisco. For more information, visit


 Rheumatoid Arthritis
 Lancet Rheumatology
 Clinical Data

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