For almost 4 a long time, San Antonio resident Susan Perry struggled to handle the power ache from her rheumatoid arthritis, an autoimmune illness that happens when the immune system mistakenly assaults the physique’s tissues and joints.
Perry, now 69, was identified in her early 30s and cycled by over a dozen medicines, attempting to stability discovering reduction and managing the uncomfortable side effects from the medication. At its worst, the power irritation made falling asleep difficult, and Perry required a stool to sit down on whereas volunteering at her church’s kitchen within the Crownridge space simply north of Six Flags.
In February, Perry grew to become the primary particular person in Texas to obtain a brand new jelly-bean-sized neuromodulation implant, the primary drug-free various for some sufferers with rheumatoid arthritis, referred to as the SetPoint System. It was accepted by the U.S. Meals and Drug Administration in July of final yr.
The system sits on her vagus nerve, sending electrical pulses and activating anti-inflammatory pathways to revive immune system stability. It has allowed Perry to ditch the stool at her church and sleep pain-free.
“I preserve ready to have some unhealthy days, however I’m not,” Perry mentioned. “I’m nonetheless amazed by it.”
Treating rheumatoid arthritis
Rheumatoid arthritis is a power autoimmune illness that causes irritation, ache and swelling and impacts roughly 1.3 million Individuals.
It disproportionately impacts ladies.
Initially from Indiana, Perry and her household moved to San Antonio in 1988. Perry was identified with rheumatoid arthritis shortly after, following years of unexplained stiffness, ache and fatigue.
“It was fairly scary at that time, being simply barely over 30, and never figuring out what would occur,” she mentioned.
Docs have been hesitant to begin her on medicine, which on the time got here with extra extreme uncomfortable side effects. However her flare-ups have been changing into extra extreme. She was struggling to face up and sit down in chairs and couldn’t play on the ground together with her younger kids.
“I just about broke down within the physician’s workplace and mentioned, ‘You recognize, I don’t care if I don’t stay as lengthy, I need to stay now,’” Perry mentioned.
She cycled by quite a few medicines through the years, together with gold injections, as soon as the go-to remedy for the illness, which have been largely changed by safer and simpler medicines. She has additionally tried 10 biologics, from a more moderen class of therapies that block particular elements of the immune system.
Many helped, however uncomfortable side effects and protracted signs remained.
“I’ve been by about all the pieces,” Perry mentioned.
The SetPoint implant, accepted in July 2025 to deal with reasonable to extreme rheumatoid arthritis, provided a brand new method for sufferers whose signs endured or who couldn’t tolerate the medicines’ uncomfortable side effects.
As an alternative of suppressing the immune system, the system sends delicate electrical pulses to the vagus nerve, a serious nerve concerned in regulating numerous bodily features and inflammatory responses.
A unique method to goal irritation
Dr. Daniel Peterson, a neurosurgeon at Ascension Medical Group Seton Neurosurgery, carried out Perry’s process at Dell Seton Medical Heart in Austin. He was additionally concerned within the SetPoint scientific trials.
Neuromodulation units have been round for many years, initially used to scale back the frequency of seizures in sufferers with drug-resistant epilepsy. Researchers took an interest within the vagus nerve after noticing that epilepsy sufferers who obtained vagus nerve stimulation additionally skilled enhancements in different circumstances they’d, like autoimmune circumstances, Peterson defined.
“What this system does is stimulate branches of the vagus nerve that affect these inflammatory pathways,” Peterson mentioned. “It doesn’t suppress the immune system, it modulates it again towards regular.”
The implant process itself is minimally invasive. Surgeons make a small incision within the left aspect of the neck and place the jelly-bean-sized system across the vagus nerve. Perry mentioned her surgical procedure lasted about quarter-hour and he or she was again residence earlier than lunch.
“I fastened dinner that night time,” she mentioned. “It was the simplest surgical procedure I’ve ever had.”
Sufferers cost the system wirelessly as soon as every week for about 5 minutes. Perry’s system prompts mechanically every morning round 4 a.m. whereas she sleeps, based mostly on settings programmed by her rheumatology crew.
Inside weeks of the process, Perry mentioned blood assessments confirmed her irritation ranges had dropped considerably.
Dell Seton grew to become the primary hospital in Texas to implant the system and one of many earliest websites nationwide to take part within the scientific trial, Peterson mentioned, enrolling 34 sufferers.
In a randomized scientific trial revealed earlier this yr, researchers reported sustained enhancements in illness exercise in sufferers with the system and comparatively few opposed occasions over a yr of follow-up. Some sufferers skilled short-term vocal wire weak point from the surgical procedure that later resolved.
Researchers are making ready scientific trials inspecting whether or not related neuroimmune modulation may assist deal with ailments akin to a number of sclerosis and Crohn’s illness. “There’s very promising preclinical information,” Peterson mentioned.
Nonetheless, Peterson mentioned broader adoption for rheumatoid arthritis could rely upon insurance coverage protection and whether or not rheumatologists grow to be extra snug referring sufferers for surgical procedure over drug therapies.
Perry was in a position to get her surgical procedure coated by Medicare, which accepted it for protection in November.
“The sufferers are those which might be finally going to drive the adoption,” Peterson mentioned.
