Vagus Nerve Stimulation for Moderate to Severe Rheumatoid Arthritis

Inclusion Criteria: * 22-75 years of age at screening * Active moderate or severe RA, defined as at least 4/28 tender and 4/28 swollen joints * Demonstrated an inadequate response, loss of response, or intolerance to 1 or more approved for rheumatoid arthritis biologic or targeted synthetic Disease-Modifying Anti-Rheumatic Drugs (DMARDs), including Janus kinase inhibitors (JAKi) * Receiving treatment with at least 1 conventional synthetic DMARD for at least 12 weeks and on a continuous non-changing dose and route of administration for at least 4 weeks prior to Screening and able to continue the same stable dose through Week 12 Exclusion Criteria: * Untreated or poorly controlled psychiatric illness or history of substance abuse * Significant immunodeficiency due to underlying illness * History of stroke or transient ischemic attack, or diagnosis of cerebrovascular fibromuscular dysplasia * Clinically significant cardiovascular disease * Neurological syndromes, including multiple sclerosis, Alzheimer's disease, or Parkinson's disease * Uncontrolled fibromyalgia * History of left or right carotid surgery * History of unilateral or bilateral vagotomy, partial or complete splenectomy * Recurrent vasovagal syncope episodes * Current, regular use of tobacco products * Hypersensitivity/allergy to MRI contrast agents and/or unable to perform MRI