T

he medicine for rheumatoid arthritis — an autoimmune inflammatory disease that afflicts joints — is expected to be available in Indonesia within the next few months after clinical trials involving several patients showed positive results.

Rachmat Gunadi Wachjudi, a doctor involved in the clinical trials at Hasan Sadikin Hospital in Bandung, West Java, said that he was waiting for approval from the Food and Drug Monitoring Agency before distributing the medicine to the public for wider use.

“There are about one million people who suffer from rheumatoid arthritis in Indonesia. However, most of them think that they have common rheumatism,” Rachmat said at a media health forum here last Friday.

The United States and several European and Asia-Pacific countries had approved the medicine — called tocilizumab or actemra — as a standard treatment. Tocilizumab slows down the activity of interleukin 6 (IL-6), a protein that causes painful inflammation. Rachmat cited clinical trials in Indonesia, which are supported by PT Roche Indonesia, an affiliate of Switzerland-based healthcare company Roche Group, showed tocilizumab had successfully helped several patients.

The trials had been conducted in a number of places in Indonesia since February this year, including Jakarta, Bandung, Surabaya, Malang and Yogyakarta.

One of the patients attending the forum, Eva Febriyanti, 19, testified that she felt an improvement after the second injection of tocilizumab. “I had felt pain when I moved my hands or legs before. After the second injection, I can now squat,” said Eva, who was diagnosed with rheumatoid arthritis three years ago.

Regarding the positive results, the Indonesian monitoring agency is expected to grant approval next month, so that the medicine should be available in Indonesia by July or August. The treatment is expected to cost around Rp 9 million (US$1,050) per injection.

Although the medicine to slow the ailment has been found, the exact cause of rheumatoid arthritis is still unknown.

According to Brawijaya Univeristy Department of Internal Medicine expert Handono Kalim, rheumatoid arthritis is a type of rheumatism caused by autoimmune failure. “There are many types of rheumatism. The causes are also numerous, about 90,” Handono said at the forum.

The human immune system normally attacks foreign substances. According to Handono, instead of fighting the foreign substance, in this case the immune system confuses differentiation of healthy tissue with foreign substances. When this happens, the body actually attacks itself. That is why those with rheumatoid arthritis will likely suffer other illnesses, such as heart or liver disease.

Differentiating rheumatoid arthritis from other forms of rheumatism is apparently not easy. According to Rachmat, people must be cautious if they experience joint pain for more than six weeks, particularly if joint stiffness and inflammation occurs in the hands. (rcf)