France Uveitis Combo Treatment

[Cushing2]

Hi Mike & Co.,

After many years of successfully fighting recurrent iritis/uveitis in the USA (Always with pred forte, with episodes usually cleared within 1 month) I am now on month 2 of a stubborn case that may not be getting solved due to a new treatment.
I am in France for the year and have been told by 3 separate Opthalmologists that Pred Forte simply isn't sold here. So I am using Dexafree (Deaxamethasone phosphate) drops. In addition, my current eye doc has me also taking a few drops of the NSAID Indomethacin daily. This is new to me and I am wondering if you could shed any light as to whether or not taking NSAID drops concurrently with steroid drops is a positive, a negative, or nonconclusive (in so far as its effectiveness in treating uveitis). As always, thanks for any insights.

[Mike Bartolatz]

NSAID eyedrops don't help with uveitis, Xibrom eyedrops help with cme associated with uveitis.
go to the specialist for contact information for ocular immunologists in France. oral NSAIDs may help but you have been on a steroid only protocol for so long it might be too late to try.
I don't know about availability of drugs in France but if they are available such as prednisilone acetate, generic for Pred forte, the real specialist will be able to prescribe for you.
I can't recall your history. have DMARD drugs been used to get you on a corticosteroid sparing approach to treatment?

http://www.uveitis.org patient information section of the site for INTERNATIONAL specialist list.

wish you the best,
Mike

[Cushing2]

Mike,

At the risk of showing my compete ignorance (which I now will do) could you please post a reply with a link to a decent explanation of DMARD protocol?

As a New Englander I visited Dr. Foster several years ago when he was at his old shop and it was recommended that I spend a couple of years on the then preferred cox-2 inhibitor, Vioxx. I held off as I have always been leery of systemic approaches to my uveitis. May have gotten lucky on that as my father's side has a history of heart disease and we all know what happened re. Vioxx.

Dr. Foster recently was good enough to recommend a couple of specialists to me in Paris, but Paris as I am far from Paris I turned to Dr. F's references to find a reference in my area. While I have not made it to the specific doctor I am being seen within her group so I think the docs I am seeing are the best I can do in my area.

Thank you for your opinion re. the topical NSAIDs. I am now trying to apply the kinds of regimen I would use with Pred Forte to the Dexafree. I find it interesting that many prescribed drugs in France do NOT have the preservatives that are common in drugs prescribed in the USA. My steroid drops come in "unidose" applicators that can be used to administer drops for up to 12 hours but then I am supposed to dispose of the balance and move on to the next one. The NSAID drops and the dilator drops I was prescribed come in 10ml bottles but clearly state to dispose of the unused amounts within 15 days as they are not preserved. While I like the idea of no preservatives these drugs, in particular the steroid drops, seem significantly less potent than Pred Forte.

Thanks again for your work and again, please let me know where I might read up on DMARDs,
Alex (Cushing2)

[Mike Bartolatz]

http://www.uveitis.org/medical/default.html

above is a link to Dr Foster's treatment protocol for non granulomatus (autoimmune) uveitis.

[Mike Bartolatz]

http://parsplanitisforum.yuku.com/topic/203

many articles on treatment are contained in the above link, new drugs that are experimental are in additional links here at iritis.org