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Aflibercept + spironolactone is a combination therapy approach that utilizes two medications with different mechanisms of action. Aflibercept is a recombinant fusion protein consisting of portions of VEGF receptors 1 and 2 fused to the Fc portion of human IgG1. It functions as a soluble decoy receptor that binds VEGF-A with greater affinity than its natural receptors, preventing subsequent binding and activation of native VEGF receptors. This reduces angiogenesis and vascular permeability. Spironolactone is an aldosterone receptor antagonist that competitively binds to mineralocorticoid receptors, producing a potassium-sparing diuretic effect. It has been found to reduce signs of choroidal neovascularization in patients refractory to anti-VEGF therapy. The combination may offer benefits in treating certain ocular conditions, particularly in cases where anti-VEGF therapy alone is insufficient.
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