Sirolimus + ranibizumab

Sirolimus + ranibizumab is a combination therapy under investigation for the treatment of retinal diseases, particularly neovascular (wet) age-related macular degeneration (wAMD). Sirolimus, also known as rapamycin, is a small molecule immunosuppressant and mTOR inhibitor with anti-inflammatory, antiproliferative, antifibrotic, and antiangiogenic properties. It acts by inhibiting the mammalian target of rapamycin (mTOR), thereby suppressing cell growth and angiogenesis through downregulation of hypoxia-inducible factor 1-alpha (HIF-1α) and vascular endothelial growth factor (VEGF) production[1][3][6]. Ranibizumab is a recombinant humanized monoclonal antibody fragment that binds to VEGF-A isoforms with high affinity, preventing their interaction with VEGF receptors on endothelial cells and thus inhibiting pathological angiogenesis in the retina[5]. The combination aims to synergistically disrupt multiple pathways involved in wAMD pathogenesis—autophagic dysfunction, oxidative stress, and angiogenesis—offering improved efficacy over monotherapy by targeting both upstream regulators of VEGF production (sirolimus/mTOR/HIF pathway) and direct VEGF activity at the receptor level (ranibizumab)[4].

Brand names

Susvimo

Other names

rapamycin (for sirolimus)