Abstract

COMPARATIVE EVALUATION OF FENOFIBRATE, METFORMIN, AND HERBAL DRUG COMBINATION AGAINST BEVACIZUMAB FOR ANTI-VEGF ACTIVITY IN DIABETIC RETINOPATHY

Sonam*, Dr. Bhanu Pratap Singh Sagar and Dr. Amrita Singh

Abstract

Over 100 million people globally (6% of the population) suffer from Diabetes mellitus (DM) is the most prevalent endocrine condition. It’s brought on by inefficient insulin secretion by the pancreas, which raises or lowers blood glucose levels which causing harm to numerous body systems, especially the kidney, heart, blood vessels, eyes, and nerves. A monoclonal anti-VEGF antibody, designated bevacizumab, is frequently used to treat DR. It is a very effective therapy, but also has some issues, such as its long-term effectiveness, ocular side effects, and the requirement for repeated intravitreal injections. In this preclinical study, we are using a combination of herbal and conventional drugs to design a combinational drug therapy that shows some promising results against VEGF in Wistar rats. The PPAR-α agonist fenofibrate has lipid-lowering and anti-inflammatory properties. Curcumin, a potent antioxidant, reduces inflammation and oxidative stress, whereas berberine, an AMPK activator, modulates glucose metabolism and VEGF signalling. According to preliminary results, FMBC treatment is as effective as or more effective than bevacizumab in reducing VEGF expression, preventing neovascularization, and maintaining retinal shape. However, it also has its limitations and side effects. Therefore, we combine it with herbal drugs such as Curcuma longa and berberine to counter these limitations and side effects. We also use metformin for better results, as fenofibrate has no anti-diabetic effect. Furthermore, FBC reduces inflammatory damage and strengthens antioxidant defence systems, indicating a neuroprotective function in DR. This study demonstrates the possibility of FMBC combination therapy to provide more efficient, safer, and expedited or accelerated therapy for diabetic retinopathy.

Keywords: Diabetic Retinopathy, Anti-VEGF activity, Bevacizumab, PPAR-α agonist, AMPK activator, Curcumin, Neo-vascularization.