Compounds / Healing

ARA-290

ARA-290 / Cibinetide (11-amino-acid non-erythropoietic EPO derivative; pyroGlu-Glu-Gln-Leu-Glu-Arg-Ala-Leu-Asn-Ser-Ser)

11-amino-acid synthetic peptide engineered from the helix B region of erythropoietin (EPO). Selectively binds the heteromeric 'innate repair receptor' (IRR: composed of EPO-receptor + βc-receptor) but NOT the classical homodimeric EPO-R. Result: tissue protection and anti-inflammatory effects WITHOUT erythropoiesis (no hematocrit increase), the key safety differentiator vs EPO.\n\nDeveloped by Araim Pharmaceuticals (now Lakewood-Amedex). Has FDA Orphan Drug designation for sarcoidosis-associated neuropathic pain. Multiple Phase 2 trials completed; no Phase 3 yet (as of 2026-05). One of the highest-quality evidence bases in the research-peptide space outside FDA-approved drugs.

At a glance

Half-life

~2 h Plasma half-life ~2 hours; tissue effect persists much longer due to receptor signaling cascade.

Routes

SubQ

Vial sizes

4 mg · 8 mg · 16 mg

Evidence base

3 studies 3 human

Mechanism

ARA-290 binds the innate repair receptor (IRR), a heteromer of EPOR + βcR (CSF2RB). This receptor is upregulated on damaged tissue. Activation produces: anti-inflammatory effects (reduced TNF-α, IL-6, suppressed NF-κB); cytoprotection (prevents apoptosis in vascular endothelium, neurons, cardiomyocytes); pro-regenerative effects (improved HbA1c, lipid profile, and PainDetect score in T2D neuropathy patients); small nerve fiber regeneration in sarcoidosis-associated neuropathy; corneal nerve fiber density increases documented via confocal microscopy; mitochondrial function support. NO erythropoiesis: does not bind EPOR homodimer that drives RBC production.

Dosing

Where a study reports an amount, it appears in that study's entry below, attributed to the source.

Published evidence

1. Human RCT 2018

   Cibinetide Improves Corneal Nerve Fiber Abundance in Patients With Sarcoidosis-Associated Small Nerve Fiber Loss and Neuropathic Pain

   Dahan A, et al. IOVS

   Direct corneal confocal microscopy evidence of small nerve fiber regeneration after cibinetide treatment.

2. Human RCT 2015

   ARA 290, a Nonerythropoietic Peptide Engineered from Erythropoietin, Improves Metabolic Control and Neuropathic Symptoms in Patients with Type 2 Diabetes

   Brines M, Dunne AN, van Velzen M, Proto PL, Ostenson CG, Kirk RI, Petropoulos IN, Javed S, Malik RA, Cerami A, Dahan A Mol Med

   4 mg SubQ daily for 28 days in T2D patients with neuropathy improved HbA1c, lipid profile, and PainDetect score (3.3 vs 1.1 placebo); increased corneal nerve fiber density. No hematological adverse effects.

   PMID 25387363

3. Human RCT 2012

   Safety and efficacy of ARA 290 in sarcoidosis patients with symptoms of small fiber neuropathy

   Heij L, Niesters M, Swartjes M, Hoitsma E, Drent M, Dunne A, Grutters JC, Vogels O, Brines M, Cerami A, Dahan A Mol Med

   28-day ARA-290 in sarcoidosis-associated small fiber neuropathy: significant improvement in pain scores and small nerve fiber regeneration. Safety established.

   PMID 23168581

Reported side effects

Injection site reaction

Common Mild · Mild local; consistent with peptide injectables.

No hematocrit increase (notable absence)

Very common Mild · Notable safety differentiator from EPO. Confirmed across all human trials at doses up to 8 mg daily for 28 days. Does not bind EPOR homodimer.

Headache

Occasional Mild · Trials.

Interactions

• EPO Caution

  Both engineered from EPO; ARA-290 is non-erythropoietic, EPO is. Combination not studied.

• BPC-157 Synergy

  Both pro-regenerative; complementary mechanisms (BPC-157 = angiogenesis + GH axis; ARA-290 = IRR tissue protection + nerve regeneration). Common biohacker stack for nerve injury recovery.

Reconstitution and storage

Lyophilized vial; reconstitute with 1-2 mL BAC water. At 4 mg/mL, a 4 mg draw is 1 mL.

Refrigerated reconstituted; lyophilized stable RT short-term.

Open the reconstitution calculator for ARA-290