ARA-290
ARA-290 (Cibinetide)
ARA-290 (Cibinetide) is a synthetic 11-amino acid peptide derived from the helix B surface peptide of erythropoietin (EPO), engineered to selectively activate the innate repair receptor (IRR) without binding to the classical EPO receptor, thereby avoiding erythropoietic effects. It is primarily investigated for its tissue-protective, anti-inflammatory, and neuroprotective properties, with clinical trials focusing on painful diabetic peripheral neuropathy, sarcoidosis-associated small fiber neuropathy, and inflammatory conditions. Research has shown meaningful reductions in neuropathic pain scores and improvements in corneal nerve fiber density in human trials.
Mechanism of Action
ARA-290 selectively binds to the innate repair receptor (IRR), a heterodimer composed of the EPO receptor and the beta common receptor (βcR), which is upregulated in injured and stressed tissues but expressed minimally in healthy tissue. Activation of the IRR triggers downstream signaling through JAK2/STAT3, PI3K/Akt, and NF-κB inhibitory pathways, resulting in reduction of pro-inflammatory cytokines (TNF-α, IL-1β, IL-6), promotion of cellular survival, and stimulation of neural repair including increased small fiber nerve density. Unlike EPO, ARA-290 does not activate the homodimeric EPO receptor and therefore does not stimulate red blood cell production or carry thrombotic risk associated with EPO therapy.
Evidence by Health Goal(12 goals)
Dosing Protocols
Subcutaneous injection, consistent daily timing preferred
Cycle: 12 weeks on, with reassessment; some protocols extend to 28 weeks based on clinical trial data
Dosage of 4mg/day subcutaneously is the most studied human dose from Phase 2 clinical trials in sarcoidosis-associated and diabetic small fiber neuropathy. Reconstitute lyophilized peptide with bacteriostatic water; rotate injection sites. This compound is research-use only and not FDA-approved.
Safety & Side Effects
ARA-290 has demonstrated a favorable safety profile in Phase 1 and Phase 2 clinical trials, with no serious adverse events attributed directly to the compound and no erythropoietic or thromboembolic effects observed at therapeutic doses. It is not FDA-approved and remains an investigational compound; use outside of clinical trials is unregulated, and long-term safety data beyond 28 weeks in humans is limited.
Possible Side Effects
- !Injection site reactions (mild erythema, transient stinging)
- !Mild fatigue or transient lethargy in early weeks of use
- !Headache reported in a subset of trial participants
- !Mild nausea, typically resolving within the first week
- !Dizziness or orthostatic hypotension (rare, transient)
- !Hypersensitivity or allergic reaction to peptide components (rare)
Interactions
- -May have additive anti-inflammatory effects when combined with corticosteroids or DMARDs, potentially allowing dose reduction of immunosuppressants — monitor closely
- -Theoretical synergy with other neuroprotective agents (e.g., alpha-lipoic acid, benfotiamine) in diabetic neuropathy protocols; combination safety not formally studied
- -May modestly lower blood pressure via anti-inflammatory vascular effects — use caution with antihypertensive medications
- -No known direct interaction with anticoagulants, but the absence of thrombotic risk distinguishes it from EPO; concurrent anticoagulant use does not require specific adjustment based on current data
- -Immunomodulatory effects may theoretically interfere with live vaccine responses — avoid concurrent live vaccination during active use
Cost & Where to Buy
ARA-290 is a specialty research peptide with limited vendor availability; pricing reflects research-grade lyophilized peptide from reputable peptide suppliers. Cost varies significantly by vendor, purity certification (HPLC), and batch quantity. Not available as a pharmaceutical product outside of trials.
Search on Amazon