ARA-290
Also called Cibinetide
An investigational peptide studied for small-fiber nerve damage (neuropathy). Early trials showed changes in some nerve measurements, but not a confirmed pain benefit.
Overview
What it is
A peptide engineered from erythropoietin (EPO) to keep its tissue-protective signaling without stimulating red blood cell production.
How it works
It activates the "innate repair receptor," a signaling system involved in responses to tissue injury.
What the research shows
In a 2012 pilot in sarcoidosis-related neuropathy, one screening score improved more than placebo, but pain scores improved in both groups equally. In a 2017 phase 2b trial, only the middle dose improved corneal nerve-fiber measurements, and the pain result was not statistically significant. A study in type 2 diabetes reported better HbA1c and symptom scores over 28 days.
Studied for
- Sarcoidosis-related small-fiber neuropathyphase 2
- Neuropathic symptoms in type 2 diabetessmall study
Safety and regulatory status
Safety and side effects
Short studies found no major safety signals, but they cannot rule out rare or delayed problems. Avoiding EPO's blood effects does not mean it has no other risks.
Regulatory status
Not FDA approved. EMA orphan designation for sarcoidosis, which is not marketing approval.
Mixing and dosing reference
Reference information only. Read before using this section.
ARA-290 (10 mg Vial) Dosage Protocol
- Vial
- 10 mg ARA-290
- Add diluent
- 2 mL
- Concentration
- 5 mg/mL
- 1 unit (U-100)
- 50 mcg in 0.01 mL
- Route
- Subcutaneous
Human Study Calculation
| Period | Amount per Administration | U-100 Units (mL) |
|---|---|---|
| Days 1–28 | 4 mg (4,000 mcg) | 80 units (0.80 mL) |
How to mix
- Clean the peptide-vial stopper and diluent-vial stopper with alcohol, then allow both to dry.
- Draw exactly 2.0 mL of bacteriostatic water with a new sterile syringe and inject it slowly down the inside wall of the peptide vial.
- Gently swirl or roll the vial until the contents are dissolved. Do not shake.
- Label the vial with the compound, 5 mg/mL concentration, and preparation date. Store it according to verified product-specific instructions.
Dosing details
- Published human studies used distinct research designs rather than one universal ARA-290 regimen.
- Type 2 diabetes with painful neuropathy: 4 mg subcutaneously once daily for 28 days.
- Sarcoidosis pilot: 2 mg intravenously three times weekly for four weeks.
- Sarcoidosis dose-ranging study: 1, 4, and 8 mg subcutaneous arms administered for 28 consecutive days.
- Calculation scope: The primary table converts only the cited 4 mg subcutaneous study amount for this 10 mg vial.
- The diabetes study record and published report document the 4 mg, 28-day schedule, while the sarcoidosis review, published outcomes, and European trial record describe separate condition-specific designs and endpoints.
Storage
- Storage conditions and use-by periods depend on formulation, container, sterility controls, and validated product data.
- Follow the exact product label and supplier documentation for the unopened lyophilized vial.
- After reconstitution, refrigerate only when supported by the product’s validated instructions.
- Protect the vial from light and avoid repeated temperature cycling.
- Do not use a vial that is cloudy, discolored, damaged, or contains unexpected particles.
- General references on lyophilized formulations and compounding explain why stability and beyond-use dating must be formulation-specific; neither source establishes a product-specific shelf life.
Administration technique
- The primary calculation represents subcutaneous administration under the conditions of the cited phase 2 study. General injection literature describes technique and absorption considerations but does not validate a specific research product.
- Use a new sterile syringe and needle for every administration.
- Clean the vial stopper and selected site with alcohol and allow both to dry.
- Use an appropriate subcutaneous site and rotate sites systematically.
- Keep syringe-volume calculations separate from decisions about route, amount, and schedule.
- Place used needles immediately in an approved sharps container.
- General subcutaneous-delivery reviews and patient guidance from Cleveland Clinic and Johns Hopkins, together with CDC route guidance, describe technique considerations; these sources do not validate ARA-290 or a specific research product.
Important notes
- These checks keep the mass, concentration, route, and evidence source from being confused.
- A 10 mg vial contains 10 mg total; it does not define the amount used per administration.
- At 5 mg/mL, one U-100 unit represents 50 mcg. Recalculate whenever vial mass or final liquid volume changes.
- U-100 units are volume markings, not peptide international units.
- Intravenous and subcutaneous research schedules are not interchangeable through simple unit conversion.
- Short trials cannot establish long-term safety or general effectiveness.
Protocol source: PeptideDosages.com
Common questions
Does ARA-290 regenerate nerves?
Studies saw changes in some small-nerve measurements, which is narrower than "regenerating nerves."
How long does it take to work?
Four weeks was the common study period, not a guaranteed timeline.
Can it be combined with BPC-157?
That combination has not been studied.
Related in Performance and Recovery
Sources and further reading (6)
- Heij L, et al. ARA 290 in sarcoidosis patients with small fiber neuropathy. Mol Med, 2012.
- Culver DA, et al. Cibinetide improves corneal nerve fiber abundance in sarcoidosis. IOVS, 2017.
- Brines M, et al. ARA 290 improves metabolic control and neuropathic symptoms in type 2 diabetes. Mol Med, 2014.
- EMA. EU/3/13/1191: cibinetide orphan designation.
- NINDS. Peripheral neuropathy.
- Source summary: PeptideDosages.com research overview (rewritten for NVO).
Laboratory research material: ARA-290 Research Use Only