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 (16 mg Vial) Dosage Protocol
- Vial
- 16 mg Ara-290
- Add diluent
- 2 mL
- Concentration
- 8 mg/mL
- 1 unit (U-100)
- 80 mcg in 0.01 mL
- Route
- Subcutaneous
Standard / Gradual Approach
| Week | Daily Dose | Units (per injection) (mL) |
|---|---|---|
| Week 1 | 2 mg (2,000 mcg) | 25 units (0.25 mL) |
| Weeks 2–8 (or up to 16) | 4 mg (4,000 mcg) | 50 units (0.50 mL) |
How to mix
- Draw 2.0 mL bacteriostatic water with a sterile syringe.
- Inject slowly down the vial wall; avoid foaming.
- Gently swirl or roll until fully dissolved (do not shake vigorously).
- Label with reconstitution date and refrigerate at 2–8 °C (35.6–46.4 °F), protected from light.
Dosing details
- Published studies used different routes, populations, and schedules. They should not be blended into one generalized 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 mg, 4 mg, or 8 mg subcutaneously for 28 consecutive days.
- Study design: The cited 4 mg daily phase 2 study used the same amount throughout its 28-day treatment period.
- 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.
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