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ARA-290, also called cibinetide, is a small synthetic peptide modelled on part of the hormone erythropoietin (EPO). It was developed to keep EPO’s tissue-protective, anti-inflammatory effects without EPO’s effect on red blood cells. It has been tested mainly for small fiber neuropathy, the burning, tingling nerve pain that can come with sarcoidosis and type 2 diabetes.
The human evidence is real but limited. A few small Phase 2 trials, each lasting about four weeks, found improvements in neuropathy symptoms and in nerve fibers measured in the eye. Most of the other claimed benefits, from wound healing to heart protection, come from animal studies. ARA-290 is not an approved medicine anywhere.
This guide covers what ARA-290 is, how it works, what the studies found, the doses used in trials, side effects, legal status and how it compares with other peptides. For a quick profile, see our ARA-290 compound page.
Key Takeaways
- ARA-290 (cibinetide) is a synthetic 11-amino-acid peptide modelled on erythropoietin. It keeps EPO’s tissue-protective, anti-inflammatory signal but does not stimulate red blood cell production.
- Small Phase 2 trials in sarcoidosis and type 2 diabetes found better neuropathy symptom scores and more corneal nerve fibers than with placebo. Promising, but not proof.
- The trials mostly used 4 mg a day under the skin for 28 days; an early pilot used 2 mg intravenously three times a week. There is no established dose outside these studies.
- Findings on burns, the retina, the heart and islet transplants come from animal studies only. There is no evidence it helps cuts, bruises or burns in people.
- ARA-290 is not approved anywhere. Its FDA orphan drug designation for sarcoidosis neuropathy supports development; it is not an approval.
What Is ARA-290?
ARA-290 is a linear peptide of 11 amino acids. Its sequence was modelled on helix B, one part of the three-dimensional structure of erythropoietin. EPO is the hormone, made mainly by the kidneys, that tells the bone marrow to produce red blood cells (1). ARA-290 was developed by Araim Pharmaceuticals, and its international nonproprietary name is cibinetide.
EPO does more than make red blood cells. In damaged or inflamed tissue, it also acts as a protective signal. ARA-290 is a nonhematopoietic EPO analogue: it keeps that protective signal but does not stimulate red blood cell production.
That difference matters. The effect on red blood cells is what makes EPO risky outside its approved uses, through thicker blood, blood clots and raised blood pressure. You can read more about the parent hormone on our EPO page.
How Does ARA-290 Work?
Erythropoietin acts on two different receptors. The classic EPO receptor drives red blood cell production. A second receptor, made of an EPO receptor unit paired with the beta common receptor (CD131), appears in tissue under stress or injury. It is called the innate repair receptor (IRR), also known as the tissue-protective receptor. ARA-290 is designed to activate only this second receptor.
Through the innate repair receptor, ARA-290 dampens inflammation. In lab and animal studies, it reduced the activation of macrophages and other innate immune cells and lowered inflammatory signals such as tumor necrosis factor (TNF) and interleukin-6 (IL-6).
Lab research also suggests ARA-290 dampens TRPV1, an ion channel on pain nerves that senses heat and produces the burning pain that is common in neuropathy (2).
In small fiber neuropathy, the thin nerve fibers in the skin and organs are damaged or lost, which causes burning, tingling and pain, often in the hands and feet. Research suggests ARA-290 may help these fibers recover rather than only masking the pain (3). In human trials, this was measured as a change in the small nerve fibers of the cornea, which can be imaged directly with a special microscope.
Benefits of ARA-290: What the Research Shows
ARA-290 has more human data than most research peptides, but it is still at an early stage. Every human trial so far has been small, short (about four weeks) and run in people with a specific disease. Nothing here shows a benefit for healthy people or for lifters.
| Area | What was found | Type of evidence |
|---|---|---|
| Small fiber neuropathy in sarcoidosis | Better symptom scores and more corneal nerve fibers than placebo | Small Phase 2 trials in people |
| Neuropathy in type 2 diabetes | Better neuropathy symptoms and some markers of blood sugar control than placebo | One small Phase 2 trial in people |
| Diabetic retinopathy | Protected nerve, glial and blood vessel cells of the retina | Rat study |
| Islet cell transplants | Less inflammatory damage to transplanted islets | Mouse study |
| Heart damage from blocked blood flow | Less heart muscle damage | Rat studies |
| Burns, cuts and bruises | Early burn-wound research only | Animal studies; no human data |
Small Fiber Neuropathy in Sarcoidosis
Sarcoidosis is an inflammatory disease that forms small clusters of immune cells (granulomas) in organs such as the lungs and skin. Many patients also develop small fiber neuropathy, with pain, burning and tingling, and treatment options are limited. This is where most ARA-290 research has been done (4).
In a small randomized, placebo-controlled pilot trial, patients received 2 mg of ARA-290 intravenously three times a week for four weeks. Neuropathy symptom scores improved more than with placebo, and no safety concerns were raised (5).
Later Phase 2 trials in sarcoidosis switched to a daily injection under the skin for 28 days. Compared with placebo, they found improved symptoms and an increase in small nerve fibers in the cornea, and 4 mg a day became the dose carried forward. These results are encouraging, but each trial involved only a few dozen patients and a single month of treatment.
Type 2 Diabetes and Nerve Pain
In a small 28-day trial in people with type 2 diabetes and neuropathy, 4 mg of ARA-290 a day under the skin improved neuropathy symptoms compared with placebo. The researchers also reported improvements in some markers of blood sugar control, including HbA1c.
This is one short trial. ARA-290 is not a diabetes treatment, and it should never replace prescribed diabetes or nerve pain medication.
The Eye and Retina
In diabetic rats, ARA-290 protected the retina from the damage to nerve, glial (support) and blood vessel cells that drives diabetic retinopathy (6). This has not been tested in people.
The corneal nerve results from the human trials are a different matter. Doctors image the nerves in the cornea as a window on small fiber neuropathy elsewhere in the body. More corneal nerve fibers point to nerve regrowth, not better eyesight, and no study has shown that ARA-290 prevents vision loss.
Other Animal Findings
Animal studies have also explored ARA-290 in other kinds of nerve pain (7). None of these uses has been tested in human trials.
Islet cell transplants are used to treat some people with type 1 diabetes, but many of the transplanted cells die from inflammation after surgery. In mice, ARA-290 reduced the release of inflammatory cytokines from macrophages and helped more of the transplanted islets survive (8).
Animal research has also looked at ARA-290 in burn wounds (9), and rat studies reported less heart muscle damage after the heart’s blood supply was cut off (10). There is no human data for either, so these findings do not support using ARA-290 for burns, cuts, bruises or heart problems.
Is ARA-290 Legal?
ARA-290 is not approved as a medicine by the FDA, the European Medicines Agency or any other major regulator. It has been through Phase 2 trials, but no Phase 3 results have been published, and there is no prescription version you can get from a pharmacy.
The FDA did grant ARA-290 orphan drug designation for neuropathy in sarcoidosis. That status gives a company incentives to develop a drug for a rare disease. It is not an approval, and it does not mean the drug has been shown to work.
ARA-290 is not a controlled substance. Vendors sell it as a research chemical labelled “not for human use”, and the rules on buying, importing and using research peptides differ by country. See our guide “Are Peptides Legal – Legality Status for Each Country”.
Athletes in tested sports should treat ARA-290 as banned. WADA prohibits any substance that is not approved for human therapeutic use (category S0).
Who Is Interested in ARA-290?
Most interest comes from people living with small fiber neuropathy, especially from sarcoidosis or diabetes, because that is where the human trials were done. Some people with other chronic nerve pain look at it too.
The evidence does not reach further than that. There are no trials in multiple sclerosis, lupus or other autoimmune diseases, and no human data on wounds, cuts, bruises or burns. If you have a diagnosed condition, keep your prescribed treatment and talk to your doctor; ARA-290 is not a replacement for it.
For lifters, there is no evidence that ARA-290 helps muscle growth, strength or injury recovery.
Forms of ARA-290 Peptide
In the clinical trials, ARA-290 was given either as an intravenous infusion (in the first pilot trial) or as a daily injection under the skin (subcutaneous). Research vendors usually sell it as a freeze-dried powder in vials that has to be mixed with bacteriostatic water before use.
Some sellers also offer pre-mixed pens and nasal sprays. No published human study has tested ARA-290 as a nasal spray, so there is no data on how much is absorbed that way or what amount would match the trial doses.
ARA-290 Dosage
There is no approved or established dose of ARA-290. The figures below are the doses used in clinical studies, not recommendations.
| Study | Who took part | Dose and route | Length |
|---|---|---|---|
| Pilot trial | Sarcoidosis with small fiber neuropathy | 2 mg intravenously, three times a week | 4 weeks |
| Phase 2 trials | Sarcoidosis with small fiber neuropathy | Daily subcutaneous injection; 4 mg a day was the dose carried forward | 28 days |
| Phase 2 trial | Type 2 diabetes with neuropathy | 4 mg a day, subcutaneous | 28 days |
So the dose behind most of the human data is 4 mg a day under the skin for 28 days. No results have been published for lower “maintenance” doses, longer courses or repeat courses.
Mixing and Volume
The volume of a dose depends entirely on how the vial is mixed, so a volume in millilitres means nothing without the concentration. At 6 mg/ml, 4 mg is about 0.67 ml. At 4 mg/ml, 4 mg is 1 ml, and 0.7 ml would hold only 2.8 mg. Always work from milligrams, not millilitres. Our peptide reconstitution calculator does the maths for any vial size.
How It Was Given
In the daily trials, ARA-290 was injected under the skin. For technique and hygiene, see our guides on how to inject peptides subcutaneously and where peptides are injected. A product sold as a research chemical is not made to medicine standards, which adds a risk that no injection technique removes.
Cycle Length
The studied course is 28 days. There is no data on how long benefits last after stopping, how long a break should be or whether repeat courses are safe. User reports suggest the effect can fade after stopping (see below).
ARA-290 Stacks
No study has tested ARA-290 together with other peptides, so any stack is untested. People who combine it with other compounds are guessing at both the benefits and the interactions.
If you take prescribed medication for diabetes, nerve pain or sarcoidosis, check with your doctor before adding anything. Our peptide stack guide covers common peptide combinations by goal.
ARA-290 User Reviews
User reports are anecdotes, not evidence. People who post online are not a random sample, product quality varies, and there is no placebo group. With that in mind, here is what some users with neuropathy have shared.
One user said:
“I’ve taken it it helps with pain but it’s temporary. You have to keep doing it from time to time at least and it’s expensive.”
Another user in the same thread wrote:
“ARA is freaking awesome. Works better than IVIG ever did for me. Within 2hrs i feel better, but, you need to keep using it.”
A third user said:
“I am almost done with a month of ara 290. I’m not part of a trial but I am using it. It’s not cheap. I have seen really great results. My neuropathy was very bad and it has improved significantly. I have tried almost everything and this was the most helpful by far. Whether it lasts I’ll have to see.”
The common thread: some people report real relief, but they also say the effect fades unless they keep using it, and that it is expensive. That fits the trials, which only tested about four weeks of treatment and say nothing about the long run.
ARA-290 Side Effects
In the published trials, which were small and lasted about a month, no serious safety problems were attributed to ARA-290. Because it does not activate the classic EPO receptor, it is not expected to raise red blood cell counts, which is the main danger of EPO itself.
As with any injection, redness, itching, swelling or bruising at the injection site can happen. The bigger unknowns are long-term safety, which has never been studied, and product quality. Research-grade peptides are not made under drug manufacturing controls, so a vial may not contain what the label says.
Where Can I Buy ARA-290?
ARA-290 is not available on prescription, so it is only sold by research peptide vendors. Few of them carry it, and it costs more than most peptides.
Ask for a recent third-party certificate of analysis (COA) for the exact batch, showing identity and purity. Our guide on how to read a peptide COA explains what to check. Biotech Peptides has sold ARA-290 as a research peptide; check its current range and the batch COA before buying anything.
Pros
- Product pages include direct “Download COA” links, making documentation relatively easy to find.
- Can synthesize custom peptides when researchers provide the desired sequence and quantity.
- Specializes in peptides and peptide blends.
Cons
- Cannot accept returns due to concerns about product degradation through improper handling, heat, light, or sanitation.
- Clearly states same-day fulfillment and its free-shipping threshold, but provides less specific delivery-time information than other suppliers.
ARA-290 vs. Other Peptides
| ARA-290 | EPO | Thymosin alpha 1 | |
|---|---|---|---|
| Origin | Synthetic, modelled on EPO | Natural hormone, made mainly by the kidneys | Natural peptide, first isolated from the thymus |
| Main action | Tissue protection, less inflammation | Red blood cell production | Immune modulation |
| Raises red blood cells | No | Yes | No |
| Approval | None | Approved for some types of anemia | Approved in some countries, not in the US |
ARA-290 vs. EPO
EPO is a prescription drug for some types of anemia, for example in kidney disease. It raises red blood cell counts, which is why it is abused in endurance sport and why it carries a risk of blood clots and high blood pressure. ARA-290 borrows EPO’s tissue-protective signal without the effect on red blood cells, and it is not approved for any use.
ARA-290 vs. Thymosin Alpha 1
Thymosin alpha 1 is a natural peptide from the thymus; ARA-290 is synthetic, designed from the structure of EPO. Both calm or adjust the immune system, but in different ways.
ARA-290 acts on the innate repair receptor to dampen inflammation and protect tissue. Thymosin alpha 1 works through toll-like receptors on immune cells to modulate immunity. Thymosin alpha 1 is approved as a drug in some countries (not in the US), for example for hepatitis B, while ARA-290 is not approved anywhere. Read more in our Thymosin Alpha-1 guide.
Is ARA-290 Legit?
ARA-290 is a serious research compound, not a fad. It came out of academic and company research, it has been through randomized, placebo-controlled trials, and it is one of the few research peptides with human data in a specific condition.
But legit is not the same as proven. The trials were small and lasted about four weeks, no Phase 3 results have been published, and it is not approved anywhere. Orphan drug designation does not show that it works, and the animal findings on burns, the heart and transplants have not been tested in people.
Anyone considering it has to weigh modest human evidence against unknown long-term safety, high cost and the quality risk of research-grade products.
The Bottom Line
ARA-290 is one of the better-studied research peptides for nerve pain, but the human evidence is still small, short and limited to small fiber neuropathy.
- Small Phase 2 trials in sarcoidosis and type 2 diabetes found better neuropathy symptoms and more corneal nerve fibers than placebo after about four weeks.
- The trials mostly used 4 mg a day under the skin for 28 days. There is no established dose beyond that, and long-term safety is unknown.
- Claims about burns, the heart and transplants rest on animal studies. ARA-290 is not approved anywhere, and orphan drug status is not an approval.
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