ARA-290 (Cibinetide)
An 11-amino-acid peptide derived from the tertiary structure of erythropoietin that activates the tissue-protective innate repair receptor without stimulating red-cell production. Studied mainly for neuropathic pain in sarcoidosis and diabetes, giving it modest but real early-phase human data.
01 Overview
ARA-290 (cibinetide) was designed to separate erythropoietin's tissue-protective, anti-inflammatory actions from its erythropoietic effect. It signals through the innate repair receptor (a beta-common/EPOR complex), reducing inflammation and promoting small-nerve-fibre repair.
Early-phase trials in sarcoidosis-associated small-fibre neuropathy and diabetic neuropathy reported improvements in pain and corneal nerve-fibre measures. It remains investigational, with grey-market sale for neuropathy and recovery outpacing the evidence base.
02 Mechanism
Selective agonist of the innate repair receptor (heteromer of EPOR and the beta-common receptor), producing tissue-protective and anti-inflammatory effects without stimulating erythropoiesis.
03 Dosing
| Tier | Dose | Route | Notes |
|---|---|---|---|
| Trial dose | 4 mg/day | SubQ | Daily subcutaneous dose used in neuropathy trials; investigational only. |
04 Effects
| Effect | Magnitude | Evidence | |
|---|---|---|---|
| Reduced neuropathic painImproved pain scores in sarcoidosis and diabetic small-fibre neuropathy in phase 2 studies. | Pain-score improvement in early trials | Clinical | |
| Small-nerve-fibre repairCorneal confocal microscopy showed improved nerve-fibre measures, suggesting regenerative activity. | Increased corneal nerve fibre density | Clinical |
05 Side effects
| Effect | Severity | Frequency | Evidence | Countermeasures |
|---|---|---|---|---|
| Injection-site reactionsLocal reactions at subcutaneous injection sites. | Mild | Common | Clinical | |
| HeadacheMild transient headache reported in some participants. | Mild | Uncommon | Clinical |