Educational use only — not medical advice. This guide summarizes information reported in published research and community practice for educational purposes. It is not medical advice and not a recommendation to use any compound. Any doses, schedules, or combinations shown are examples of what has been reported, not instructions for you. Many peptides described here are research compounds that are not FDA-approved for the uses discussed and may be investigational or restricted. Effects, risks, and legal status vary; individual needs and results vary. Consult a qualified, licensed healthcare professional before making any decision. Do not use this content to diagnose, treat, or dose yourself.
ARA-290 at a glance
- What it is
- ARA-290 (cibinetide), an 11-amino-acid peptide derived from the helix B domain of erythropoietin
- Researched for
- Small fiber neuropathy, particularly in sarcoidosis, plus neuropathic pain and tissue-protection research
- Commonly reported range
- Phase 2 trials tested 1, 4 and 8 mg daily by subcutaneous injection; 4 mg met the primary endpoint
- Route reported
- Subcutaneous injection
- Reported frequency
- Once daily in the published trial design
- Reported cycle
- The pivotal Phase 2 study dosed daily for 28 days
- Plasma half-life
- Very short - reported on the order of minutes
- Regulatory status
- Investigational; not FDA-approved. Research use only
Reported ranges from research/community — examples, not recommendations.
What it is / mechanism
ARA-290 is a short peptide engineered from the helix B region of erythropoietin (EPO). Its design addresses a specific problem: EPO has well-documented tissue-protective effects, but using EPO itself for that purpose also stimulates red-blood-cell production and raises thrombotic risk. ARA-290 was developed to separate the two. It does not bind the classical homodimeric EPO receptor that drives erythropoiesis; instead it selectively activates the so-called innate repair receptor, a heterocomplex of the EPO receptor beta-common receptor subunits expressed on injured tissue and immune cells. Published research describes activation of this receptor as producing anti-inflammatory and tissue-protective signaling - dampening pro-inflammatory cytokine responses and supporting nerve-fiber repair - without the haematopoietic activity of EPO. That selectivity is the central rationale for the molecule.
Researched effects
In published clinical research ARA-290 has been associated with regeneration of small nerve fibers and improvement in neuropathic symptoms. The Phase 2b study in painful sarcoid neuropathy met its pre-specified primary endpoint, reporting a significant increase in corneal nerve fiber area measured by corneal confocal microscopy at the 4 mg dose - a treatment effect corresponding to roughly a 23% increase from baseline - alongside increased skin nerve fiber measures and clinically meaningful placebo-corrected reductions in pain intensity among participants with moderate to severe baseline pain. These are reported trial findings in a specific patient population, not guaranteed outcomes, and the compound remains investigational. Nothing here is a promise of efficacy or a personal recommendation.
Evidence & regulatory status
- Evidence base: a double-blind, randomized, placebo-controlled two-center Phase 2b study of 64 participants with painful sarcoid neuropathy, comparing daily subcutaneous 1, 4 and 8 mg cibinetide against placebo over 28 days, with results reported in 2017. Earlier work characterized the innate repair receptor mechanism in preclinical models.
- Regulatory status: ARA-290 (cibinetide, developed by Araim Pharmaceuticals) is investigational and not FDA-approved for any indication. It has received orphan-drug attention in the sarcoidosis neuropathy setting but is not an approved medicine.
- Research-use framing: material supplied as ARA-290 is for laboratory and research purposes only. Described dosing reflects the published trial protocol, not clinical guidance, and no dose has been established for use outside a trial.
Dosage — reported ranges (overview)
The figures below describe the published Phase 2 trial protocol and are provided as educational context, not a recommendation. That study administered 1 mg, 4 mg or 8 mg by subcutaneous injection once daily for 28 days. The 4 mg arm is the one that met the pre-specified primary endpoint, which is a useful detail because it means the highest dose tested was not the one that demonstrated the effect - more was not better in this trial. Outside that trial setting there is no established dose, no approved label and no long-term dosing data. Community-reported protocols exist but are not supported by controlled evidence.
A printable protocol sheet with a reconstitution reference and an injection log comes with All-Access Lifetime.
Reconstitution — bac-water math
ARA-290 is dosed in milligrams, so reconstitution is a concentration calculation. Add bacteriostatic water to the lyophilized vial and the concentration is the vial's total mg divided by the water volume in mL. On a U-100 insulin syringe, 100 units equals 1 mL, so units to draw = dose (mg) / concentration (mg/mL) x 100. Worked example: a 10 mg vial reconstituted with 2 mL of bacteriostatic water gives 5 mg/mL; a 4 mg example is then 4 / 5 = 0.8 mL, which is 80 units on a U-100 syringe. Note that at larger water volumes a 4 mg amount exceeds the 100-unit capacity of a standard 1 mL insulin syringe, which is why the volumes below stop at 2 mL. This is concentration math only, not a personal dose.
| Bac water added | Concentration | 1 mg (trial-range example) | 4 mg (trial-range example) |
|---|
| 1 mL | 10 mg/mL | 1 mg = 10 units | 4 mg = 40 units |
| 1.5 mL | 6.7 mg/mL | 1 mg = 15 units | 4 mg = 60 units |
| 2 mL | 5 mg/mL | 1 mg = 20 units | 4 mg = 80 units |
This is concentration math, not a dose recommendation.
Injection / administration basics
The published trial administered ARA-290 as a once-daily subcutaneous injection using standard sterile technique with site rotation. General handling concepts - sterile technique, site rotation, consistent daily timing - are covered here as general information; the detailed workflow comes with All-Access Lifetime, which includes the printable protocol sheet and injection log for every compound. This is general educational information, not a personal administration protocol; a qualified professional should guide any actual use.
Half-life & frequency rationale
ARA-290 has a very short plasma half-life, reported on the order of minutes, which is characteristic of small peptides cleared rapidly from circulation. As with several tissue-protective peptides, the reported duration of biological effect is attributed to downstream receptor signaling and repair processes rather than to sustained plasma concentration - which is the rationale for the daily dosing schedule used in trials despite the brief plasma exposure.
Side effects, safety & contraindications
In the published Phase 2b study no significant safety issues were observed in any treatment group, and the compound was generally well tolerated over the 28-day period. Injection-site reactions are the commonly reported issue. A specific point worth noting is that ARA-290 was designed not to stimulate erythropoiesis, so it is not expected to raise haemoglobin or haematocrit the way EPO does - this separation is the molecule's design rationale rather than an incidental property. Human safety data beyond short trial durations are limited, and long-term safety has not been established. These are reported observations, not an exhaustive safety profile, and nothing here is medical advice.
Stacking — overview
ARA-290 is most often discussed alongside other tissue-repair and anti-inflammatory peptides. Community and research discussion commonly groups it with BPC-157 and KPV in repair and inflammation contexts, and with GHK-Cu where tissue remodeling is the focus. There is no controlled evidence for any of these combinations; they reflect reported pairings, not recommendations.
Tissue protection (reported)
ARA-290 + BPC-157
Inflammation focus (reported)
ARA-290 + KPV
Repair and remodeling (reported)
ARA-290 + GHK-Cu
Stacking across compounds
The overview above covers ARA-290. The cross-compound material — which pairings are redundant rather than additive, where interaction risk is documented versus merely unstudied, and the blend arithmetic worked end to end — lives in the Peptide Stacking Guide, which is free to read in outline and $39 in full (included with All-Access Lifetime).
Included with this guide
The ARA-290 Stacking Module
The overview above is the free summary. The ARA-290 Stacking Module goes through each combination in depth — the mechanism-level reason it is proposed, what is actually reported in practice, and the cautions specific to that pairing — plus what to avoid and why. Included with ARA-290 Standard Access.
- How to think about stacking ARA-290 — 4 principles
- 3 combinations covered in detail
- What to avoid, and why — 3 items
- Combination-specific cautions
Combinations covered: Tissue protection, Inflammation focus, Repair and remodeling.
For how combinations are grouped by research context, the named blends, and why a pre-mixed blend vial cannot be calculated from its total milligrams, see the peptide stacks guide.
Storage & handling
- Lyophilized (unreconstituted) vials are typically stored refrigerated and protected from light; the sealed powder is generally described as stable at room temperature for short periods before use.
- After reconstitution, keep refrigerated at about 2-8 C, protect from light, and use within a few weeks; do not freeze and avoid shaking.
References
Key sources include the Phase 2b double-blind placebo-controlled study of cibinetide in painful sarcoid neuropathy, with corneal confocal microscopy endpoints reported in Investigative Ophthalmology and Visual Science in 2017; preclinical work by Brines, Cerami and colleagues characterizing the innate repair receptor and the separation of EPO's tissue-protective activity from its haematopoietic activity; and Araim Pharmaceuticals' published development materials. Note that no Phase 3 outcome data are available and the compound remains investigational.
Related peptide guides
Continue exploring related educational guide topics in the Medibact library.
Guide FAQ
Quick answers about guide scope, access, and educational use context.
What is ARA-290?
ARA-290, also called cibinetide, is an 11-amino-acid peptide derived from the helix B domain of erythropoietin. It selectively activates the innate repair receptor to produce anti-inflammatory and tissue-protective effects without stimulating red-blood-cell production the way EPO does. It is investigational, not FDA-approved, and supplied for research use only.
What dose of ARA-290 was used in trials?
The published Phase 2b study in painful sarcoid neuropathy tested 1 mg, 4 mg and 8 mg by daily subcutaneous injection over 28 days. The 4 mg arm met the pre-specified primary endpoint - notably, the highest dose tested was not the one that demonstrated the effect. These are trial figures for educational context, not a recommendation.
Does ARA-290 raise red blood cell count like EPO?
It is specifically designed not to. ARA-290 does not bind the classical homodimeric EPO receptor that drives erythropoiesis; it targets the innate repair receptor instead. Separating tissue protection from haematopoietic stimulation - and therefore from EPO's thrombotic risk - is the entire rationale for the molecule.
How do I calculate ARA-290 units after reconstitution?
Divide the vial's total milligrams by the millilitres of bacteriostatic water added to get mg/mL, then divide your amount by that concentration and multiply by 100 for U-100 insulin-syringe units. A 10 mg vial with 2 mL gives 5 mg/mL, so 4 mg is 80 units. Be aware that adding more water pushes a 4 mg amount past the 100-unit capacity of a standard 1 mL syringe. This is concentration math, not a dose recommendation.
Does this page tell me how much ARA-290 to use?
No. The amounts shown describe a published clinical trial protocol, provided for educational context. This page does not recommend a personal dose, route or frequency and is not medical advice. ARA-290 is investigational with no approved label and no established dose outside a trial - consult a qualified professional.
Compliance and trust notes
- Educational content only; no personalized health or outcome claims.
- No personalized use recommendation outputs.
- Use this material for general learning and research-context literacy.
