Library / Peptides / Immune Support / ARA-290
Emerging evidence · Grade B

ARA-290

Cibinetide (ARA-290)
Evidence
Emerging
Route
Subcutaneous injection or Intravenous
Frequency
3 times per week or daily
Category
Immune Support
TL;DR
ARA-290 (cibinetide) is an 11-amino-acid peptide derived from the structure of erythropoietin (EPO) that selectively activates the innate repair receptor (IRR), a heteromer of the EPO receptor and the beta common receptor. Unlike EPO, it does not stimulate red blood cell production but retains tissue-protective and inflammation-modulating properties.
Part 01 · How it works

Mechanism.

ARA-290 (cibinetide) is an 11-amino-acid peptide derived from the structure of erythropoietin (EPO) that selectively activates the innate repair receptor (IRR), a heteromer of the EPO receptor and the beta common receptor. Unlike EPO, it does not stimulate red blood cell production but retains tissue-protective and inflammation-modulating properties. It has been studied in sarcoidosis-related neuropathy, diabetic neuropathy, and chronic pain.

Think of EPO as a manager with two jobs: making red blood cells and repairing damaged tissue. ARA-290 is like hiring a specialist who only does the repair work, without triggering the blood cell production that can cause dangerous clotting.

Mechanism · technical
Cibinetide selectively activates the innate repair receptor (IRR), composed of EPOR/betacR heterodimers, which is expressed on damaged tissues and immune cells. This triggers anti-apoptotic signaling via JAK2/STAT5 and PI3K/Akt pathways, reducing inflammation and promoting tissue repair. Unlike erythropoietin, it does not activate the classical EPOR homodimer responsible for erythropoiesis, avoiding thrombotic risks.
Part 02 · Dosing & administration

How it's taken.

Values below describe how ARA-290 has been administered in published trials and labeling. Provided for educational purposes only — this is not medical advice and not instructions for self-administration. Consult your healthcare provider before making any health decision.

Standard dose
2-4 mg
Subcutaneous injection or Intravenous · 3 times per week or daily
Duration
4-12 weeks in clinical trials

Investigational drug (cibinetide). Non-erythropoietic EPO analogue. Dosing from clinical trial protocols. Not commercially available.

Need help with reconstitution?

Use the free peptide calculator for dilution, unit conversion, and injection volume.

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Part 03 · Safety

Side effects, rare serious events, who shouldn't.

Reported side effects
Well-tolerated in multiple Phase II trials. Most common side effects include mild injection site reactions and transient headache. No hematological effects (no increase in red blood cells, hematocrit, or thrombotic events) observed.
Absolute · do not use
×
Pregnancy or breastfeeding
×
Children under 18
×
Known hypersensitivity to cibinetide or any component
×
Active systemic infection (may modulate immune response)
×
Uncontrolled autoimmune disease
Interactions
Immunosuppressants (tacrolimus, cyclosporine)
Cibinetide modulates innate immune repair pathways; may alter immunosuppressive efficacy
Moderate
Erythropoiesis-stimulating agents (EPO)
Cibinetide acts on EPO receptor heterodimer; theoretical interaction with EPO therapy
Moderate
Inflammation-modulating biologics (TNF inhibitors)
Additive inflammation-modulating effects; theoretical risk of excessive immune suppression
Moderate
Labs to monitor
CBC with Differential
Baseline and monthly
Monitor hematologic parameters given EPO receptor interaction
CMP (Comprehensive Metabolic Panel)
Baseline and every 3 months
Liver and kidney function
HbA1c
Baseline and every 3 months
Track glycemic control in diabetic neuropathy patients
CRP / ESR
Baseline and monthly
Track inflammatory markers
Part 04 · Research log

Every study we cite.

Each study with its published finding and a plain-language note on limitations or funding.

01
2016
0
ARA 290 for treatment of sarcoidosis-associated small fiber neuropathy
Improved corneal nerve fiber density and reduced neuropathic pain in sarcoidosis patients
Small RCT; single center
PMID 27044758 ↗
02
2019
0
Cibinetide for diabetic neuropathy
Showed improvements in corneal nerve regeneration markers in diabetic patients
Phase II; industry-sponsored
Part 05 · Cost & access

Where you can get it.

Regulatory status
Not FDA-approved. Has received Orphan Drug Designation from the FDA for sarcoidosis. Multiple Phase II clinical trials completed. Being developed by Araim Pharmaceuticals.
The Peptide Column takes no affiliate commission from any source.
Part 06 · Your appointment

Questions to bring.

01
Has cibinetide shown benefits for my specific type of neuropathy in clinical trials?
02
How does ARA-290 differ from erythropoietin in terms of safety and blood clot risk?
03
What is the current regulatory pathway for cibinetide, and are there ongoing trials I could join?
04
Are there any interactions between ARA-290 and my current medications?