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Regeneration

ARA-290 (Cibinetide)

A peptide derived from erythropoietin without its blood effects, meant for tissue protection and nerve pain.

2 min read 9 sources

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ARA-290 vial with white powder and the black TPD label on a white round podium, next to a long winding chain of blue and white glass beads in a bright lab
Phase 2 · not approved

Summary

At a glance

Sources checked on 26 Oct 2026

Fewer nerve symptoms
11.5 points

questionnaire score after 4 weeks in sarcoidosis, placebo 2.9 points, 22 participants1

More nerve fibres in the cornea
697 µm²

placebo-adjusted after 28 days, middle study dose, significant3

Largest trial (phase 2b)
64 participants

sarcoidosis with nerve fibre loss, three dose levels versus placebo3

Typical study length
28 days

daily dosing under the skin in the trials on sarcoidosis and type 2 diabetes2

  • ARA-290 (cibinetide) is a small peptide designed from the structure of erythropoietin but without its blood-forming action. It activates the innate repair receptor made of the EPO receptor and CD131.48
  • In a pilot study in sarcoidosis with small fibre neuropathy the symptom score fell by 11.5 points after 4 weeks versus 2.9 points with placebo.1
  • In a phase 2b trial with 64 participants the area of nerve fibres in the cornea increased significantly versus placebo at the middle study dose.3
  • In type 2 diabetes long-term blood sugar, blood lipids and nerve pain symptoms improved. In diabetic macular oedema visual acuity was unchanged after 12 weeks.45
  • The studies found no safety concerns. ARA-290 is not approved. Everything here is research, not a recommendation.158
Profile

Updated May 2026

Class
EPO-derived peptide

non-hematopoietic

Use
Subcutaneous

in mg

Half-life
short
Status
Clinical pilot studies
Sizes
10 to 16 mg

2 sizes in the shop

Contents 15 sections
  1. At a glance
  2. What is ARA-290?
  3. How it works
  4. What you need
  5. Reconstitution
  6. Dosing
  7. Injection
  8. What the research shows
  9. Research status
  10. Side effects
  11. Storage
  12. Related compounds
  13. FAQ
  14. Glossary
  15. Sources

What is ARA-290?

ARA-290 (cibinetide) is a small peptide derived from a part of the erythropoietin molecule, but deliberately without its blood-forming action. It activates the so-called innate repair receptor, which brakes inflammation and triggers tissue repair.

Comparison

Erythropoietin and its derivative

Compounds from the TPD lexicon, as described there. Tap a card to open its entry.

EPO derivative without blood formation ARA-290 (Cibinetide) IRR
Hormone for blood formation EPO EPO receptor

Simplified: EPO stimulates blood formation. ARA-290 was designed from the structure of EPO so that it does not. It acts through the innate repair receptor. 48

How it works

Via the innate repair receptor, ARA-290 acts anti-inflammatory and tissue-protective without raising red blood cells (unlike classic EPO). In research the focus is mainly on relieving nerve pain in small-fiber neuropathy.

Where it acts

Where ARA-290 acted in studies

Tap a point or a card. Colour = innate repair receptor, grey = observed.

  1. Eye (corneal nerves)

    More nerve fibre area in the cornea in sarcoidosis (phase 2b)3

    IRR
  2. Skin (fine nerve fibres)

    More regenerating nerve fibres in the skin at the middle study dose3

    Observed in trials
  3. Exercise capacity

    Longer distance in the 6-minute walk test in sarcoidosis2

    Observed in trials
  4. Blood sugar and lipids

    Better long-term blood sugar (HbA1c) and blood lipids in type 2 diabetes4

    Observed in trials
  5. Brain

    Weaker brain response to happy faces, no effect on mood (healthy people)6

    Observed in trials

Targets in the ChEMBL database8

Compound CHEMBL3545305 (Cibinetid): one recorded mechanism, Agonist according to ChEMBL.

Innate repair receptor (EPO receptor plus CD131)
Gene
EPOR, CSF2RB
UniProt
P19235, P32927
ChEMBL
CHEMBL4804252
Action
Agonist according to ChEMBL
Fine transparent glass nerve fibres, reddish and irritated at one spot, small blue molecules dock onto bud-shaped receptors along the fibres
Acting on the innate repair receptor. Symbolic image.

What you need

Supplies

2 things, numbered as in the picture

Tick off what you already have. Vial and BAC water are our real shop photos at the same size.

ARA-290 vial and bacteriostatic water at the same size with the black TPD label, next to two U-100 insulin syringes, two alcohol swabs and a sharps container with a blue lid

  1. ARA-290 vial

    The ARA-290 vial (lyophilized powder).

    In the shop

  2. Water and supplies

    Bacteriostatic water, U-100 insulin syringes, alcohol swabs.

    In the shop

Reconstitution

Use the peptide calculator. A 4mg vial with 2ml water gives 2mg per ml, 2mg is then 100 units on the U-100 syringe. Just add the water to the vial and let it dissolve.

Step by step

Dissolving the powder

Four steps, the same for every vial size.

  1. 1Wipe the cap

    Clean the rubber stopper with an alcohol swab.

  2. 2Add BAC water

    Just add it, it does not matter if it hits the powder directly.

  3. 3Swirl or shake

    Until everything has dissolved, both are fine.

  4. 4Draw up

    With the U-100 insulin syringe.

Less water higher concentration fewer units on the syringe Example: 10 mg + 2 ml = 5 mg/ml

Dosing

Dosing

Dosing, titration and syringe

Loading the dosing information …

  • Getting started and stepping up, drawn as a staircase
  • Units on the U-100 syringe for every step
  • How long one vial lasts

Injection

The injection is subcutaneous, into the fat layer under the skin. Common spots are the abdomen (keep about two finger-widths clear of the navel), the front and the inner side of the thigh, or the back of the upper arm.

The short version:

Injection

Where and at what angle

Pick a spot or switch the angle. Subcutaneous means: into the fat layer, not the muscle.

Rotate the spot each time, never the same one twice in a row.

90°More fat under the skin

Rule of thumb: where there is more fat under the skin, insert straight at 90 degrees. In lean people with little fat, 45 degrees, so the needle stays in the fat layer. Simplified diagram.

  1. Clean the spot with an alcohol swab and let it dry

  2. Pinch up a small fold of skin

  3. Insert the needle: at 90 degrees where there is more fat under the skin, at 45 degrees in lean people with little fat

  4. Inject slowly, wait a moment, then withdraw

  5. Put the needle straight into the sharps container

Rotate the site each time so the tissue does not get irritated. Never the same spot twice in a row.

What the research shows

A randomized pilot study (Heij/Brines, 2012) gave sarcoidosis patients with small-fiber neuropathy 2mg ARA-290 three times a week and saw significant improvement in neuropathy symptoms and quality of life, with good tolerability. The data is promising but still at the pilot stage.

Study results

What the trials measured

Interactive: switch tabs, tap points, show or hide arms. Arms are named relative to each other, no dosing advice.

Small fibre symptoms in sarcoidosis1

Change in the questionnaire score (SFNSL) after 4 weeks, lower is better

SFNSL score1 12 with ARA-290, 10 with placebo
Placebo -2.9 Punkte
ARA-290 -11.5 Punkte

Values from the abstract. In this pilot study ARA-290 was given three times a week as an infusion into a vein. Pain and fatigue improved equally in both groups, depression scores did not change.

Nerve fibres in the cornea3

Placebo-adjusted change in fibre area after 28 days

Corneal nerve fibre area (CNFA)3 64 participants with sarcoidosis, three dose levels
Lowest study dose 109 µm²
Middle study dose 697 µm²
Highest study dose (8 mg) 431 µm²

Values from the abstract, already adjusted for placebo. Only the middle study dose was significant, the ranges of the other two included zero. Regenerating nerve fibres in the skin also increased only at the middle dose.

Glass nerve fibre branching like fine roots, light trails run along it, bright background
Studies so far up to phase 2. Symbolic image.

Research status

Where the research stands

The registry lists four trials with ARA-290, all phase 2 or earlier. The first pilot studies in sarcoidosis (2012 and 2013) are not entered there. A trial in type 2 diabetes and prediabetes has no current status in the registry and is not shown here. As of 26 Oct 2026. 7

  1. Preclinical Animal models of nerve pain
  2. Phase 1 no registered trial
  3. Phase 2 3 trials, 2 completed, 1 stopped early
  4. Phase 3 no registered trial
  5. Approval not yet
Not approved. The highest stage reached according to ChEMBL is phase 2.8
Show all 3 phase 2 trials on a timelineHide timeline 2 completed 0 running 1 stopped early 3 with results
Phase 2

Bar: start to primary endpoint (planned for running trials). Green = completed, blue = progress until 26 Oct 2026, grey = stopped early.

Side effects

  • Well tolerated in the studies, unlike EPO without a rise in red blood cells.
  • Local reactions at the injection site.

Storage

Before mixing the powder is robust, normal room temperature (around 20 to 25 degrees) is fine, ideally kept in the dark. After mixing, keep in the fridge (2 to 8 degrees), do not freeze. It stays good there for at least 4 to 6 months with barely any loss of potency, in practice considerably longer. Swirl or shake to mix, both are fine.

Shelf life

How long it keeps

Undissolved (powder) Room temperature, around 20 to 25 degrees, dark

Robust, no fridge needed. Best kept in the dark.

Dissolved (mixed) Fridge, 2 to 8 degrees, do not freeze

At least 4 to 6 months with barely any loss of potency. The bacteriostatic water brings a preservative.

  • Keep it dark
  • Dissolved: 2 to 8 degrees
  • Note the mixing date on the vial
Nine vials with white powder and blue caps in the door shelf of a bright fridge
Powder dark at room temperature, once dissolved into the fridge (2 to 8 degrees), stable there for at least 4 to 6 months. Symbolic image.

Related

Related compounds

A different path: all in the TPD lexicon.

ARA-290 (Cibinetide)
EPO The parent hormone, stimulates blood formation BPC-157 Another research peptide focused on regeneration TB-500 (Thymosin Beta-4) Another research peptide focused on regeneration KPV Another research peptide focused on inflammation

FAQ

Common questions about ARA-290 (Cibinetide)

Short answers, each backed by the sources below.

What is ARA-290?

A small peptide with the drug name cibinetide, designed from the structure of erythropoietin. Unlike EPO it is meant not to make the body form red blood cells. It acts through the innate repair receptor, a complex of the EPO receptor and CD131.48

What do the sarcoidosis studies show?

In the first pilot study with 22 participants the symptom score fell by 11.5 points after 4 weeks versus 2.9 with placebo. A second study with daily dosing under the skin for 28 days found fewer symptoms, more nerve fibres in the cornea and a longer walking distance. In the phase 2b trial with 64 participants only the middle study dose was significant.123

What about type 2 diabetes?

In a phase 2 trial with daily dosing under the skin for 28 days long-term blood sugar and blood lipids improved over 56 days and so did nerve pain symptoms. In participants with clearly reduced corneal nerve fibre density this density increased, with placebo it did not.4

Does ARA-290 help with eye diseases?

In diabetic macular oedema a small study with 9 participants showed no improvement in visual acuity or retinal thickness after 12 weeks. Only the visual function questionnaire came out slightly better. The trial ended early because the study drug expired.57

Does ARA-290 affect mood?

In a study with 36 healthy people the brain responded more weakly to happy faces one week after dosing and attention to positive pictures increased. ARA-290 had no effect on mood or emotional state. A clear antidepressant-like profile did not emerge.6

Which side effects are known?

No safety concerns appeared in the studies. In diabetic macular oedema there were no serious side effects and no antibodies against the compound after 12 weeks. The abstracts give no percentages for individual side effects.145

Glossary

Terms explained briefly

Dotted words in the text open these explanations directly.

Cibinetide
The drug name of ARA-290.
Corneal nerve fibres
With a special microscope the fine nerves of the cornea can be counted and measured. In studies they serve as a measure of the loss of fine nerve fibres.
Erythropoietin (EPO)
A hormone from the kidney that stimulates the formation of red blood cells.
HbA1c
Long-term blood sugar value reflecting the average of the last two to three months.
Innate repair receptor
A receptor made of the EPO receptor and the subunit CD131. It is thought to dampen inflammation and protect tissue.
Lyophilisate
Freeze-dried powder. Without water a peptide keeps much longer.
Macular oedema
Swelling of the point of sharpest vision in the retina, common in diabetes.
Placebo-adjusted
The value of the placebo group has already been subtracted. What remains is the difference attributed to the compound.
Sarcoidosis
An inflammatory disease in which small nodules form in organs, most often in the lungs. It can damage the fine nerves.
Small fibre neuropathy
Damage to the finest nerve fibres. Typical are burning, tingling and pain, often in the hands and feet.
Subcutaneous
Into the fat layer just under the skin.

Evidence

Sources

Show all 9 sourcesHide sources 6 Studies1 Trial registry2 Database checked 26 Oct 2026

Studies

  1. Randomised pilot study in sarcoidosis with small fibre neuropathy

    Heij et al., Molecular Medicine, 2012

    DOI 10.2119/molmed.2012.00332 PMID 23168581
    Checked 26 Oct 2026 via doi.org, Crossref, PubMed
  2. 28 days under the skin in sarcoidosis: symptoms, corneal nerves, walk test

    Dahan et al., Molecular Medicine, 2013

    DOI 10.2119/molmed.2013.00122 PMID 24136731
    Checked 26 Oct 2026 via doi.org, Crossref, PubMed
  3. Phase 2b trial: corneal nerve fibres in sarcoidosis

    Culver et al., Investigative Ophthalmology and Visual Science, 2017

    DOI 10.1167/iovs.16-21291 PMID 28475703 NCT02039687
    Checked 26 Oct 2026 via doi.org, Crossref, PubMed
  4. Phase 2 trial in type 2 diabetes with nerve pain

    Brines et al., Molecular Medicine, 2015

    DOI 10.2119/molmed.2014.00215 PMID 25387363
    Checked 26 Oct 2026 via doi.org, Crossref, PubMed
  5. Phase 2 trial in diabetic macular oedema

    Lois et al., Journal of Clinical Medicine, 2020

    DOI 10.3390/jcm9072225 PMID 32674280 NCT06626971
    Checked 26 Oct 2026 via doi.org, Crossref, PubMed
  6. ARA-290 and the processing of emotions in healthy people

    Cerit et al., European Neuropsychopharmacology, 2015

    DOI 10.1016/j.euroneuro.2015.09.005 PMID 26431906 NCT02070783
    Checked 26 Oct 2026 via doi.org, Crossref, PubMed

Trial registry

  1. Trials with ARA-290 on ClinicalTrials.gov

    ClinicalTrials.gov, U.S. National Library of Medicine

    Checked 26 Oct 2026 via ClinicalTrials.gov API v2

Database

  1. Cibinetide in ChEMBL (mechanism and highest phase)

    ChEMBL, EMBL-EBI (CHEMBL3545305)

    Checked 26 Oct 2026 via ChEMBL
  2. Structure of cibinetide in PubChem

    PubChem, U.S. National Library of Medicine (CID 91810664)

    Checked 26 Oct 2026 via PubChem

In the shop

ARA-290 (Cibinetide) in the catalog

Sizes, prices and shipping times are on the product page.

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