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ARA-290 (Cibinetide)
An 11-amino-acid peptide derived from the helix-B domain of erythropoietin (EPO) that selectively activates the innate repair receptor (an EPO-receptor/CD131 heterocomplex) to trigger anti-inflammatory and tissue-repair signaling WITHOUT the red-blood-cell-stimulating (erythropoietic) effect of EPO. Honest appraisal: investigational only. There are real but small phase-2 human trials — most notably in sarcoidosis-associated small-fibre neuropathy and in type-2-diabetic neuropathy — showing improved neuropathic-pain symptoms and corneal small-nerve-fibre regrowth. It is not an approved drug, not a dietary supplement, and the trials are small with mixed/surrogate endpoints.
Research peptide — not a dietary supplement
ARA-290 is a research compound, not a regulated dietary supplement. It is typically administered by injection and sold “for research use only.” The evidence below is largely preclinical (animal and in-vitro) or early-stage, so no evidence score is assigned. This page is provided for transparency and education — it is not a recommendation to use. Consult a qualified healthcare provider, and be aware that purity, dosing, and legal status vary by jurisdiction.
What the evidence says
Most ARA-290 studies are mechanism or observational rather than RCTs that measure a clinical effect — keep findings provisional.
Most evidence is from medium-quality randomised trials published 2012–2021 with a typical study size of 9 participants.
Based on 14 studies · 5 RCTs · 9 total participants
Confidence
Moderate confidenceBy outcome
Small phase-2 trials show improved neuropathic-pain symptoms and corneal nerve-fibre regrowth in sarcoidosis and diabetes, but endpoints are surrogate, one trial was negative, and it remains an unapproved investigational peptide.
No trials currently enrolling · 2 completed on ClinicalTrials.gov
1 of the completed trials have posted results
Registered trials show research momentum for ARA-290, not proof of effect — a registration is a plan, and posted results are sponsor-reported, not peer-reviewed. They are never counted toward the evidence rating above.
Browse these trials on ClinicalTrials.govClinicalTrials.gov · as of Aug 2026
ARA-290 (cibinetide, also called pHBSP) is a short synthetic peptide engineered from the helix-B region of erythropoietin. EPO itself is tissue-protective and anti-inflammatory but stimulates red-cell production, which causes thrombosis risk and limits its use for non-hematologic indications.
ARA-290 was designed to keep the protective signaling and drop the erythropoietic effect: it acts on the so-called innate repair receptor (IRR), proposed to be a heteromeric complex of the EPO receptor (EPOR) and the beta-common receptor (CD131), rather than the EPOR homodimer that drives erythropoiesis.
Activating the IRR is reported to dampen inflammatory (NF-kB / pro-inflammatory cytokine) signaling and promote tissue repair. The honest evidence picture is investigational.
Preclinical work is extensive (rodent models of neuropathic pain, autoimmune neuritis, colitis, diabetic wound healing, retinal ischemia, Alzheimer-like pathology).
The human data are limited to small phase-2 trials: a 22-patient randomized pilot and a 64-subject phase-2b randomized trial in sarcoidosis-associated small-fibre neuropathy (improved neuropathic-pain symptom scores and increased corneal/intraepidermal nerve-fibre abundance — a surrogate for disease modification), and a ~28-day phase-2 trial in type-2 diabetes reporting improved neuropathic symptoms plus a metabolic signal (HbA1c, lipids).
A small phase-2 diabetic-macular-edema trial was essentially negative on its primary visual endpoints. Across trials it was well tolerated with no erythropoietic effect by design and no anti-drug antibodies reported.
Importantly: the underlying IRR mechanism is itself debated — at least one biophysical study failed to confirm a direct EPOR/CD131 interaction. ARA-290 is sold grey-market as a 'research peptide'; it is not approved and not a regulated dietary supplement. Evidence is best characterized as Emerging.
Selectively activates the proposed EPO-receptor/beta-common-receptor (CD131) heterocomplex — the 'innate repair receptor' — which signals tissue protection and repair rather than red-cell production. The existence of a direct EPOR/CD131 complex is debated in the biophysical literature.
Engineered from EPO's helix-B domain to retain protective signaling while NOT stimulating erythropoiesis — avoiding the thrombosis/hematocrit risk that limits recombinant EPO for non-anemia uses.
In preclinical models, dampens myeloid-cell activation and pro-inflammatory mediators (cytokines, NF-kB p65), shifts macrophage and T-cell phenotypes toward repair, and reduces neurogenic inflammation after nerve injury.
In human small-fibre-neuropathy trials, 28 days of dosing increased corneal nerve-fibre area and regenerating (GAP-43+) intraepidermal fibres — surrogate markers of nerve regeneration.
How ARA-290 works — from molecular targets to health outcomes. Click an edge to see supporting research.This visualization is in beta — pathways are being refined and expanded.
Not studied — avoid.
ARA-290 is investigational and unapproved. Do not self-source or self-administer.
Shares the EPO-receptor pathway. Although ARA-290 is non-erythropoietic by design, combined use with EPO or ESAs has not been studied — theoretical interaction.
Anti-inflammatory/immunomodulatory activity could in theory be additive with immunosuppressive drugs; combinations are unstudied in humans outside transplant preclinical work.
Tip: Rotate injection sites; investigational use only
Tip: Avoid unregulated sources entirely; no purity or sterility guarantee
ARA-290 has an evidence score of 3.5/10 — emerging evidence based on 12 indexed studies. An 11-amino-acid peptide derived from the helix-B domain of erythropoietin (EPO) that selectively activates the innate repair receptor (an EPO-receptor/CD131 heterocomplex) to trigger anti-inflammatory and tissue-repair signaling WITHOUT the red-blood-cell-stimulating (erythropoietic) effect of EPO. Honest appraisal: investigational only. There are real but small phase-2 human trials — most notably in sarcoidosis-associated small-fibre neuropathy and in type-2-diabetic neuropathy — showing improved neuropathic-pain symptoms and corneal small-nerve-fibre regrowth. It is not an approved drug, not a dietary supplement, and the trials are small with mixed/surrogate endpoints. Representative study: PMID 33423557.
The commonly studied dose of ARA-290 is Investigational. Phase-2 trials used 4 mg/day subcutaneously for ~28 days (a phase-2b dose-ranging trial tested 1, 4 and 8 mg/day; an early pilot used 2 mg three times weekly intravenously). No validated or approved regimen exists.. Individual needs vary — start at the lower end of the range and adjust based on how you respond.
Timing is flexible for ARA-290 — consistent daily use matters more than the time of day. Trials self-administered a once-daily subcutaneous injection irrespective of meals.
ARA-290 should be used with caution — talk to a healthcare provider before taking it. The most commonly reported side effects are injection-site reactions, infection / contamination from non-sterile grey-market product. Use caution if any of these apply to you: Pregnancy / breastfeeding (not studied); Any use outside a clinical trial or physician supervision (investigational, unapproved); Known hypersensitivity to the peptide.
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Reviewed by Dr. Baher Al Hakim · Last reviewed June 2026 · evidence from 14 studies · how we score · editorial policy
This information is for educational purposes only. It is not a substitute for professional medical advice. Always consult a qualified healthcare provider before starting, stopping, or changing any supplement or medication.
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