Content reviewed by clinical research staff

Last reviewed: March 2026Sources: PubMed, FDA, WADA Prohibited List

Evidence graded using the PeptideScholar A-D system.

ARA-290 (Cibinetide)

Innate Repair Receptor (IRR) agonist11 amino acids

BHuman Studies
85
Excellent Credibility
3 cited studies | Evidence level B

ARA-290 (cibinetide) is a peptide engineered from the structure of erythropoietin (EPO) that selectively activates the Innate Repair Receptor (IRR) without stimulating erythropoiesis. It was developed to harness EPO's tissue-protective and anti-inflammatory properties while avoiding the risks of increased red blood cell production. It has shown promise in Phase 2 clinical trials for neuropathic pain, diabetic complications, and tissue repair.

Mechanism of Action

Selectively binds to the Innate Repair Receptor (IRR), a heterodimer of the erythropoietin receptor (EPOR) and the common beta receptor (βc/CD131). This activates anti-inflammatory, anti-apoptotic, and tissue-protective signaling pathways without triggering erythropoiesis. Promotes small nerve fiber repair, reduces neuroinflammation, and improves metabolic parameters including glucose control.

Benefits

  • Improved corneal nerve fiber density and reduced neuropathic pain in sarcoidosis patients — Phase 2 clinical trial[1][3]
  • Improved metabolic control and reduced neuropathic symptoms in type 2 diabetes — randomized trial[2]
  • Demonstrated tissue-protective effects lasting beyond the treatment period
  • Investigated for diabetic macular edema — Phase 2
Not medical advice - research-reported information only

This content is for informational purposes only and does not constitute medical advice.

ARA-290 (Cibinetide) - Dosing in Published Research

Reported routes: Subcutaneous injection
In Phase 2 clinical trials, ARA-290 was administered at 4 mg subcutaneously daily for 28 days. Dosing was once daily. Peptide must be reconstituted from lyophilized powder. Optimal treatment duration and long-term maintenance dosing have not been established beyond 28-day protocols.

The dosing information above is sourced from published research literature and clinical trials. These are not recommendations. Individual responses vary. Always consult a healthcare provider before considering any peptide-based therapy.

Side Effects

  • Well-tolerated in Phase 2 trials — no serious adverse events attributed to drug[1][2]
  • No increase in hemoglobin/hematocrit — non-erythropoietic by design
  • Injection site reactions reported (mild)[3]
  • Long-term safety beyond 28-day treatment courses not established

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ARA-290 (Cibinetide) is not FDA-approved. Always consult a licensed healthcare provider before considering any peptide.

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Research & Evidence

References

  1. 1.Cibinetide Improves Corneal Nerve Fiber Abundance in Patients With Sarcoidosis-Associated Small Nerve Fiber Loss and Neuropathic Pain.. Invest Ophthalmol Vis Sci, 2017. "Phase 2 trial: cibinetide significantly increased corneal nerve fiber area and reduced neuropathic pain scores in sarcoidosis patients" [PMID: 28475703]
  2. 2.ARA 290, a nonerythropoietic peptide engineered from erythropoietin, improves metabolic control and neuropathic symptoms in patients with type 2 diabetes.. Mol Med, 2015. "Randomized trial showing ARA-290 improved HbA1c, lipid profiles, and neuropathic pain scores in T2DM patients" [PMID: 25387363]
  3. 3.ARA 290 improves symptoms in patients with sarcoidosis-associated small nerve fiber loss and increases corneal nerve fiber density.. Mol Med, 2013. "First clinical demonstration that ARA-290 can reverse small nerve fiber damage in sarcoidosis, with sustained benefit after treatment" [PMID: 24136731]

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ARA-290 (Cibinetide) FAQ