ARA-290 / Cibinetide
Non-Erythropoietic EPO Fragment
Evidence grade 2 of 5, Thin. Read how the Atlas grades evidence.
Two small placebo-controlled human trials in sarcoidosis-associated small-fibre neuropathy report modest, statistically significant signals: the 2012 pilot (Heij et al., Molecular Medicine, n=22, PMID 23168581) improved neuropathic symptom and pain scores, and the completed Phase 2b (NCT02039687, Araim Pharmaceuticals, n=64) met its primary corneal-nerve-fibre-area endpoint at the 4 mg dose with about a 23% increase from baseline. This is a preliminary-to-early-phase human signal, promising but not confirmatory, with no completed Phase 3 and no regulatory approval, so it grades grade 2 rather than the entry's grade 3.
- FDA
- Not FDA-approved. Completed Phase 2; holds FDA Orphan Drug and Fast Track designations for sarcoidosis neuropathic pain, which are development designations, not approvals.
- WADA
- Not named on the WADA Prohibited List, though as an EPO-derived peptide it could be read into the S2 peptide-hormone/EPO-receptor class; athletes should verify current status.
Reference only. Not medical advice.
What can go wrong
Human safety data limited to two small short-term trials (n=22 and n=64, up to 28 days) that reported no significant safety issues; long-term and gray-market safety unknown.
Talk to a clinician before taking this. The Atlas can tell you what has been studied about ARA-290 / Cibinetide. It cannot tell you how it would interact with your body, your history, or anything else you are taking, and nothing on this page is a reason to start.
An 11-amino-acid erythropoietin-derived (helix-B) peptide that activates the innate repair receptor without raising red blood cell count. Developed by Araim Pharmaceuticals; completed Phase 2 for sarcoidosis-associated small-fibre neuropathy with modest, promising but not confirmatory signals. Not FDA-approved.
What people take it for
These are the reasons people give for taking it. They are not effects it has been shown to have.
How it is supposed to work
ARA-290 (cibinetide) is an 11-amino-acid peptide taken from a part of the hormone erythropoietin (EPO) that handles tissue protection rather than red-blood-cell production. It activates the innate repair receptor to reduce inflammation and protect and repair tissue, especially nerves, without EPO’s blood-thickening effect, which is its key design advantage.
ARA-290, also called cibinetide, is an 11-amino-acid peptide built from a surface of erythropoietin not involved in blood-cell production. It selectively activates the innate repair receptor, a complex distinct from the classical erythropoietin receptor, so it triggers tissue protection without erythropoiesis.
- Type
- EPO-derived peptide
- Length
- 11 amino acids
- Receptor
- Innate repair receptor
- No effect on
- Red blood cells
- Lead use
- Small-fiber neuropathy
- Status
- Phase 2, unapproved
EPO’s Healing Half Without The Blood-Thickening Half
ARA-290 is one of the more elegantly designed and legitimately developed peptides in this library, and the honesty is about how far that development has gone. Erythropoietin has two separable activities: making red blood cells, which carries clot and blood-pressure risk, and a tissue-protective, anti-inflammatory, nerve-repairing action through a different receptor. ARA-290 was engineered to capture only the second, and it works as intended, with trials showing no effect on blood counts. It holds orphan-drug and fast-track designations for sarcoidosis-related small-fiber neuropathy and has completed multiple Phase 2 trials in sarcoidosis and diabetic neuropathy, reducing neuropathic pain and, notably, regenerating small nerve fibers, with good short-term safety. The honest limits are real. It remains investigational and unapproved, stalled at Phase 2 with no reported Phase 3 results, the total number of patients studied is small, and the long-term effects of chronically switching on a repair-and-immune receptor are unknown. Sold gray-market as a research peptide for nerve repair and tissue protection, it is more credible than most but still unproven medicine.
Safety in detail
Gray-market ARA-290 is sold as a research chemical not intended for human consumption, so purity, dose, and sterility are unverified and fall outside the trial conditions under which the modest safety signal was observed.
- Designed to avoid EPO’s red-blood-cell and clotting effects, and generally well tolerated in trials.
- It remains investigational, without an approved product, so broad-population safety is not established.
- Gray-market versions, sold to nerve-pain and recovery users, are unverified.
- Not approved for any use.
Children and teenagers
ARA-290 has no validated pediatric use and is an investigational, unapproved peptide. There is no appropriate pediatric use.
What people get wrong
Nothing recorded here yet. There is almost certainly something people get wrong about this one, and the blank space means we have not written it down, not that the record is clean.
Who profits, and who pushes back
Nobody is named here yet, because we have not done that work on this entry. Read that as unfinished. Somebody almost certainly sells this, and somebody almost certainly disputes it. Assume both until we have checked.
ARA-290 reaches users through the gray-market research-peptide trade for nerve repair and tissue protection, sold on its Phase 2 results. Its legitimate future is pharmaceutical, as a potential approved therapy for small-fiber neuropathy, rather than as a research-grade injectable.
How we got here
Cibinetide descends from erythropoietin: researchers led by Michael Brines and Anthony Cerami mapped the tissue-protective activity of EPO to its helix-B region and built an 11-amino-acid peptide, pHBSP, that engages the innate repair receptor while lacking EPO's red-blood-cell-stimulating action. Araim Pharmaceuticals developed it under the code ARA-290, and the World Health Organization later assigned the INN cibinetide for clinical and regulatory use. It advanced through a 2012 intravenous pilot and a completed 2015 subcutaneous Phase 2b in sarcoidosis-associated small-fibre neuropathy, earning FDA Orphan Drug and Fast Track designations, but it stalled short of Phase 3 and now circulates on the research-peptide gray market under its ARA-290 code for neuropathy and healing uses.
ARA-290 was engineered in the 2000s by separating erythropoietin’s tissue-protective activity from its blood-cell-stimulating function, capturing the former in a short peptide. It advanced through Phase 2 trials in sarcoidosis and diabetic neuropathy, earning orphan-drug and fast-track designations, while remaining short of approval.
The numbers behind the grade
- Type
- EPO-derived peptide (11 aa)
- Action
- Tissue-protective, anti-inflammatory
- Studied for
- Neuropathy
- No EPO effect
- By design
- Approved
- No
- Stage
- Investigational
The people taking it
A scientifically elegant, EPO-derived tissue-protective peptide with genuine clinical-trial history in neuropathy and a small but growing gray-market following.
ARA-290’s users are people with neuropathy or chronic nerve pain seeking repair, plus tissue-protection and recovery enthusiasts in the gray-market peptide community drawn by its credible design and trial record.
Studied for nerve and tissue protection (notably small-fiber neuropathy) and used gray-market by some for nerve pain and recovery; it has no approved consumer use.
Set against the alternatives
ARA-290 belongs with the tissue-protective and repair peptides, near the mitochondrial protector SS-31 and the regenerative peptides BPC-157 and TB-500, and the cardiovascular protector Angiotensin 1-7. What distinguishes it is a rational, well-understood design and a genuine clinical-trial record with orphan and fast-track status, which makes it more credible than the typical gray-market regenerative peptide, even though it remains unapproved.
What we do not know
- Whether its promising neuropathy results lead to approval.
- How broadly its tissue-protective effect applies across conditions.
- Whether gray-market use carries hidden risks.
Legal status
ARA-290 (cibinetide) is an investigational peptide studied for nerve and tissue protection, particularly neuropathy; it is not approved or marketed. It has some gray-market presence among users seeking nerve-pain relief, where it is research-use-only material.
Status current as of July 2026. Regulatory positions change, sometimes quickly.
The market for this
What follows describes how this is bought and sold. It is not a buying guide and it is not an endorsement of any seller.
No approved route exists. It is available only as research-use-only material, which is not for human use; anyone considering it for neuropathy should seek proper medical care and insist on third-party-tested product if they proceed.
Where studied, produced for trials; the gray-market supply is research material synthesized overseas with the usual quality caveats.
What this entry does not yet cover
What follows is unfinished work on our side, not a finding about ARA-290 / Cibinetide.
- Timeline. We have not built the dated record of research and regulatory events.
- Supply chain. We have not mapped where it is made.
- What could change. No forward-looking summary yet.
Sources
2012 randomized double-blind pilot: IV ARA 290 improved small-fibre-neuropathy symptom and SF-36 pain/physical-function scores versus placebo in sarcoidosis patients and appeared safe (n=22, 4 weeks)
Heij L et al., Molecular Medicine 2012;18(1):1430-6 (PubMed)
Full-text of the 2012 pilot: three-times-weekly IV ARA 290 (2 mg) vs placebo for 4 weeks, significant week-4 improvement in SFNSL score
Phase 2b trial registration: daily subcutaneous 1/4/8 mg cibinetide vs placebo for 28 days, n=64, sponsor Araim Pharmaceuticals, status Completed (primary completion Jan 2015)
Phase 2b primary endpoint met: significant increase in corneal nerve fibre area vs placebo at the 4 mg dose (about 23% from baseline), plus increased skin nerve fibre length and reduced pain in moderate-to-severe subgroup
Dahan/Brines et al., Investigative Ophthalmology and Visual Science (IOVS), ARVO Journals
Sponsor announcement framing the Phase 2b result as nerve-fibre regeneration and symptom improvement in the orphan sarcoidosis indication; confirms Araim Pharmaceuticals as developer
Independent coverage summarizing the Phase 2b result and orphan-disease context for sarcoidosis small-fibre neuropathy
Mechanism and identity: ARA 290 / cibinetide is an 11-amino-acid EPO-derived peptide that activates the innate repair receptor without stimulating erythropoiesis; ARA-290 is Araim's development code and cibinetide is the INN
WADA reference: current Prohibited List, used to confirm cibinetide is not named on the list, with the caveat that an EPO-derived peptide could be read into the S2 peptide-hormone class
Patient-facing summary of small-fibre-neuropathy and ARA-290 trial results from the sarcoidosis research community
The studies that matter
Sarcoidosis neuropathy trials2010s
Cibinetide improved small-fiber neuropathy symptoms and measures of nerve fiber health in sarcoidosis patients in early and mid-stage trials.
Diabetic and neuropathic pain2010s-2020s
It has been studied for diabetic neuropathy and neuropathic pain, with a focus on its tissue-protective, anti-inflammatory action.
EPO-derived design2000s-2010s
Built to separate EPO’s tissue-protective signaling from its erythropoietic effect, avoiding the clotting risks of EPO.