library.onepin.app/ara-290 Peptide Education Library
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OnePin Peptide Library · Repair & Recovery

Repair & Recovery Synthetic EPO-derived peptide Not FDA-approved · investigational

ARA-290

ARA290 · Cibinetide

Synthetic EPO-derived peptideInnate Repair Receptor (IRR) agonistNon-erythropoietic tissue repair peptideNeuroprotective peptide

ARA-290 (Cibinetide) is a synthetic 11-amino acid peptide derived from the B helix of erythropoietin (EPO) that selectively activates the innate repair receptor (IRR), a heterodimer of the EPO receptor (EPOR) and the beta common receptor (CD131). Unlike EPO itself, ARA-290 does not stimulate erythropoiesis (red blood cell production) or affect hematocrit, which eliminates the thrombotic and cardiovascular risks associated with EPO use. ARA-290 promotes tissue repair, reduces inflammation, and provides neuroprotection through the IRR pathway, which is distinct from the classical EPO receptor responsible for erythropoiesis. It has been studied in Phase 2 clinical trials for diabetic neuropathy and sarcoidosis-related neuropathy.

Quick Start
Route
SubQ injection
Start low
2-4 mg daily
Frequency
Daily for 28-day cycles
Timing
No evidence-based fed or fasted requirement

Can be taken any time. No fasting required. 28-day cycle protocol.

Start here. Every protocol below is ordered lowest-first. Begin at the smallest effective dose, hold about a week to assess tolerance, and step up only if needed.

Tiered Protocols · lowest first
Quick Start
Conservative start
2-4 mg daily · SubQ injection · Daily for 28-day cycles
Lowest starting point. Hold about a week to assess tolerance before stepping up.
2-4 mg daily
Daily for 28-day cycles
Standard
Neuropathy Repair Protocol
4 mg · SubQ · Daily
human clinical trial · Heij/Dahan et al. 2012 (Mol Med)
4 mg
Daily
Reconstitution CalculatorU-100
050100u
Draw to
units
01

How it works

ARA-290 binds to and activates the innate repair receptor (IRR), which is a heterodimer of EPOR and CD131 (beta common receptor). This receptor is expressed on neurons, endothelial cells, and immune cells and is upregulated in response to tissue injury and inflammation. IRR activation triggers anti-apoptotic signaling (preventing cell death at injury sites), anti-inflammatory cytokine modulation, neural repair and remyelination signaling, endothelial protection and vascular repair, and macrophage phenotype switching from pro-inflammatory M1 to reparative M2. Critically, ARA-290 does NOT activate the classical EPOR homodimer responsible for erythropoiesis. This selectivity means ARA-290 provides tissue protective effects without increasing red blood cell production, hematocrit, or thrombotic risk.

ARA-290 binds to and activates the innate repair receptor (IRR), which is a heterodimer of EPOR and CD131 (beta common receptor). This receptor is expressed on neurons, endothelial cells, and immune cells and is upregulated in response to tissue injury and inflammation. IRR activation triggers anti-apoptotic signaling (preventing cell death at injury sites), anti-inflammatory cytokine modulation, neural repair and remyelination signaling, endothelial protection and vascular repair, and macrophage phenotype switching from pro-inflammatory M1 to reparative M2. Critically, ARA-290 does NOT activate the classical EPOR homodimer responsible for erythropoiesis. This selectivity means ARA-290 provides tissue protective effects without increasing red blood cell production, hematocrit, or thrombotic risk.

02

What to expect

Early
Days 1–7

Days 1-7: No significant changes expected. IRR activation initiates repair signaling but neural repair is a slow process.

Mid
Weeks 2–4

Weeks 2-4: Neuropathic symptoms may begin to improve. Phase 2 trial showed measurable improvements at 28 days. Anti-inflammatory effects accumulate.

Later
Weeks 4–12

Weeks 4-12: Nerve fiber density improvements (measured by corneal confocal microscopy in clinical trials). Sustained tissue repair effects. Best assessed through symptom tracking and objective nerve function testing.

03

Evidence

HumanPresent
AnimalStrong
In-vitroPresent
2012Safety and efficacy of ARA 290 in sarcoidosis patients with symptoms of small fiber neuropathy: a randomized, double-blind pilot study · Heij L et al, Molecular Medicine ↗peer reviewed
2013ARA 290 for treatment of small fiber neuropathy in sarcoidosis · Dahan A et al, Expert Opinion on Investigational Drugs ↗review
2015ARA 290, a Nonerythropoietic Peptide Engineered from Erythropoietin, Improves Metabolic Control and Neuropathic Symptoms in Patients with Type 2 Diabetes · Brines M et al, Molecular Medicine ↗peer reviewed
2017Cibinetide Improves Corneal Nerve Fiber Abundance in Patients With Sarcoidosis-Associated Small Nerve Fiber Loss and Neuropathic Pain · Culver DA et al, Investigative Ophthalmology and Visual Science ↗peer reviewed
04

The honest take

Non-erythropoietic tissue repair

Confirmed. ARA-290 selectively activates IRR without activating the classical EPO receptor. No effect on hematocrit or RBC production in clinical trials. This is its primary design advantage over EPO.

Nerve repair / neuropathy

Phase 2 data shows objective nerve fiber density improvement (corneal confocal microscopy). Neuropathic pain reduction. The best-supported clinical claim for ARA-290.

Anti-inflammatory

Macrophage M1-to-M2 polarization documented. Distinct from classical anti-inflammatory pathways (NSAIDs, steroids). Complementary to other anti-inflammatory peptides.

05

Interactions & stacking

What's safe to combine, and what belongs in a separate pin.

Safe & synergistic

BPC-157ARA-290 innate repair + BPC tissue repair through different pathways
TB-500ARA-290 neuroprotection + TB systemic repair
GHK-CuARA-290 neural + GHK-Cu collagen/tissue
GHKNon-overlapping mechanisms

Keep separate

EPOARA-290 is designed to provide tissue protection WITHOUT erythropoietic effects. Combining with EPO would add the erythropoietic and thrombotic risks that ARA-290 was specifically engineered to avoid.
CJC-1295 with DACDAC maleimide reactivity concern.
06

Side effects & safety

Commonly reported

  • Well tolerated in clinical trials
  • Mild injection site reaction
  • Safety profile comparable to placebo in Phase 2 data

Less common & notes

  • ARA-290 was specifically designed to avoid EPO-related risks (erythrocytosis, thrombosis, hypertension).
  • Clinical trial safety data is favorable.
  • No significant hematological changes observed.
  • No significant cardiovascular events.
  • Long-term data beyond 28 days is limited from controlled trials.
07

Pharmacokinetics

Illustrative plasma concentration · 24 h
Half-life
0.5h
Peak · Tmax
0.1h
Elimination
2.5h
Activity
12-24 hours (IRR-mediated anti-apoptotic and repair signaling persists)

Storage. Store unreconstituted vials frozen (-20C) or refrigerated (2-8C). After reconstitution with BAC water, refrigerate at 2-8C. Stable for 28 days. Protect from light. EPO-derived structure but no special handling beyond standard peptide care.

08

Regulatory status

ARA-290 (Cibinetide) is an investigational drug. Phase 2 clinical trials completed by Araim Pharmaceuticals. Not yet approved by FDA or any regulatory agency. Available as a research peptide. WADA status: Not specifically listed but may fall under S0.

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Open ARA-290 straight into OnePin with your vial and dose pre-filled, then let it handle the syringe math and remind you before the vial runs out.

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Go deeper

The guide & community

The complete ARA-290 walkthrough, real protocol discussion and coaching live inside the BlessUp community on Skool.

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