ARA-290
Also known as: Cibinetide · Innate Repair Receptor agonist
Contents
MW
1257.35 Da
Amino Acids
11 AA
Half-Life
12-14 hours
Route
SubQ
Formula
C52H90N16O21
Amino Acid Sequence
QEQLERALNSS
Mechanism of Action
ARA-290 (Cibinetide) is an 11-amino acid peptide derived from the B helix of erythropoietin (EPO). It binds the innate repair receptor (IRR), a heterodimer of EPOR (EPO receptor) and βcR (beta common receptor), NOT the classical erythropoietic EPO receptor homodimer.
PRIMARY MECHANISM — IRR ACTIVATION: The IRR is expressed on immune cells, endothelial cells, Schwann cells, and neurons. Activation triggers anti-inflammatory and tissue-protective signaling cascades including JAK2/STAT3 and PI3K/AKT pathways — WITHOUT stimulating red blood cell production (no erythropoietic effects).
ANTI-INFLAMMATORY: NF-κB suppression → reduced TNF-α, IL-1β, IL-6 in inflamed tissue. Promotes M2 macrophage polarization (tissue repair phenotype).
SMALL FIBER NEUROPATHY REPAIR: ARA-290's most studied clinical application. Promotes Schwann cell survival and axonal regeneration in damaged small nerve fibers. Phase II trials showed improvement in small fiber neuropathy symptoms and corneal nerve fiber density.
The separation of tissue-protective from erythropoietic EPO effects was a key pharmacological innovation — EPO itself cannot be used for neuroprotection because it causes dangerous polycythemia (excess red blood cells).
Dosing Protocol
Low Dose
███ – ███ mcg/day
Standard Dose
███ mcg/day
High Dose
███ – ███ mcg/day
Dosing protocols are for paid members
Get exact dosing ranges, injection frequency, timing rationale, and reconstitution math.
Get Clinical Access — $79/moFrequency
3x/week (SubQ or IV).
Half-Life
12-14 hours
Reconstitution Guide
Full reconstitution protocol with BAC water volumes, concentration math, and units-to-draw per dose is available on the Clinical plan.
Unlock reconstitution guide →Clinical Warnings
Research phase only — not FDA approved.
Limited long-term safety data.
Does not affect red blood cell production (unlike EPO).
Manufacturing limited to research settings.
Contraindications
Absolute
Pregnancy
Relative Cautions
Hematologic malignancies
Polycythemia
Side Effect Profile
Mild
- ●Injection site reaction
- ●Mild headache
Moderate
- ●Dizziness
- ●Fatigue
- ●Nausea
Synergistic Peptides
Common Stacks
BPC-157
NAD+
Research Status
PHASE II DATA. PMID 23563706 (Heij 2012): Sarcoidosis SFN RCT, pain reduction, SFNSL improvement. PMID 25402832 (Brines 2014): T2D neuropathy, 4 mg SubQ x28 days, HbA1c + neuropathic symptoms improved. PMID 27913395 (Culver 2017): Corneal nerve fiber increase confirmed.
Frequently Asked Questions
How does ARA-290 work?
ARA-290 (Cibinetide) is an 11-amino acid peptide derived from the B helix of erythropoietin (EPO). It binds the innate repair receptor (IRR), a heterodimer of EPOR (EPO receptor) and βcR (beta common receptor), NOT the classical erythropoietic EPO receptor homodimer. PRIMARY MECHANISM — IRR ACTIVATION: The IRR is expressed on immune cells, endothelial cells, Schwann cells, and neurons. Activation triggers anti-inflammatory and tissue-protective signaling cascades including JAK2/STAT3 and PI3K/A
What is the standard dose of ARA-290?
ARA-290 dosing protocols are available with a ClinPep Clinical subscription. Dosing varies by indication and patient factors — consult a licensed healthcare provider. General frequency: 3x/week (SubQ or IV).
What is the half-life of ARA-290?
The half-life of ARA-290 is 12-14 hours. This determines optimal dosing frequency and timing.
Who should not use ARA-290?
ARA-290 is absolutely contraindicated in: Pregnancy. Use with caution in: Hematologic malignancies; Polycythemia.
What are the side effects of ARA-290?
Common mild side effects include: Injection site reaction, Mild headache. Moderate effects: Dizziness, Fatigue, Nausea.
What peptides stack well with ARA-290?
ARA-290 is commonly stacked with: BPC-157, NAD+, SS-31.
How do you reconstitute ARA-290?
ARA-290 is reconstituted with bacteriostatic water. Exact volumes, concentrations, and units-to-draw calculations are available in the ClinPep Clinical plan. Always follow your compounding pharmacy's instructions.
How long should you cycle ARA-290?
ARA-290 cycle protocols vary by indication. Detailed cycle length, on/off schedules, and monitoring guidelines are available with ClinPep Clinical access. Consult your healthcare provider for personalized cycling guidance.
References & Citations
2 PubMed studies · 3 clinical trials
The time to develop treatments for diabetic neuropathy.
Rendell Marc S. Expert opinion on investigational drugs. 2021
Diabetic neuropathy is a multifaceted condition affecting up to 50% of individuals with long standing diabetes. The most common presentation is peripheral diabetic sensory neuropathy (DPN). We carried
Corneal nerve fiber size adds utility to the diagnosis and assessment of therapeutic response in patients with small fiber neuropathy.
Brines Michael, Culver Daniel A, Ferdousi Maryam, Tannemaat Martijn R et al.. Scientific reports. 2018
Small fiber neuropathy (SFN) is a common feature of many inflammatory diseases, often presenting with pain and disability. SFN is diagnosed using symptoms, thermal threshold testing, and intra-epiderm
Registered Clinical Trials
ARA290 in T2D (Effects of ARA 290, an Erythropoietin Analogue) in Prediabetes and Type 2 Diabetes)
The Use of ARA290 for the Treatment of Diabetic Macular Oedema
Study of Efficacy of ARA 290 on Corneal Nerve Fiber Density and Neuropathic Symptoms of Subjects With Sarcoidosis
Symptom Indications
Full Clinical Access
Complete ARA-290 Protocol
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This information is for educational and research reference purposes only. ClinPep does not provide medical advice, diagnosis, or treatment recommendations. All protocols should be reviewed by a licensed healthcare provider.