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Healing & RecoveryResearch strength: ModerateEvidence: Moderate

ARA-290

Cibinetide (ARA-290)

Also known as: Cibinetide

An EPO-derived peptide that activates tissue-protective repair signaling without raising red blood cells, studied for nerve pain in sarcoidosis.

Overview

ARA-290, or cibinetide, is an 11-amino-acid peptide derived from the tissue-protective region of erythropoietin, engineered to avoid EPO's red-blood-cell effects and their clotting risks. It activates the innate repair receptor and has shown nerve fiber regeneration and reduced neuropathic pain in Phase 2 trials for small fiber neuropathy in sarcoidosis. It is investigational and not approved.

Mechanism of action

Selectively activates the innate repair receptor to drive tissue protection and nerve repair without stimulating red blood cell production.

Key studies & citations

  • Animal2008

    Nonerythropoietic, tissue-protective peptides derived from the tertiary structure of erythropoietin

    An 11-amino-acid peptide mimicking the aqueous face of EPO helix B was tissue-protective in stroke, renal and nerve-injury models and was not erythropoietic in vitro or in vivo.

    Proceedings of the National Academy of Sciences
  • Human2012

    Safety and efficacy of ARA 290 in sarcoidosis patients with symptoms of small fiber neuropathy: a randomized, double-blind pilot study

    22 patients, 4 weeks of IV ARA 290 versus placebo: significant improvement in small-fiber neuropathy symptom score and SF-36 pain and physical functioning, no safety signals.

    Molecular Medicine
  • Human2013

    ARA 290 improves symptoms in patients with sarcoidosis-associated small nerve fiber loss and increases corneal nerve fiber density

    28 days of daily subcutaneous ARA 290 improved neuropathic symptoms and increased corneal small nerve fiber density in a blinded placebo-controlled trial.

    Molecular Medicine
  • Human2017

    Cibinetide improves corneal nerve fiber abundance in patients with sarcoidosis-associated small nerve fiber loss and neuropathic pain

    Phase 2b in 64 patients: 4 mg/day cibinetide significantly increased corneal nerve fiber area versus placebo; pain improved in all groups, so the pain effect was not clearly separated from placebo.

    Investigative Ophthalmology and Visual Science

Frequently asked questions

Does ARA-290 raise red blood cells like EPO?

No. It was specifically engineered to keep EPO's tissue-protective effects while removing the red-blood-cell stimulation and its clotting risks.

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