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ARA-290 (Cibinetide (ARA-290))

Category: Pain & Inflammation. Status: Investigational.

An 11-amino-acid peptide derived from erythropoietin (EPO) that targets the innate repair receptor without the blood-cell-stimulating (erythropoietic) effects of EPO. Investigated for neuropathic pain and inflammatory conditions such as sarcoidosis-associated small fiber neuropathy.

How it works

Selectively activates the innate repair receptor (a heteromer of the EPO receptor and the beta-common receptor), triggering anti-inflammatory and tissue-protective signaling while avoiding hematopoietic stimulation.

Key facts

  • Molecular weight: ~1257 Da
  • Half-life: Short (minutes in plasma); effects outlast plasma levels
  • Bioavailability: High via subcutaneous injection
  • Storage: Lyophilized: refrigerate. Reconstituted: 2-8°C, use within ~2-4 weeks.

Dosing overview

  • Typical dose: 1-4 mg per dose
  • Frequency: Daily during a course
  • Duration: 4 weeks (typical study course)
  • Route: Subcutaneous injection

Protocol notes

  • Trials commonly used ~2-4 mg subcutaneously once daily for about 28 days.
  • Aimed at reducing neuropathic pain and improving small-fiber nerve function.
  • Reassessed after the course; some studies looked at repeat courses.

Reported benefits

  • Reduces neuropathic pain
  • Anti-inflammatory tissue protection
  • Supports small-fiber nerve repair
  • No increase in red blood cell mass (unlike EPO)

Possible side effects

  • Generally well tolerated in trials
  • Mild injection site reactions
  • Headache (uncommon)

Research

  • ARA-290 in sarcoidosis-related small fiber neuropathy (2017): Reduced neuropathic pain and improved corneal nerve fiber measures versus placebo.
  • Cibinetide and innate repair receptor signaling (2016): Demonstrated tissue-protective, anti-inflammatory effects without erythropoiesis.

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