ARA-290¶
Quick Facts¶
Tags: Neuroprotection, Nerve Regeneration, Tissue Repair, Erythropoietin Analog
Quick Summary
ARA-290 (cibinetide) is an 11‑amino‑acid peptide that activates the Innate Repair Receptor to promote tissue protection and nerve regeneration without erythropoietic effects.
- Typical Dose: 1–8 mg (commonly 4 mg daily)
- Frequency: Once daily
- Route: Injectable (subcutaneous; IV only in clinical settings)
- Cycle: 28 days (typical)
- Storage: 2–8°C (refrigerated)
Overview¶
ARA-290 (cibinetide) is an engineered 11‑amino‑acid peptide modeled on erythropoietin that selectively activates the Innate Repair Receptor (IRR). It produces tissue‑protective and regenerative effects without stimulating red blood cell production. ARA-290 has completed multiple Phase 2 studies and carries FDA orphan drug designations for some indications.
Key Benefits¶
- Tissue protection and wound‑healing support
- Nerve regeneration and neuropathic pain improvement
- Anti‑inflammatory effects with a favorable safety record in human trials
Mechanism of Action¶
ARA-290 binds the EPOR/β‑common receptor complex (the Innate Repair Receptor), triggering downstream tissue‑protective signaling while avoiding erythropoietic activity.
Molecular Information¶
- Length: 11 amino acids
- Sequence: pGlu‑Glu‑Leu‑Glu‑Arg‑Ala‑Leu‑Asn‑Ser‑Ser (N‑terminal pyroglutamate)
Research Indications¶
- Neuroprotection (Most Effective): Demonstrated corneal nerve fiber area increases (~23%) in clinical studies and improvement in neuropathic pain metrics.
- Tissue Repair (Effective): Promotes regeneration and enhanced wound‑healing markers in preclinical and human work.
- Anti‑inflammatory (Moderate): Reduces inflammatory signaling in relevant models.
Research Protocols¶
| Goal | Dose | Frequency | Route |
|---|---|---|---|
| Neuropathy treatment | 4 mg daily | Once daily | Subcutaneous |
| Tissue protection | 1–8 mg daily | Once daily | Subcutaneous |
| Acute intervention | 2 mg | 3× weekly | Intravenous |
| Research protocol | 4 mg daily | Once daily for 28 days | Subcutaneous |
Timing: ARA-290 has a short plasma half‑life (~20 minutes) but induces long‑lasting cellular effects; morning dosing may align with circadian repair processes.
Peptide Interactions¶
Compatible / Complementary
- BPC‑157 — Synergistic
- TB‑500 — Synergistic
- Thymosin beta‑4 — Compatible
- Semaglutide — Compatible
Monitor
- NAD+ — Monitor when combined
- Growth hormone — Use with caution
- Anti‑TNF biologics — Timing considerations required
Avoid
- EPO (erythropoietin) — Avoid combination
How to Reconstitute¶
- Allow vial to reach room temperature (15-20 minutes).
- Clean vial top with an alcohol swab.
- Slowly inject 1 mL bacteriostatic (sterile) water into the vial.
- Gently swirl to dissolve (do not shake vigorously).
- Slight cloudiness can be normal.
- Use immediately or store reconstituted solution at 2–8°C for up to 24 hours.
- Protect from light during storage and use.
- Rotate injection sites (anterior thigh recommended).
Quality Indicators¶
Positive Signs
- Pharmaceutical‑grade manufacturing under GMP with full documentation
- Verified peptide sequence and N‑terminal pyroglutamate modification
- Sterile lyophilized powder with appropriate excipients (e.g., sucrose or mannitol)
- Certificates of analysis showing purity >95%, endotoxin <1 EU/mg, and sterility testing
Warning Signs
- Protect from light; discoloration suggests degradation
What to Expect¶
- Week 1–2: Early anti‑inflammatory effects and possible mild pain relief
- Week 2–4: Progressive nerve regeneration and improved tissue‑healing markers
- Week 4–6: Peak effects, maximal nerve fiber density gains and symptom improvement
- Month 2–6: Sustained benefits due to lasting cellular changes
Side Effects & Safety¶
- Excellent safety in clinical trials with no serious drug‑related adverse events reported
- No anti‑drug antibodies detected in trials
- No erythropoietic effects (no polycythemia risk seen with ARA-290)
- Contraindicated or advised against with recent anti‑TNF therapy (within 6 months) or recent EPO use (within 2 months)
- Monitor injection site reactions; rotate sites
- Not recommended for pregnancy or for patients with BMI >34 kg/m²
References¶
Sarcoidosis Neuropathy Phase 2b Trial (2017)
- Double‑blind, placebo‑controlled trial in 64 patients; 4 mg dose showed significant nerve regeneration and pain reduction.
- Link: https://clinicaltrials.gov/study/NCT02039687
Type 2 Diabetes Neuropathy Phase 2 (2015)
- Randomized controlled trial in 48 patients with diabetic peripheral neuropathy showing sustained HbA1c improvement and nerve regeneration.
- Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4365069/
Diabetic Macular Edema Pilot Study (2020)
- Open‑label pilot in 9 patients showing safety and improved patient‑reported outcomes.
- Link: https://doi.org/10.3390/jcm9072225