ARA-290 (cibinetide) is a synthetic 11-amino-acid peptide (MW ~1257 g/mol) derived from the helix B surface of erythropoietin (EPO). Unlike recombinant EPO, ARA-290 does not bind the classical EPO receptor homodimer and therefore does not stimulate erythropoiesis (red blood cell production), avoiding the thrombotic and cardiovascular risks of EPO. Instead, it selectively activates the innate repair receptor (IRR), a heterodimer of EPOR and β-common receptor (CD131), expressed on tissues undergoing stress or damage. ARA-290 received FDA Orphan Drug Designation for treatment of sarcoidosis-associated small fiber neuropathy. Multiple Phase II clinical trials have been completed demonstrating improvements in neuropathic pain, autonomic function, and corneal nerve fiber regeneration.
Category: Tissue Repair / Neuropathic Pain. Evidence rating: C (early/mixed human evidence).
Clinical status: Phase II clinical trials completed for sarcoidosis neuropathy, diabetic neuropathy, and corneal nerve repair. FDA Orphan Drug Designation granted. Not yet approved.
ARA-290 selectively binds the innate repair receptor (IRR), a heteromeric complex of the erythropoietin receptor (EPOR) and β-common receptor (CD131/βcR). The IRR is upregulated in tissues under metabolic stress, inflammation, or injury — it is not significantly expressed in healthy tissue,…
Research base: 1 registered clinical trial and 12 indexed publications reference ARA-290 (Cibinetide).
Safety considerations: Well-tolerated in all completed Phase II trials with no serious drug-related adverse events reported; No erythropoietic stimulation — no increase in hemoglobin, hematocrit, or thrombotic risk; Most common adverse events: mild injection site reactions, transient headache.
Reviewed by the PeptideAtlas Editorial Team. Last reviewed: 2026-07-05.
EPO binds the classical EPO receptor homodimer (EPOR/EPOR) and stimulates red blood cell production, which carries thrombotic and cardiovascular risks. ARA-290 selectively activates the innate repair receptor (EPOR/CD131 heterodimer) and has zero erythropoietic activity. It promotes tissue repair and reduces inflammation without the hematologic effects of EPO.
No. ARA-290 is an investigational drug developed by Araim Pharmaceuticals. It is not commercially available and is not sold by grey-market peptide suppliers. Access is limited to clinical trials.
The IRR is a heterodimer of the erythropoietin receptor (EPOR) and the β-common receptor (CD131). It is not significantly expressed on healthy tissue but is upregulated when cells are under metabolic stress, inflammation, or damage. This provides ARA-290 with inherent tissue selectivity — it acts preferentially on damaged tissue.
Multiple Phase II trials have been completed for sarcoidosis-associated small fiber neuropathy, diabetic neuropathy, and type 2 diabetes metabolic endpoints. Phase III trials have not yet been announced as of 2026.