ARA-290
Ara-290 (cibinetide) is an 11–amino acid non-erythropoietic peptide derived from erythropoietin’s helix-B domain. It selectively activates the innate repair receptor (IRR), an EPOR/CD131 heterodimer, to promote anti-inflammatory and tissue-protective effects without stimulating red blood cell production. Clinical trials have demonstrated benefits for diabetic neuropathy and sarcoidosis-related small-fiber neuropathy.
Reconstitution Steps
Draw 3.0 mL bacteriostatic water with a sterile syringe. EACH
Inject slowly down the vial wall; avoid foaming.
Gently swirl/roll until dissolved (do not shake).
Label with reconstitution date and refrigerate at 2–8 °C (35.6–46.4 °F), protected from light.
Protocol Overview
Concise summary of the once-daily regimen based on clinical trial designs.
Goal: Support tissue protection, anti-inflammatory signaling, and neuropathic symptom management via IRR activation.
Schedule: Daily subcutaneous injections for 4–8 weeks (clinical trials used 28-day protocols; extension to 8–16 weeks based on individual response).
Dose Range: 2–4 mg daily; 4 mg is the established target dose.
Reconstitution: 2.0 mL per 16 mg vial (8 mg/mL) for accurate unit measurements.
Storage: Lyophilized refrigerated or frozen; reconstituted refrigerated up to 28 days.
Dosing Protocol
Suggested daily titration approach reflecting clinical study parameters.
Start: 2 mg daily during week 1 to assess tolerance.
Target: 4 mg daily from week 2 onward.
Frequency: Once per day (subcutaneous).
Cycle Length: 4–8 weeks standard; may extend to 16 weeks based on individual assessment.
Timing: Any consistent time daily; rotate injection sites.
Storage Instructions
Proper storage preserves peptide quality.
Lyophilized: Store at 2–8 °C (35.6–46.4 °F); for long-term storage, −20 °C (−4 °F) is acceptable.
Reconstituted: Refrigerate at 2–8 °C (35.6–46.4 °F); use within ~30 days; avoid freeze–thaw cycles.
Allow vials to reach room temperature before opening to reduce condensation uptake.
Important Notes
Practical considerations for consistency and safety.
Use a new sterile insulin syringe for each injection; dispose in a sharps container.
Rotate injection sites (abdomen, thighs, upper arms) to reduce local irritation and prevent lipohypertrophy.
Inject slowly; wait a few seconds before withdrawing the needle.
Document daily dose and injection site to maintain consistency.
No clinically significant adverse effects were reported at 4 mg/day in 28-day clinical trials.
How This Works
Ara-290 (cibinetide) binds to the innate repair receptor (IRR), a heterodimer of EPOR and CD131 (βc subunit), which is distinct from the classical erythropoietin receptor. This selective binding triggers anti-apoptotic and anti-inflammatory signaling cascades that protect tissues and promote repair without stimulating erythropoiesis. Preclinical research demonstrates that Ara-290 can reprogram a pro-inflammatory, tissue-damaging environment into one favoring healing and regeneration. Additionally, analgesic effects have been observed through immunomodulation and direct inhibition of TRPV1 ion channels activated by capsaicin.
Potential Benefits & Side Effects
Observations from preclinical and clinical literature.
Neuroprotection: Clinical trials in diabetic neuropathy showed improvements in HbA1c, lipid profiles, and neuropathic pain scores with 4 mg daily dosing.
Nerve regeneration: In sarcoidosis-associated small-fiber neuropathy, treatment led to significant increases in corneal nerve fiber density (objective nerve regrowth) and improved symptoms compared to placebo.
Tissue protection: Anti-inflammatory and anti-apoptotic effects observed across multiple organ systems in preclinical models.
No erythropoietic effects: Unlike full EPO, Ara-290 does not stimulate red blood cell production, avoiding related side effects.
Tolerability: Well tolerated in clinical studies; occasional mild injection-site reactions (redness, transient discomfort) may occur with subcutaneous administration.
Lifestyle Factors
Complementary strategies that may support therapeutic goals.
Optimize glycemic control through diet and medication adherence if addressing diabetic neuropathy.
Incorporate regular physical activity appropriate to individual capacity to support nerve health and circulation.
Prioritize adequate sleep and stress management to support tissue repair processes.
Avoid smoking and limit alcohol consumption, both of which can exacerbate neuropathic conditions.
Injection Technique
General subcutaneous guidance from clinical best-practice resources.
Clean your hands and work on a clean surface.
Swab the vial’s rubber stopper and injection site with alcohol; allow to dry.
Draw the calculated dose into the insulin syringe, eliminating air bubbles.
Suitable SC injection areas include the abdomen (2 inches from navel), outer thighs, upper outer arms, or flank/hip area.
Pinch a fold of skin between thumb and forefinger; insert the needle at 45–90° into subcutaneous tissue.
Do not aspirate for subcutaneous injections; inject slowly and steadily.
After injection, release the pinched skin and withdraw the needle at the same angle.
Apply gentle pressure with a clean cotton or alcohol pad; do not rub vigorously.
Rotate sites systematically with each dose to prevent irritation or tissue damage.
Immediately dispose of the used syringe in a proper sharps container.
