ARA-290 (Cibinetide) Dosage Guide

Evidence-based protocols for the innate repair receptor (IRR) agonist — clinical trial dosing for diabetic neuropathy, small fiber neuropathy, sarcoidosis, tissue repair, and anti-inflammatory support.

Compiled by PeptideWiki Editorial Team·Last reviewed February 24, 2026

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Research Peptides

ARA-290

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What Is ARA-290 (Cibinetide)?

ARA-290 (also known as Cibinetide) is a synthetic 11-amino-acid peptide designed to selectively activate the innate repair receptor (IRR). The IRR is a heterodimeric receptor complex composed of the erythropoietin receptor (EPOR) and CD131 (also called the beta common receptor, βcR). This receptor is distinct from the classical EPO receptor homodimer that drives red blood cell production.

The critical distinction is this: natural erythropoietin (EPO) activates the EPOR/EPOR homodimer to stimulate erythropoiesis (red blood cell production in bone marrow), while ARA-290 selectively activates the EPOR/CD131 heterodimer (the IRR) to trigger tissue-protective, anti-inflammatory, and repair pathways — without any effect on red blood cell production. This selectivity is what makes ARA-290 therapeutically interesting: it captures EPO's tissue-protective benefits while avoiding the dangerous hematological side effects (blood thickening, clotting risk) that limit EPO's use outside of anemia treatment.

ARA-290 was developed by Araim Pharmaceuticals and has progressed through multiple Phase 2 clinical trials, primarily for diabetic neuropathy and sarcoidosis-associated small fiber neuropathy. These trials used subcutaneous injection of 2–4 mg daily for 28 days and demonstrated improvements in corneal nerve fiber density (a biomarker for small fiber nerve health), neuropathic pain scores, and quality of life measures.

Use our Peptide Dosage to calculate your exact subcutaneous dose based on vial size and concentration.

Dosing information in this guide is derived from published clinical trial data and research literature and community protocols — not from approved pharmaceutical labeling.

Key Characteristics:

Selective innate repair receptor (IRR) agonist — activates the EPOR/CD131 heterodimer for tissue protection and repair; does NOT activate the classical EPOR/EPOR homodimer for erythropoiesis
11-amino-acid synthetic peptide — molecular weight ~1.3 kDa; designed based on the tissue-protective signaling domain of EPO without the erythropoietic domain
No erythropoietic activity — does NOT increase red blood cells, hemoglobin, or hematocrit — confirmed in clinical trials; avoids blood thickening and clotting risks of EPO
Clinical trial-validated dosing — 2–4 mg subcutaneous daily for 28 days in Phase 2 trials for diabetic neuropathy and sarcoidosis-associated neuropathy
Neuroprotective and neuroregenerative — promotes small nerve fiber regeneration; improvements in corneal nerve fiber density demonstrated in clinical trials
Anti-inflammatory tissue protection — IRR activation triggers anti-apoptotic, anti-inflammatory, and cytoprotective signaling cascades including JAK2/STAT5, PI3K/Akt, and NF-κB modulation

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How ARA-290 Dosage Is Determined

ARA-290 is one of the few research peptides with dosing informed directly by formal human clinical trials rather than solely by preclinical animal studies and community extrapolation. Multiple Phase 2 trials have established the dose range, treatment duration, and route of administration used in practice today.

Phase 2 Clinical Trials — Diabetic Neuropathy

Brines et al. conducted Phase 2 trials evaluating ARA-290 in patients with type 2 diabetes and neuropathy. These studies used 4 mg subcutaneous injection once daily for 28 days. Corneal confocal microscopy (a non-invasive biomarker for small fiber nerve density) demonstrated improvements in corneal nerve fiber density and branch density in the treatment group compared to placebo. Neuropathic pain scores also improved. These results established 4 mg daily as the primary clinical dose.

Sarcoidosis-Associated Small Fiber Neuropathy

Heij et al. evaluated ARA-290 in sarcoidosis patients with small fiber neuropathy (SFN) — a condition where the body's immune response damages small sensory nerves. Using the same 4 mg daily subcutaneous protocol for 28 days, the study demonstrated improvements in corneal nerve fiber parameters and patient-reported quality of life. This confirmed that ARA-290's IRR-mediated tissue repair extends beyond diabetic neuropathy to immune-mediated nerve damage.

Dose-Finding Rationale

The 2–4 mg dose range was selected based on preclinical pharmacokinetic and pharmacodynamic modeling. ARA-290 has a short plasma half-life (approximately 10–12 minutes after subcutaneous injection), but its biological effects persist much longer because IRR activation triggers downstream signaling cascades (JAK2/STAT5, PI3K/Akt) that continue for hours after the peptide itself has been cleared. The 4 mg dose was shown to achieve sufficient plasma levels for reliable IRR activation across the target tissue compartments.

IRR Selectivity — Why No Erythropoiesis

ARA-290's structure was specifically engineered to bind the EPOR/CD131 heterodimer (IRR) with high affinity while having negligible affinity for the EPOR/EPOR homodimer that drives erythropoiesis. This selectivity has been confirmed in clinical trials: patients receiving 4 mg daily for 28 days showed no changes in hemoglobin, hematocrit, reticulocyte counts, or any other erythropoietic parameters. This is the key safety advantage over EPO and EPO-derived compounds.

Strength of evidence: Strong clinical (Phase 2). ARA-290 has unusually strong clinical evidence for a research peptide. Multiple Phase 2 trials with proper placebo controls, defined endpoints, and peer-reviewed publications support the 2–4 mg daily subcutaneous dose for 28 days. This is a significantly stronger evidence base than most research peptides, which rely primarily on preclinical animal data and community extrapolation.

Standard ARA-290 Dosage Ranges

ARA-290 dosing is primarily based on clinical trial data. The subcutaneous route is standard, with intravenous administration used only in controlled research settings. Note that ARA-290 is dosed in milligrams (mg), not micrograms — a higher dose range than many other research peptides.

Subcutaneous Injection (Standard)

Level	Dose per Injection	Frequency	Duration	Notes
Starting / Lower	2 mg	1x daily	28 days	Lower end of clinical range; assess tolerance
Standard (Clinical)	4 mg	1x daily	28 days	Primary dose used in Phase 2 trials; most commonly recommended
Repeat Course	4 mg	1x daily	28 days (after break)	Additional course after 2–4 week assessment period if needed

Intravenous (Research Settings Only)

Dose: 2–4 mg IV bolus, used in early clinical pharmacology studies
Context: Hospital or clinical research settings only; not practical for outpatient or self-administration
Note: IV administration provides faster peak plasma levels but the same downstream biological effects as subcutaneous injection; SubQ is preferred for all practical use

Milligrams, not micrograms: ARA-290 is dosed in milligrams (mg). The standard clinical dose is 4 mg (= 4,000 mcg). This is considerably higher than many peptides that are dosed in the microgram range (100–500 mcg). Always confirm your units when calculating reconstitution volumes to avoid dosing errors.

Administration Routes Compared

Unlike some peptides with multiple practical routes (oral, topical, intranasal), ARA-290 is effectively limited to subcutaneous injection for practical use. Its 11-amino-acid size makes it too large for reliable oral bioavailability and too small to be formulated for practical topical or transdermal delivery to deep tissues.

Parameter	Subcutaneous	Intravenous	Oral
Typical Dose	2–4 mg	2–4 mg	Not viable
Bioavailability	Good (standard route)	100% (direct)	Negligible (degraded)
Clinical Evidence	Phase 2 trials	Early-phase studies	None
Practical for Self-Use	Yes	No (clinical setting only)	No
Ease of Use	Requires injection skill	Requires medical supervision	N/A
Key Advantage	Proven, practical, reliable	Fastest peak levels	N/A

Subcutaneous is the standard. All published clinical trial data for ARA-290 uses subcutaneous injection. This is the only route with established efficacy data and is the recommended method for all practical use. The short plasma half-life (~10–12 minutes) does not limit efficacy because the downstream biological signaling cascades activated by IRR persist for hours after the peptide is cleared.

Calculate Your ARA-290 Dose

ARA-290 is supplied as a lyophilized (freeze-dried) powder, typically in 5 mg or 10 mg vials. You reconstitute it with bacteriostatic water, then draw your dose using an insulin syringe. Because ARA-290 is dosed in milligrams (not micrograms), the injection volumes are somewhat larger than for low-dose peptides.

Worked Example (5 mg Vial):

Vial size: 5 mg (5,000 mcg) of ARA-290
Bacteriostatic water added: 1 mL
Concentration: 5 mg ÷ 1 mL = 5 mg per mL
Target dose: 4 mg
Volume to draw: 4 ÷ 5 = 0.8 mL = 80 units on an insulin syringe

Quick Reference — 5 mg Vial

Bac Water Added	Concentration	2 mg Dose	4 mg Dose
0.5 mL	10 mg/mL	20 units (0.2 mL)	40 units (0.4 mL)
1 mL	5 mg/mL	40 units (0.4 mL)	80 units (0.8 mL)
2 mL	2.5 mg/mL	80 units (0.8 mL)	Not practical (1.6 mL)

Quick Reference — 10 mg Vial

Bac Water Added	Concentration	2 mg Dose	4 mg Dose
1 mL	10 mg/mL	20 units (0.2 mL)	40 units (0.4 mL)
2 mL	5 mg/mL	40 units (0.4 mL)	80 units (0.8 mL)
2.5 mL	4 mg/mL	50 units (0.5 mL)	100 units (1 mL)

Watch your injection volume. Because ARA-290 is dosed in milligrams, the injection volume can be larger than typical peptide injections. With a 5 mg vial reconstituted in 1 mL, a 4 mg dose requires 0.8 mL — nearly a full insulin syringe. Using a 10 mg vial with 2 mL water keeps the volume at a more comfortable 0.8 mL. Avoid reconstituting with too much water, which would push the injection volume above 1 mL (the maximum for a standard insulin syringe).

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ARA-290 Dosage by Goal

ARA-290's IRR activation provides tissue-protective and repair-promoting effects across multiple contexts. The standard 4 mg daily protocol applies across most goals, with variations primarily in duration and stacking rather than dose.

Diabetic Neuropathy & Small Fiber Neuropathy

The primary clinical indication studied in Phase 2 trials. ARA-290 promotes small nerve fiber regeneration via IRR-mediated signaling. Corneal confocal microscopy has demonstrated improvements in corneal nerve fiber density — a validated surrogate biomarker for systemic small fiber nerve health — after 28 days of treatment.

Dose: 4 mg subcutaneous, once daily
Duration: 28 days per course; reassess before repeating
Expected timeline: Measurable nerve fiber improvements at 28 days; symptomatic improvement may begin at 2–3 weeks but continue developing after treatment ends
Stack: + SS-31 for mitochondrial support in nerve cells (complementary neuroprotective mechanism)

Sarcoidosis-Associated Neuropathy

Sarcoidosis causes immune-mediated damage to small nerve fibers. ARA-290's anti-inflammatory and tissue-repair properties through IRR activation address both the inflammatory insult and the resulting nerve damage. Clinical trials have demonstrated improvements in this specific patient population.

Dose: 4 mg subcutaneous, once daily
Duration: 28 days per course; may require multiple courses
Stack: + Thymosin Alpha-1 for immune modulation support (addresses the immune dysregulation underlying sarcoidosis)

General Tissue Protection & Repair

Beyond neuropathy, IRR activation by ARA-290 triggers broadly cytoprotective signaling cascades (anti-apoptotic, anti-inflammatory) that may support tissue repair in various contexts. The IRR is expressed in multiple tissue types including cardiac, renal, neural, and vascular tissue. Preclinical models have shown protection against ischemia-reperfusion injury, kidney injury, and cardiac damage.

Dose: 2–4 mg subcutaneous, once daily
Duration: 14–28 days depending on the repair context
Stack: + BPC-157 250–500 mcg for complementary tissue repair (angiogenesis + growth factor upregulation)

Anti-Inflammatory Support

IRR activation modulates NF-κB signaling and reduces pro-inflammatory cytokine production through a different mechanism than direct NF-κB inhibitors like KPV. ARA-290's anti-inflammatory effects are mediated through the tissue-protective signaling cascade rather than direct transcription factor inhibition, providing a complementary anti-inflammatory approach.

Dose: 2–4 mg subcutaneous, once daily
Duration: 28 days per course
Stack: + KPV for dual anti-inflammatory pathways (IRR-mediated tissue protection + direct NF-κB inhibition)

Dose is consistent across goals. Unlike many peptides where the dose varies significantly by goal, ARA-290's clinical dose of 4 mg daily is relatively consistent across indications. The primary variations are in treatment duration (shorter courses for acute tissue repair, standard 28-day courses for neuropathy) and stacking partners (which are selected based on the target condition).

Cycling & Duration

ARA-290 cycling follows the clinical trial paradigm: defined treatment courses of 28 days, with assessment periods between courses. This is not primarily driven by desensitization concerns (the IRR does not appear to rapidly downregulate) but rather by the nature of tissue repair — biological processes initiated during the treatment course continue developing during the off-period.

Protocol	On-Period	Off-Period	Notes
Standard (Clinical)	28 days	2–4 weeks	Matches clinical trial protocol; assess response during off-period
Repeat Course	28 days	2–4 weeks	Second course if first shows benefit but further improvement is desired
Extended (Chronic Neuropathy)	28 days	4 weeks	Multiple sequential courses for chronic conditions; reassess between each
Short Course (Tissue Repair)	14–21 days	As needed	Shorter course for acute tissue protection scenarios; less clinical data

Repair continues after treatment stops. One important feature of ARA-290 is that the biological repair processes it initiates (nerve fiber regeneration, tissue remodeling) continue after the 28-day treatment course ends. Clinical trials measured outcomes both at the end of treatment and at follow-up visits weeks later, with some parameters continuing to improve post-treatment. The off-period is not wasted time — it is when much of the actual repair occurs.

When to Repeat a Course

First course showed benefit: If symptoms improved during or after the first 28-day course but further improvement is desired, a repeat course after a 2–4 week break is reasonable.
Chronic neuropathy: Nerve regeneration is slow. Multiple 28-day courses may be needed to achieve meaningful clinical improvement in severe or long-standing neuropathy.
No benefit after first course: If no improvement is observed after a full 28-day course plus a 4-week assessment period, reconsider whether ARA-290 is appropriate for the specific condition. Consult a healthcare provider.
Symptom recurrence: If symptoms return after initial improvement, a repeat course may help reinitiate repair signaling.

ARA-290 Stacking Protocols

ARA-290's IRR-mediated tissue repair mechanism is distinct from most other peptide mechanisms, making it a good candidate for complementary stacking. Because IRR activation triggers anti-apoptotic and cytoprotective signaling, it pairs well with peptides that address other aspects of tissue health: angiogenesis, mitochondrial function, immune modulation, and growth factor production.

ARA-290 + BPC-157 — Tissue Repair Stack

Combines ARA-290's IRR-mediated cytoprotection with BPC-157's angiogenic and growth factor-driven tissue repair. ARA-290 protects cells from apoptosis and reduces inflammation (the defense), while BPC-157 promotes new blood vessel formation and tissue regeneration (the rebuild). These mechanisms are fully complementary.

Compound	Dose	Route	Purpose
ARA-290	4 mg, 1x daily	SubQ	IRR activation; cytoprotection; anti-apoptotic signaling
BPC-157	250–500 mcg, 1–2x daily	SubQ	Angiogenesis; growth factor upregulation (VEGF, EGF); tissue repair

ARA-290 + SS-31 (Elamipretide) — Neuroprotective Stack

A targeted neuroprotection approach pairing ARA-290's IRR-mediated nerve repair with SS-31's mitochondrial protection. SS-31 stabilizes cardiolipin in the inner mitochondrial membrane, improving cellular energy production in metabolically stressed neurons. This combination addresses both the signaling environment (IRR activation) and the energy supply (mitochondrial function) needed for nerve regeneration.

Compound	Dose	Route	Purpose
ARA-290	4 mg, 1x daily	SubQ	IRR activation; nerve fiber regeneration signaling
SS-31	0.5–1 mg, 1x daily	SubQ	Mitochondrial cardiolipin stabilization; neuronal energy support

Protocol note: This stack is particularly relevant for diabetic neuropathy, where mitochondrial dysfunction in peripheral neurons is a key driver of nerve damage. SS-31 addresses the metabolic insult while ARA-290 promotes the repair response.

ARA-290 + Thymosin Alpha-1 — Immune-Mediated Neuropathy Stack

Designed for conditions where immune dysregulation contributes to nerve damage (such as sarcoidosis-associated neuropathy). ARA-290 promotes nerve repair via IRR activation while Thymosin Alpha-1 modulates adaptive immune function, enhancing T-cell regulation and potentially reducing the autoimmune or inflammatory attack on nerve fibers.

Compound	Dose	Route	Purpose
ARA-290	4 mg, 1x daily	SubQ	IRR activation; nerve repair; anti-inflammatory tissue protection
Thymosin Alpha-1	1.6 mg, 2–3x per week	SubQ	Adaptive immune modulation; T-cell regulation; immune surveillance

ARA-290 + BPC-157 + SS-31 — Comprehensive Neuroprotection Stack

A three-peptide approach targeting all major aspects of nerve health: IRR-mediated repair signaling (ARA-290), angiogenesis and growth factor support (BPC-157), and mitochondrial energy optimization (SS-31). This comprehensive stack addresses the signaling, vascular, and metabolic components of nerve repair simultaneously.

Compound	Dose	Route	Purpose
ARA-290	4 mg, 1x daily	SubQ	IRR activation; tissue-protective signaling cascade
BPC-157	250–500 mcg, 1–2x daily	SubQ	Angiogenesis; growth factor upregulation; vascular support
SS-31	0.5–1 mg, 1x daily	SubQ	Mitochondrial support; cellular energy optimization

ARA-290 is NOT EPO. Do not stack ARA-290 with erythropoiesis-stimulating agents expecting synergistic red blood cell effects. ARA-290 does not stimulate erythropoiesis at all. Its tissue-protective mechanism is entirely separate from EPO's hematopoietic function. Stacking with EPO provides no IRR-related benefit and introduces unnecessary hematological risks.

Explore more combinations with our Peptide Stack Builder or browse the Top 10 Peptide Stacks guide.

Safety, Side Effects & Contraindications

Safety Profile: ARA-290 was well-tolerated in Phase 2 clinical trials at doses up to 4 mg daily for 28 days. No serious adverse events were attributed to the drug. The absence of erythropoietic effects eliminates the major safety concerns associated with EPO (polycythemia, thrombosis, hypertension). ARA-290 does not manipulate sex hormones, does not cause receptor desensitization, and does not affect endocrine feedback loops. However, Phase 3 trials have not been completed, and long-term safety data is limited.

Reported Side Effects (Clinical Trials)

Mild and infrequent:

Injection site reactions — mild redness, soreness, or swelling at the injection site; the most commonly reported adverse event; typically transient
Mild headache — reported by a small percentage of participants in clinical trials; generally self-resolving
Transient dizziness — reported rarely; mild and short-lasting
Mild nausea — infrequent; did not lead to discontinuation in clinical trials

NOT associated with ARA-290:

No increases in hemoglobin, hematocrit, or red blood cell count (no erythropoietic effects — confirmed in clinical trials)
No hypertension or blood pressure changes
No thromboembolic events (no blood clotting risk increase)
No hormonal effects (no impact on testosterone, estrogen, cortisol, or prolactin)
No appetite changes, weight gain, or metabolic disruption
No known receptor desensitization or tolerance development within 28-day courses

The key safety advantage over EPO: Erythropoietin (EPO) carries significant risks including polycythemia (dangerously elevated red blood cell count), hypertension, and thromboembolic events (blood clots, stroke, heart attack). These risks have severely limited EPO's use for tissue protection despite its proven cytoprotective properties. ARA-290 was specifically designed to capture EPO's tissue-protective benefits via the IRR while completely avoiding erythropoietic activation. Clinical data confirms this separation is real and robust.

Contraindications

Pregnancy and breastfeeding — no safety data exists for ARA-290 during pregnancy or nursing. Avoid entirely.
Known hypersensitivity — discontinue use if allergic reactions occur (rash, hives, difficulty breathing, swelling).
Active malignancy — IRR activation triggers anti-apoptotic and cytoprotective signaling cascades. While these are beneficial for tissue repair, the theoretical concern is that anti-apoptotic signaling could potentially support tumor cell survival. Patients with active cancer should not use ARA-290 without oncologist consultation.
Concurrent EPO therapy — while ARA-290 does not stimulate erythropoiesis, combining it with EPO or EPO-stimulating agents has not been adequately studied. Consult a healthcare provider if currently receiving EPO therapy.

When to Stop or Reduce Dose

Any signs of allergic reaction (rash, hives, swelling, difficulty breathing)
Persistent or worsening injection site reactions beyond the first week
No improvement in symptoms after a complete 28-day course plus 4-week assessment period
Development of any new or unexpected symptoms during treatment — err on the side of caution and consult a healthcare provider
If diagnosed with a new malignancy while on treatment — discontinue and consult an oncologist

Regulatory Status: ARA-290 (Cibinetide) has been evaluated in Phase 2 clinical trials but has not received FDA approval or completed Phase 3 registration trials. It is classified as a research peptide / investigational drug. Development was conducted by Araim Pharmaceuticals. Regulatory status may vary by jurisdiction. Verify your local laws before purchasing or using this compound.

Common ARA-290 Dosing Mistakes

Avoid these common errors to get the most out of your ARA-290 protocol:

Confusing ARA-290 with EPO and expecting red blood cell effects: ARA-290 activates the innate repair receptor (EPOR/CD131 heterodimer), NOT the classical EPO receptor homodimer. It has zero erythropoietic activity. Do not use ARA-290 expecting increases in hemoglobin, hematocrit, or athletic performance from red blood cell production — that is EPO’s mechanism, not ARA-290’s.

Dosing in micrograms instead of milligrams: ARA-290 is dosed in milligrams (2–4 mg), not micrograms. Many other peptides are dosed in micrograms (mcg), which can cause confusion. A dose of 4 mcg would be 1,000 times too low. Always double-check units when preparing your dose. The clinical standard is 4 mg (4,000 mcg) per injection.

Expecting rapid symptom relief within days: ARA-290 activates tissue repair and nerve regeneration pathways. Nerve fiber regrowth is a slow biological process that takes weeks to months. Clinical trials measured outcomes at 28 days and beyond. Do not abandon the protocol after a few days because symptoms have not changed — the peptide is initiating repair processes that take time to manifest as symptom improvement.

Using oral administration instead of subcutaneous injection: Unlike very small tripeptides (such as KPV), ARA-290 is an 11-amino-acid peptide that cannot survive oral digestion. All clinical evidence is based on subcutaneous injection. Oral administration would result in near-complete degradation and no therapeutic effect. SubQ injection is the only validated route.

Running continuous cycles without assessment breaks: Clinical trials used defined 28-day treatment courses with assessment periods between cycles. Taking breaks between courses allows you to evaluate whether the treatment is working, whether symptoms have improved, and whether a repeat course is warranted. Continuous indefinite dosing has not been studied and provides no proven advantage over structured courses.

Using ARA-290 as a replacement for standard neuropathy treatments: ARA-290 is a research peptide, not an approved neuropathy treatment. Diabetic neuropathy and small fiber neuropathy require proper medical management including blood sugar control, pain management, and monitoring. ARA-290 should complement — not replace — evidence-based treatments prescribed by a neurologist or endocrinologist.

Storing reconstituted ARA-290 at room temperature: Like all reconstituted peptides, ARA-290 solution must be refrigerated (2–8°C) and protected from light. Use bacteriostatic water for reconstitution and use the solution within 3–4 weeks. Do not freeze reconstituted solution. Lyophilized (unreconstituted) powder can be stored frozen for longer periods.

Assuming higher doses provide better results: Clinical dose-finding studies selected 2–4 mg as the optimal range for IRR activation. Higher doses have not been shown to provide additional benefit and may not improve outcomes. The IRR has a specific activation threshold, and exceeding the studied dose range is not supported by evidence. Stick to the clinically validated 2–4 mg range.

Frequently Asked Questions

Key Takeaways

ARA-290 (Cibinetide) selectively activates the innate repair receptor (IRR) — an EPOR/CD131 heterodimer that triggers tissue-protective, anti-inflammatory, and repair signaling without erythropoiesis
No red blood cell effects — ARA-290 does NOT stimulate erythropoiesis, does not increase hemoglobin or hematocrit, and carries none of EPO's hematological risks
Clinical trial-validated dosing: 4 mg subcutaneous once daily for 28 days — established in Phase 2 trials for diabetic neuropathy and sarcoidosis-associated neuropathy
Dosed in milligrams, not micrograms: the standard dose is 4 mg (4,000 mcg) — significantly higher than most research peptides; double-check units
Subcutaneous injection only: oral administration is not viable for this 11-amino-acid peptide; all clinical data uses SubQ injection
Primary indications: diabetic neuropathy, small fiber neuropathy, sarcoidosis-associated neuropathy, general tissue repair, anti-inflammatory support
Repair continues after treatment: nerve regeneration and tissue repair processes initiated during the 28-day course continue developing during the off-period
Top stacks: + BPC-157 for tissue repair, + SS-31 for neuroprotection, + Thymosin Alpha-1 for immune-mediated neuropathy
Well-tolerated in clinical trials — mild injection site reactions most common; no hormonal effects, no hematological changes, no tolerance development
Not FDA-approved — Phase 2 data is strong but Phase 3 trials have not been completed. This is an investigational compound. Consult a healthcare provider.

This article is for educational and informational purposes only. See our Disclaimer.

References

Brines M, et al. “ARA 290, a nonerythropoietic peptide engineered from erythropoietin, improves metabolic control and neuropathic symptoms in patients with type 2 diabetes.” Mol Med. 2015;20(1):658-666. PubMed
Heij L, et al. “Safety and efficacy of ARA 290 in sarcoidosis patients with symptoms of small fiber neuropathy: a randomized, double-blind pilot study.” Mol Med. 2012;18(1):1430-1436. PubMed
Brines M, Cerami A. “The receptor that tames the innate immune response.” Mol Med. 2012;18(1):486-496. PubMed
Brines M, Cerami A. “Erythropoietin-mediated tissue protection: reducing collateral damage from the primary injury response.” J Intern Med. 2008;264(5):405-432. PubMed
Dahan A, et al. “ARA 290 improves symptoms in patients with sarcoidosis-associated small nerve fiber loss and increases corneal nerve fiber density.” Mol Med. 2013;19(1):334-345. PubMed
Brines M, et al. “Nonerythropoietic, tissue-protective peptides derived from the tertiary structure of erythropoietin.” Proc Natl Acad Sci USA. 2008;105(31):10925-10930. PubMed
Leist M, et al. “Derivatives of erythropoietin that are tissue protective but not erythropoietic.” Science. 2004;305(5681):239-242. PubMed
Brines M, Cerami A. “Discovering erythropoietin's extra-hematopoietic functions: biology and clinical promise.” Kidney Int. 2006;70(2):246-250. PubMed
Swartjes M, et al. “ARA 290, a peptide derived from the tertiary structure of erythropoietin, produces long-term relief of neuropathic pain coupled with suppression of the spinal microglia response.” Mol Pain. 2014;10:13. PubMed

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