ARA-290 (Cibinetide)
ARA-290 (Cibinetide) is a synthetic 11-amino acid peptide designed to selectively activate the innate repair receptor (IRR) — a heterodimer of the erythropoietin receptor and the beta common receptor — without triggering the erythropoietic effects of native EPO. This selectivity allows it to target tissue-protective and anti-inflammatory pathways without the cardiovascular risks of hematocrit elevation. The most compelling human evidence comes from trials in sarcoidosis-associated small fiber neuropathy, where ARA-290 improved corneal nerve fiber density and reduced neuropathic pain scores compared to placebo in a phase 2 trial. Broader development for diabetic peripheral neuropathy and other small fiber neuropathies is ongoing, though no regulatory approval has been granted.
Evidence last reviewed: 19 Apr 2026
Not a routine supplement — not recommended for self-directed use.
Information here is educational only, not a recommendation to use. See our Safety page.
Evidence is from research or clinical settings — does not imply safety outside supervised contexts.
The evidence for ARA-290 comes primarily from moderate-quality randomized controlled trials showing improvements in nerve fiber density and pain scores in specific neuropathies. However, broader applications and regulatory approvals are still pending, indicating a need for further research.
Corneal nerve fiber abundancePatients with sarcoidosis-associated small nerve fiber loss and neuropathic pain · RCTModerate
Cibinetide improved corneal nerve fiber area and increased regenerating intraepidermal fibers, indicating potential for disease modification.
Pain intensityPatients with moderate-severe neuropathic pain · RCTModerate
Subjects reported a clinically meaningful decrease in pain intensity, particularly in the 4 mg group.
Functional capacity (6-minute walk test)Patients with sarcoidosis-associated small nerve fiber loss · RCTModerate
Improvement in functional capacity as measured by the 6-minute walk test was observed.