ARA-290
Can the tissue effects of erythropoietin be preserved without touching red blood cell production? ARA-290 was born precisely from this question.
- Research Use Only
- Molecule under study
- Living document
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- Current research state
- An experimental molecule with orphan drug designation for certain indications; published Phase 2 clinical trials.
- Current clinical phase
- Phase 2 clinical trials — no regulatory approval
- Last update
- 21 July 2026 · Reference fact sheet v1.0
- Living document
- Updated regularly as research progresses.
What is ARA-290?
ARA-290, also known as cibinetide, is a short peptide (sequence: pyroglutamate-EQLERALNSS, 11 amino acids) that mimics the external loop of erythropoietin (EPO) involved in the protein's tissue effects.
It was developed to separate two properties of EPO: on one hand red blood cell production (dependent on the homodimeric EPOR receptor), on the other tissue-protective effects, attributed in the proposed model to an EPOR/CD131 complex known as the "innate repair receptor".
ARA-290 is described as preferentially activating this tissue pathway; its direct binding to the EPOR/CD131 complex nevertheless remains debated in the literature.
Names you may come across
This molecule may appear under several names in the scientific, clinical or technical literature. Here are the main designations you may come across.
Development code widely used in the scientific literature.
International nonproprietary name (INN).
Simplified functional description.
Understanding it simply
Three simple reference points for understanding ARA-290.
A targeted fragment, not EPO
ARA-290 mimics only the part of EPO that triggers tissue effects. It does not increase red blood cell counts.
A proposed repair receptor
According to the proposed model, it would act via a complex (EPOR/CD131) whose expression increases with injury or inflammation; this mechanism is not definitively established.
A clinical focus: neuropathy
Its most advanced clinical trials concern neuropathic pain associated with sarcoidosis and, to a lesser extent, diabetes.
What research shows today
Science advances step by step. We clearly distinguish what is firmly established from what remains under study.
- An 11-amino-acid peptide derived from the helix B region of erythropoietin (EPO). — established
- Proposed to act via an "innate repair receptor" (EPOR/CD131 complex) distinct from the homodimeric EPO receptor; this model rests on preclinical data and remains debated. — established
- Absence of an effect on erythropoiesis demonstrated in vivo and in humans. — established
- Phase 2 clinical trials published in sarcoidosis-associated small fiber neuropathy and type 2 diabetes. — established
- Overall clinical efficacy requires confirmation in large Phase 3 trials. — ongoing
Several small phase 2 clinical trials published (notably in sarcoidosis-associated neuropathy and type 2 diabetes), with preliminary signals; no completed phase 3 development to date.
What the research shows
- Peptide structure well characterized; no erythropoietic activity reported in published studies.
- Absence of an effect on erythropoiesis demonstrated in vivo (mice, nonhuman primates) and in humans.
- Anti-inflammatory and protective effects described in several preclinical models (ischemia, nerve injury, diabetes).
- Published phase 2 clinical trials, particularly in sarcoidosis-associated small fiber neuropathy (ARA-290-SNS trial).
What still remains to be studied
- Overall clinical efficacy and duration of effect remain to be confirmed in larger phase 3 cohorts.
- The optimal therapeutic role (specific indications, target patients) has not yet been established.
- Long-term tolerability data (beyond several months of continuous use) remain limited.
What we know today
Not all information carries the same weight of evidence. We therefore present it across three clearly distinct levels, from the most solid to the most indicative.
What scientific publications show
Scientific evidence- Preclinical studies converge on a profile of tissue protection (kidney, heart, nerve, retina) without hematological effects.
- Small phase 2 trials in sarcoidosis-associated neuropathy report improvements on some endpoints (symptom scores, corneal nerve fibers) versus placebo, without a clear effect demonstrated across all pain endpoints.
- Exploratory clinical research has been conducted in type 2 diabetes (endothelial function, neuropathic symptoms).
What some professionals report
Documented- The clinical authors emphasize that phase 2 results must be confirmed by phase 3 trials before any conclusions can be drawn.
- The tolerability profile reported in published trials is described as favorable, with mainly injection-site reactions.
What the community reports
Field observations- Little community feedback is available: ARA-290 remains a little-known molecule, found primarily in research settings.
- Individual observations do not replace clinical trials.
The clinical assessment of ARA-290 relies primarily on published trials, with the caution required for any experimental molecule.
How does ARA-290 work?
The proposed model involves a receptor complex expressed mainly in injured tissue — hence an action sometimes described as "on demand". This model remains to be confirmed.
- EPOR/CD131 complex (proposed model)
- Heterodimeric complex proposed as the target of ARA-290, with expression thought to increase under tissue stress; its composition and direct binding remain debated.
- Anti-inflammatory pathways
- Modulation of pro-inflammatory cytokines in several preclinical models.
- Sensory neurons
- Effect studied in small nerve fibers, in connection with trials in sarcoidosis-associated neuropathy.
- Endothelial function
- Improvement observed in some studies in type 2 diabetes.
The reported absence of erythropoietic effect is attributed to the lack of activation of the homodimeric EPO receptor; the exact role of the EPOR/CD131 complex remains a working model.
Clinical trials timeline
A molecule under study progresses step by step. Here, simply, is where the research currently stands.
- Discovery· 2000sCompleted
Rational peptide design
Brines and Cerami identify the external loop of EPO as the motif responsible for tissue effects; ARA-290 is designed as a mimetic.
- Preclinical· 2008-2012Completed
Tissue injury models
Protective effects described in models of renal and cardiac ischemia, nerve injury, and diabetic retinopathy.
- Phase 1· 2011-2012Completed
Tolerability in humans
Early clinical studies confirm good tolerability and the absence of an erythropoietic effect.
- Phase 2· 2013-2017Completed
Sarcoidosis-associated neuropathy (ARA-290-SNS)
Small randomized placebo-controlled trials in sarcoidosis-associated small fiber neuropathy: improvements reported on some endpoints, without a clear benefit demonstrated on all pain endpoints.
- Ongoing· CurrentlyOngoing
Ongoing research
Ongoing publications and targeted exploratory trials; no regulatory approval to date.
Available analyses
No analytical document has been published for this molecule to date.
Open the analysis libraryFrequently asked questions
Is ARA-290 an approved medicine?
No. It is an experimental molecule at the phase 2 clinical stage. PHL presents it for educational and reference purposes (Research Use Only).
Does ARA-290 increase red blood cell counts like EPO?
Established: no. It was specifically designed to target EPO's tissue pathway without its hematological effect.
For which indication has it been studied most extensively in clinical trials?
Established: sarcoidosis-associated small fiber neuropathy, through several randomized placebo-controlled trials.
Can it be used for sports recovery?
To be studied: no published clinical data support this use. Any extrapolation from preclinical studies would be speculative.
How is it administered in studies?
Established: in the vast majority of published trials, ARA-290 is administered subcutaneously in a medical setting.
What adverse effects have been reported?
Established: published trials report good overall tolerability, with mainly injection-site reactions. To be studied: long-term tolerability beyond several months.
Scientific publications
Selected reference publications on ARA-290 / cibinetide — design, mechanism, and phase 2 clinical trials. An evolving bibliography.
Glossary
- Erythropoietin (EPO)
- A hormone produced by the kidney that stimulates red blood cell production.
- Erythropoiesis
- The process of red blood cell production.
- Heterodimeric receptor
- Receptor made up of two different subunits (here, according to the proposed model, EPOR and CD131).
- Innate repair receptor
- Name given to the EPOR/CD131 complex proposed to explain EPO's tissue effects; its exact existence and composition remain debated.
- Small fiber neuropathy
- Damage to small nerve fibers, often responsible for pain and sensory disturbances.
- Sarcoidosis
- A systemic inflammatory disease characterized by the formation of granulomas in several organs.
- Phase 2
- A clinical trial assessing preliminary efficacy and tolerability in a limited number of patients.
Continue your discovery
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Reference fact sheet — version 1.0, updated on 21 July 2026. The full regulatory and scientific framework is gathered in the “Important information” box at the top of the fact sheet.
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