Research Reference
ARA-290
EPO-derived peptide — neuropathy and tissue repair (trial-dosed)
Research & educational purposes only. BioMaxFit does not sell, promote, or represent peptides in any way. We are strictly educational and recommend working with your doctor on anything health-related. The information below comes from published research and documents what has been studied, not what should be done. Many of these compounds are investigational and not approved by the FDA; possession or use outside an authorized clinical trial may be illegal in your jurisdiction. This is not medical advice.
ARA-290 (cibinetide) is an 11-amino-acid, EPO-derived peptide that activates the innate repair receptor to drive anti-inflammatory and tissue-protective signaling. It was engineered to skip EPO's red-blood-cell-stimulating effect.
Published Phase 2 trials used 4 mg subcutaneously once daily for 28 days — the dose that produced the strongest small-nerve-fiber response in a dose-ranging study comparing 1 mg, 4 mg, and 8 mg.
ARA-290 is an investigational drug not approved by the FDA.
Dosing Reference
Reconstitution
Add 1 mL bacteriostatic water to the 10 mg vial. Resulting concentration: 10 mg/mL.
| Dose | Syringe Units | mL Volume | Schedule |
|---|---|---|---|
| 4 mg | 40 units | 0.4 mL | Daily SubQPhase 2 trial dose (28-day course) |
Math assumes U-100 insulin syringes (1 mL = 100 units). Verify your syringe matches before use. Round half-units to the nearest visible mark.
Reconstitution
Add 1 mL of bacteriostatic water to a 10 mg vial for a concentration of 10 mg/mL. A 4 mg dose draws to 40 units (0.4 mL) on a U-100 insulin syringe.
Gently swirl — do not shake. Refrigerate at 2–8°C and use within 28 days.
Cycling Protocol
The published trials ran ARA-290 as a single 28-day daily course rather than an on/off cycle. In the sarcoidosis study, investigators continued measuring symptom and corneal-nerve outcomes through 16 weeks after the start of dosing, and reported that several improvements persisted after the 28-day course ended (Dahan et al., 2013). There is no established long-term maintenance schedule in the trial literature.
Routes of Administration
Subcutaneous injection is the only route described in the ARA-290 trial literature.
- Sites: Trial protocols used abdominal and thigh subcutaneous fat; community sources also describe upper-arm placement.
- Volume: At the 10 mg/mL standard dilution, the 4 mg trial dose draws as 0.4 mL.
- Rotation: Trial protocols describe rotating injection sites.
Stacking Protocols
The ARA-290 trial literature studied the peptide as a single agent, not as part of a stack, so there are no trial-documented combinations.
| Stack | Rationale | Notes | | --- | --- | --- | | ARA-290 + BPC-157 | Both are discussed in community sources for tissue repair via different mechanisms | No clinical-trial data on the combination; community-reported only |
Community sources occasionally describe pairing ARA-290 with other repair-focused peptides, but no controlled data supports any specific combination.
Side Effects & Safety
- Injection-site reactions — the most commonly noted event in trials (mild redness or irritation)
- No significant safety issues were reported for any treatment group across the Phase 2 sarcoidosis and diabetes trials
- No change in hematocrit — ARA-290 was engineered to skip EPO's red-blood-cell-stimulating effect, and trials reported no meaningful rise in red cell mass
- Limited long-term data — published exposure is largely confined to 28-day courses
Research Basis
The 4 mg/day dose is not a community estimate — it is the dose carried through the published Phase 2 program.
Dose-ranging sarcoidosis trial (Culver et al., 2017): A double-blind, placebo-controlled study compared 1 mg, 4 mg, and 8 mg daily subcutaneous cibinetide for 28 days in patients with painful sarcoid small-fiber neuropathy. The 4 mg dose produced the largest placebo-corrected increase in corneal nerve fiber area, with regenerating skin nerve fibers also increasing significantly at that dose.
Type 2 diabetes trial (Brines et al., 2015): A separate placebo-controlled study administered 4 mg ARA-290 daily for 28 days and reported improvements in HbA1c, lipid profile, and neuropathic symptom scores, with no safety signals.
Why 4 mg and not 8 mg: In the dose-ranging data, the 4 mg arm — not the higher 8 mg arm — showed the strongest nerve-fiber response, which is why 4 mg is the dose most often referenced for ARA-290.