ARA-290
Cibinetide · Erythropoietin helix B surface peptide · pHBSP
Erythropoietin is known for raising red blood cell count. Which is why it is a doping agent. Less well known is that it also has a tissue-protective role, acting through a completely different receptor, and that the two functions can be separated.
ARA-290 is that separation made into a molecule. It is an eleven-residue peptide taken from the helix B face of erythropoietin — the part that engages the innate repair receptor — not the classical EPO receptor. It signals repair without raising haematocrit at all, which removes the thrombotic risk that makes EPO dangerous.
What makes it worth taking seriously is that it has been tested. A randomised, double-blind, placebo-controlled trial in sarcoidosis patients with small fibre neuropathy measured corneal nerve fibre area, an objective structural measurement rather than a questionnaire, and found improvement against placebo alongside better pain and autonomic symptom scores. That is a higher standard of evidence than almost anything else in the healing category on this site.
How it works
Erythropoietin signals through two distinct receptors. The classical homodimeric EPO receptor on red cell precursors drives erythropoiesis. A separate heterodimer of the EPO receptor with the beta common receptor — often called the innate repair receptor — appears on injured tissue and mediates tissue protection instead.
ARA-290 engages only the second one. It is drawn from a face of the erythropoietin molecule that does not contact the classical receptor, which is why it produces no measurable change in haematocrit.
Through that receptor it reduces inflammatory signalling, limits apoptosis in stressed cells, and in the neuropathy work appears to support regrowth of small nerve fibres. The corneal nerve fibre measurement in the trial is what makes this more than an inference. It is a structural change somebody actually observed.
It is cleared from plasma within minutes. The effect outlasts the exposure by a long way, which suggests it triggers a repair programme rather than needing to be present continuously.
Regulatory status — United States
Not approved for any indication. Has completed randomised phase 2 trials in neuropathy and holds orphan drug designation for sarcoidosis in both the United States and the European Union. Material sold as a research chemical is not the clinical product.
Last reviewed 16 Aug 2026. Regulatory positions in this category change frequently; we date this line so you can see how current it is.
What it is studied for
Each entry states the evidence behind it. We do not rank indications by effectiveness — for most compounds here, that would be a claim nobody can support.
Small fibre neuropathy in sarcoidosis
Clinical trialThe indication with a randomised trial behind it.
EvidenceA randomised, double-blind, placebo-controlled trial in 64 patients found increased corneal nerve fibre area and improved pain and autonomic symptom scores over 28 days.
Diabetic neuropathy and metabolic effects
Clinical trialStudied in a smaller trial.
EvidenceA phase 2 study in type 2 diabetes reported improved neuropathic symptoms and reduced HbA1c. Small, and not replicated.
General tissue repair and recovery
Community practiceWhy it is bought as a research chemical.
EvidenceNo trial has studied ARA-290 for general recovery, injury or performance in people without a neuropathy diagnosis.
Identity and clearance
Molecule
- Class
- Erythropoietin-derived peptide, innate repair receptor agonist
- Molecular weight
- 1257.4 Da
- Length
- 11 amino acids
Sequence
Pyr-Glu-Gln-Leu-Glu-Arg-Ala-Leu-Asn-Ser-Ser
Taken from the helix B surface of erythropoietin, a region facing away from the classical EPO receptor binding site.
Pharmacokinetics
Clinical trialCleared within minutes, yet dosed daily and producing effects measured over months. The signal it triggers persists long after the peptide is gone.
Dose protocols reported in sources
Displayed for reference only. Every row says where it came from, and a trial protocol and a community convention are not the same kind of information. None of this is fed into the calculator, and none of it is a recommendation.
| Goal | Dose | Frequency | Route | Units, 5 mg vial | Source | Start this protocol |
|---|---|---|---|---|---|---|
| Phase 2 protocol for small fibre neuropathy | 4 mg | Once daily for 28 days | Subcutaneous4 mg daily, given as a defined 28-day course rather than continuously. The trial measured its outcomes at the end of that course. | 80 u | Clinical trial | Start this |
| Commonly described community protocol | 1 mg – 4 mg | Once daily in courses of several weeks | SubcutaneousCommunity sources describe doses at or below the trial dose. Where a trial dose exists, using less of it is a choice being made without evidence, not a cautious version of the protocol. | 20–80 u | Community practice | Start this |
Start this copies a row into a protocol of your own, which you can then edit. Where a source gave a dose range or an ambiguous frequency, those fields arrive empty — we will not pick a number on your behalf.
CheckRows marked community practice describe what people commonly do, drawn from public discussion. They are not derived from any trial and are not evidence that a dose is safe or effective.
Cycling
Clinical trial4 weeks on, Not established off.
The 28-day course comes from the trial protocol rather than from convention. What happens with repeated courses, or with continuous use, has not been studied.
Calculator
Work out what to draw
Pre-filled with a 5 mg vial as a worked example. These are not recommended values — change them to match the vial in front of you.
Draw to 80 units on a 1 mL U-100 syringe. That is 0.8 mL, containing 4 mg of ARA-290.
80 units sits exactly on a printed line.
Bioalmanac performs arithmetic on values you enter. It does not recommend doses, schedules or compounds, and nothing here is medical advice. Confirm every calculation against your vial and syringe before drawing, and speak with a licensed healthcare provider.
Open this calculation in the full calculator
Units, concentration, bacteriostatic water — the glossary defines the vocabulary, and a unit is not a fixed volume.
Safety
Reported effects
- Injection site reactionsClinical trial
Common in trials
- HeadacheClinical trial
Reported in trials
- No change in haematocritClinical trial
Confirmed in trials
Worth stating as a finding, not an absence. The whole design goal was to avoid EPO's blood-thickening effect, and the trials measured it and confirmed it.
- Effects beyond 28 daysClinical trial
Unknown
The trials were four-week courses. Nothing establishes what longer or repeated use does.
When to stop
- Any allergic response: rash, hives, facial swelling or difficulty breathing. Seek urgent care.
- An injection site that becomes hot, spreading or produces pus.
- Worsening neuropathic pain rather than improvement.
- Persistent headache that does not settle.
Interactions and situations that need care
- Pregnancy and breastfeedingAvoid
No reproductive or developmental safety data.
- Active or previous cancerUse caution
The innate repair receptor limits apoptosis, which is protective in injured tissue and is not obviously desirable in a tumour. This has not been studied, and 'unstudied' is the honest description rather than 'safe'.
- Self-treating undiagnosed neuropathyUse caution
Neuropathy has many causes, several of them treatable and some serious. Treating the symptom with a research chemical instead of establishing the cause can let a diagnosable condition progress.
What to expect
- The trial evidence is unusually good for this category: randomised, placebo-controlled, and measuring an objective structural endpoint instead of a questionnaire.
- It was studied in people with diagnosed small fibre neuropathy. Nothing establishes any effect in people without it.
- It does not raise haematocrit. That was the design goal, and the trials measured it and confirmed it.
- The studied protocol is a 28-day course at 4 mg daily. Longer or repeated use has not been studied.
- It is not approved, and orphan drug designation is a development incentive rather than a finding about whether it works.
Storage and handling
- Freeze-dried powder
- Refrigerated at 2–8 °C, protected from light.
- After mixing
- Refrigerated at 2–8 °C. Do not freeze once mixed.
- Long-term, frozen
- Unopened powder is stable at −20 °C or colder.
Checking your vial
Research chemicals carry no manufacturing standard, so what the vial looks like is often the only quality signal available before you use it. More on assessing quality and COAs.
White cake, clear solution
Standard for a short peptide.
Collapsed cake or cloudy solution
Heat damage or degradation. Do not use it.
Questions
- Does ARA-290 raise red blood cell count like EPO?
- No, and that is the point of it. It is drawn from a part of the erythropoietin molecule that engages the tissue-repair receptor — not the classical one — and the trials measured haematocrit and found no change.
- Would it help a sports injury?
- Nothing establishes that. The evidence is in small fibre neuropathy, meaning nerve fibre damage in specific disease populations. That is a different kind of tissue and a different problem from a tendon or a muscle injury.
- How can it work if it is cleared in minutes?
- It appears to trigger a repair programme rather than needing to be continuously present. The trials measured effects at 28 days from daily dosing of a peptide gone from the blood within the hour.
References
ARA-290 improves small fibre neuropathy in sarcoidosis: a randomised, double-blind, placebo-controlled trial
Molecular Medicine, 2016 · Randomised, double-blind, placebo-controlled trial
Adults with sarcoidosis and small fibre neuropathy · n = 64 · 4 mg subcutaneous, once daily · 28 days
Increased corneal nerve fibre area, an objective structural measure, with improved pain and autonomic symptom scores against placebo. No change in haematocrit. Injection site reactions were the main adverse event.
Cibinetide in type 2 diabetes with neuropathic symptoms: a phase 2 study
Diabetes care and metabolism literature, 2017 · Randomised placebo-controlled phase 2 study
Adults with type 2 diabetes · 4 mg subcutaneous, once daily · 28 days
Improved neuropathic symptom scores and a reduction in HbA1c against placebo. A small study that has not been replicated.
Commonly reported community protocols
Bioalmanac editorial summary of public community sources, 2026 · Not a study
Records dose patterns described in public discussion, generally at or below the trial dose. Carries no evidential weight about safety or effect.
Related compounds
BPC-157
A synthetic 15-amino-acid peptide studied in animals for effects on tendon, ligament and gut tissue repair. No completed human trials.
TB-500
A synthetic fragment of thymosin beta-4, a naturally occurring protein involved in cell migration and tissue repair. Animal evidence only.
GHK-Cu
A naturally occurring copper-binding tripeptide with a long history in topical skincare research. Injected use is not what the research studied.
KPV
A three-amino-acid fragment of alpha-MSH studied for anti-inflammatory effects, largely in animal models of gut inflammation.
Next
What to do with ARA-290
- Keep a record of itTurn a dose and a schedule into a protocol, then log what you actually take. ARA-290 is filled in for you.
- See what it costsPer-milligram prices read from vendor sites and confirmed by a person, so vial sizes compare.
- Check a combinationWhat our profiles record about ARA-290 alongside each other compound — including the pairs where nothing is recorded.
Keep this page honest
If something here is wrong, out of date, or missing a source, tell us and we will fix it and say that we did.
This page is educational. It describes what published research reports, not what you should do. Peptides discussed here are largely not approved for human use, and nothing on Bioalmanac is medical advice. No clinician reviews these pages.
Page last updated 16 Aug 2026