Recovery & Repair
ARA-290 (Cibinetide)
aka Cibinetide · ARA290 · ara-290 · non-erythropoietic EPO peptide · innate repair receptor agonist · EPO helix-B peptide
Grade
A lab-made 11-amino-acid offcut of the hormone EPO, engineered to keep its tissue-repair and anti-inflammatory effects while losing the red-blood-cell boost — with promising but unfinished human trials in nerve damage.
- Class
- Synthetic 11-amino-acid peptide derived from erythropoietin (non-erythropoietic EPO fragment)
- Evidence
- Grade C · Early / limited human data
- Sport / WADA
- ARA-290 is not individually named on the WADA Prohibited List, but athletes should be cautious. Although it is engineered to be non-erythropoietic, it is derived from and acts on the erythropoietin-receptor system, and WADA prohibits erythropoietin-receptor agonists and related agents under section S2 (Peptide Hormones, Growth Factors and Mimetics). Its status as an unapproved substance also means it could be caught by the clause covering substances with no current approval for human therapeutic use. Anyone in tested sport should assume risk and seek guidance rather than treat it as clearly permitted.
- Last reviewed
- 2026-06
Grade C · Early / limited human data
Why this grade
Unusually for a grey-market peptide, ARA-290 has completed several small, properly designed, placebo-controlled human Phase 2 trials (sarcoidosis small-fibre neuropathy and type 2 diabetes) with measurable, positive signals on nerve fibres and symptoms. But the trials are small, short and few, there is no completed Phase 3 replication, it is approved nowhere, and the developing company (Araim Pharmaceuticals) has ceased operations. So: real, encouraging early human data, but unfinished — a clear C rather than the D most peptides earn.
What is it?
EPO is a natural hormone famous for boosting red blood cells (and for being doped in cycling). Scientists noticed EPO also quietly protects and repairs injured tissue, and that this repair job uses a different switch from the blood-boosting one. ARA-290 is a tiny man-made piece designed to flip only the repair switch. In a few small human studies it helped people with damaged small nerves (in sarcoidosis and diabetes) feel less pain and grow some nerve fibres back. That's genuinely interesting, but the studies were small and short, no big follow-up trial was ever finished, and it isn't an approved medicine anywhere.
Think of EPO as a Swiss Army knife with two blades: a blood-boosting blade (the famous doping one) and a quieter tissue-repair blade. ARA-290 is an attempt to snap off just the repair blade and use it on its own — useful in principle, and it has passed a few real-world tests, but it's still a prototype that never made it to the shop shelves.
How is it meant to work?
ARA-290 is designed to selectively activate the so-called 'innate repair receptor' — proposed to be a heteromeric complex of the erythropoietin receptor (EPOR) and the beta-common receptor (CD131) that is upregulated in injured and inflamed tissue. Engaging this complex is thought to switch on anti-apoptotic and anti-inflammatory signalling (JAK2/STAT and PI3K-Akt pathways), dampening pro-inflammatory cytokines and supporting survival and regrowth of small nerve fibres. Crucially it does not bind the classical EPOR homodimer that drives red-blood-cell production, so it is non-erythropoietic. The receptor model itself is still scientifically debated and not universally accepted.
What's it studied for?
Research contexts. Not proven uses, and not recommendations.
Does the human evidence stack up?
There is real, if limited, human evidence — which sets ARA-290 apart from most peptides sold online. A 22-patient randomised, double-blind, placebo-controlled pilot in sarcoidosis patients with small-fibre neuropathy (Heij 2012, intravenous dosing thrice weekly for four weeks) found it safe and improved a validated neuropathy symptom score and quality-of-life measures. A roughly month-long placebo-controlled Phase 2 trial in type 2 diabetes (Brines 2015, daily subcutaneous) reported improvements in HbA1c, lipid profile, the PainDetect neuropathic-symptom score and corneal nerve fibre density. A later dose-ranging Phase 2b in sarcoid small-fibre neuropathy (64 patients, 28 days, subcutaneous) met its primary endpoint with increased corneal nerve fibre area and increased skin intraepidermal nerve fibre length, plus a meaningful pain reduction in those with worse baseline pain. Across these, tolerability looked good. The big limitations: every trial was small (tens of patients), short (about four weeks of dosing), and in a narrow patient group; no Phase 3 confirmatory trial was completed; and it is not approved as a medicine anywhere. Claims about general 'tissue repair', recovery or anti-ageing in healthy people are not backed by these trials.
What could go wrong?
- !No completed Phase 3 trial and no marketing approval anywhere; the developer, Araim Pharmaceuticals, has ceased operations and there is no active development programme.
- !Human data is confined to small, short trials in specific diseases (sarcoidosis, diabetes) — it tells you little about use in otherwise healthy people for 'recovery' or longevity.
- !The 'innate repair receptor' (EPOR/CD131) mechanism it relies on is still scientifically contested.
- !Material sold online as ARA-290 is an unlicensed research chemical: no guarantee of identity, purity or sterility, and self-injection carries infection and other risks.
- !Long-term safety in humans is essentially unknown beyond the roughly one-month trial windows.
- !Because it derives from EPO, buyers may wrongly assume it boosts performance like EPO — it is specifically engineered not to raise red cells, so online sellers' claims should be treated sceptically.
Is it legal in the UK?
ARA-290 / cibinetide is not a licensed medicine in the UK — the MHRA has not authorised it for any indication, and it is not an approved product on the UK market. It would be regarded as an unlicensed, investigational substance; supplying or selling it for human use without the appropriate authorisations would fall foul of the Human Medicines Regulations 2012. In practice it is sold as a 'research chemical not for human consumption', which places it outside any medicines-quality or safety oversight. It holds a US FDA orphan-drug (and Fast Track) designation for sarcoidosis, but those are development incentives, not approvals, and have no bearing on UK legality.
Key trials
- · Phase II (pilot)· Completed
ARA 290 in sarcoidosis patients with small-fibre neuropathy (pilot)
22 patients, randomised double-blind, intravenous dosing thrice weekly for 4 weeks; improved neuropathy symptom score (Heij 2012).
- · Phase II· Completed
ARA 290 in type 2 diabetes — metabolic control and neuropathic symptoms
Placebo-controlled, ~28 days daily subcutaneous; improved HbA1c, lipid ratios, PainDetect and corneal nerve fibre density (Brines 2015).
- · Phase IIb· Completed
Cibinetide dose-ranging Phase 2b in sarcoidosis-associated small-fibre neuropathy
64 patients, dose-ranging subcutaneous vs placebo over 28 days; met primary endpoint with increased corneal nerve fibre area and skin GAP-43+ nerve fibre length, plus pain benefit in more severe cases.
Sources
- 01Safety and Efficacy of ARA 290 in Sarcoidosis Patients with Symptoms of Small Fiber Neuropathy: A Randomized, Double-Blind Pilot Study — Heij L, Niesters M, Swartjes M, et al., Molecular Medicine (2012)
22-patient randomised double-blind pilot; intravenous ARA 290 thrice weekly for 4 weeks was safe and improved a small-fibre neuropathy symptom score. PMID and DOI verified.
- 02ARA 290, a Nonerythropoietic Peptide Engineered from Erythropoietin, Improves Metabolic Control and Neuropathic Symptoms in Patients with Type 2 Diabetes — Brines M, Dunne AN, van Velzen M, et al., Molecular Medicine (2015)
Phase 2 placebo-controlled trial; ~28 days daily subcutaneous dosing improved HbA1c, lipid ratios, PainDetect score and corneal nerve fibre density. PMID and DOI verified.
- 03Cibinetide improves corneal nerve fibre abundance in sarcoidosis-associated small nerve fibre loss and neuropathic pain (Phase 2b, dose-ranging) — PubMed search — Brines M, et al., PubMed (search) (2017)
64-subject, 28-day dose-ranging Phase 2b reported as a conference/ARVO abstract; met primary endpoint on corneal nerve fibre area. Search URL provided rather than an unverified identifier.
- 04Cibinetide / ARA-290 clinical and preclinical literature — PubMed search — Various, PubMed (search) (2026)
Wider body of cibinetide / ARA-290 trials and mechanism papers.
- 05Cibinetide — Wikipedia contributors, Wikipedia (2026)
Background on structure (11-aa, CAS 1208243-50-8) and Araim Pharmaceuticals development. Used only for background, not for efficacy claims.
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