RUO onlyImmuneCognitiveRecovery

ARA-290

Cibinetide / Innate Repair Receptor agonist / IRR agonist

A synthetic 11-amino acid peptide derived from erythropoietin (EPO) that selectively activates the Innate Repair Receptor (IRR) without stimulating red blood cell production. Studied for neuropathic pain, small fiber neuropathy, sarcoidosis, and metabolic syndrome. Has completed Phase II human trials. Genuinely interesting evidence profile for a non-hematopoietic EPO derivative.

Evidence

Limited human data

Routes

injectable

Available since

Developed by Araim Pharmaceuticals (as Cibinetide). Phase II trials completed; available through RUO vendors.

Mechanism of action

Selectively binds the Innate Repair Receptor — a heterodimer of the EPO receptor and the beta common receptor. This selective binding activates tissue protection and repair pathways without triggering red blood cell production (the primary EPO mechanism that causes cardiovascular and doping risks). Anti-inflammatory through NF-κB inhibition. Promotes nerve regeneration and small fiber repair. Improves insulin sensitivity through beta-common receptor signaling. The selective IRR agonism is the mechanistic innovation that differentiates ARA-290 from EPO itself.

Effects in the body

ARA-290 has a genuinely more developed evidence base than most RUO compounds. Phase II trials have been completed for neuropathic pain in sarcoidosis and for small fiber neuropathy — both rare conditions where nerve damage produces chronic pain that is poorly addressed by existing treatments. A 2014 Phase II RCT in sarcoidosis patients showed significant improvement in neuropathic pain scores and corneal nerve fiber density. Metabolic benefits including improved insulin sensitivity have also been documented in clinical research. The absence of hematopoietic effects makes it safer than EPO itself for non-anemia applications.

Pros & cons (from the literature)

Pros

Phase II human trials completed — stronger evidence than most RUO compounds
Selective IRR activation without red blood cell production effects
Neuropathic pain reduction documented in Phase II sarcoidosis RCT
Small fiber neuropathy research with measurable corneal nerve fiber improvement
Metabolic benefits including insulin sensitivity
Anti-inflammatory mechanism with tissue repair application

Cautions

RUO status — not FDA approved despite Phase II data
No Phase III trials completed — development appears stalled
Limited availability compared to more common peptides
Injectable only — no topical or nasal route studied
Evidence primarily in rare disease populations — translation to general wellness research unclear
Mechanism involves EPO receptor system — cardiovascular monitoring prudent

Protocol summary (from published research)

Phase II trials used subcutaneous injection at 4mg/kg three times weekly for 28 days. No established independent research protocol. Phase II dosing is the only published human reference point.

Dosing ranges reproduced from published research literature. Not a prescription, not medical advice.

FDA & regulatory status

Research Use Only. Not FDA approved. Also known as Cibinetide in clinical trial literature. Phase II trials completed for sarcoidosis neuropathy. No Phase III NDA submitted as of 2026. Development by Araim Pharmaceuticals appears to have slowed despite positive Phase II data — a pattern seen in rare disease peptide development where commercial pathway is unclear.

Evidence base

Kleine et al. 2013 Phase II sarcoidosis neuropathy RCT published. Brines et al. IRR mechanism papers published. Metabolic improvement data documented. No Phase III data. Development status uncertain as of 2026.

Primary research sources

Peer-reviewed literature referenced throughout this profile is drawn from PubMed, Cell Metabolism, and clinical trial registries cited in the evidence base above.

Important. ThePeptide.expert summarizes published research. We are not a pharmacy, do not prescribe, and make no therapeutic claims. Regulatory status varies by jurisdiction.