ARA-290 (Cibinetide): The Nerve-Repair Peptide Nobody Finished Testing

Adrian XH - Founder & Research Editor, Nootroholic
Founder & Research Editor · Peptides & Nootropics
Research use only. This page summarises published research. It isn’t medical advice and gives no dosing or usage instructions. ARA-290 isn’t approved for human use anywhere, and every vial on sale is a research chemical for laboratory use. If you live with nerve pain, see a neurologist.
Last updated: 24 September 2026Vendor COAs checked: 24 September 2026Evidence labels: Human Animal

If nerve pain keeps you up at night, you’ve probably heard podcasters mention ARA-290: a peptide that regrows nerves.

That’s half right.

In a 2017 trial of 64 people, four weeks of ARA-290 (cibinetide) grew measurable growth of nerve fibres in the eyes and skin. The company went silent. The drug was never approved. No trials since 2016.

What’s left is this 11-amino acid research chemical easy to fake sold online.

The short answer: ARA-290 has real human evidence for one kind of nerve pain, small-fibre neuropathy. For almost everything else it’s searched for, the evidence is thin or doesn’t exist.

This page gives you the three things most ARA-290 pages bury or skip:

  • Your condition, graded. Neuropathy, sciatica, fibromyalgia, MS, carpal tunnel and six more, each marked as human evidence, animal only, or nothing.
  • Every human trial in one table, with numbers taken from the original papers.
  • What vendor certificates actually prove. We read four. They don’t prove the same things.

Short on time? Jump to the evidence map.

ARA-290 key facts
Other namesCibinetide, ARA 290, pHBSP (pyroglutamate helix B surface peptide)
SequencepGlu-Glu-Gln-Leu-Glu-Arg-Ala-Leu-Asn-Ser-Ser
Molecular weight1,257.3 g/mol (monoisotopic mass 1,256.6 Da)
OriginHelix B of erythropoietin (EPO)
TargetInnate repair receptor (EPO receptor + CD131)
Half-life in bloodAbout 2 minutes
Highest trial phasePhase II: five patient trials, 182 people
Typical trial designRandomised, placebo-controlled, 28 days
StatusNot approved. US orphan drug and fast track designations for sarcoidosis nerve pain (2017). No Phase III; the developer appears to have shut down.

What Is ARA-290?

Diagram of EPO helix B and the 11-amino-acid ARA-290 sequence with its innate repair receptor target
ARA-290 is built from helix B of EPO and targets the innate repair receptor, not the red-cell EPO receptor.

A synthetic peptide formed on erythropoietin helix B. EPO (erythropoietin) is a naturally present protein which helps the body produce red blood cells.

ARA-290 copies the tissue-protective nature of this section without imitating the blood-cell-stimulating properties. Activates the body’s own repair receptors to dampen inflammation and support tissue repair.

Araim Pharmaceuticals made it and named it Cibinitide.

How ARA-290 differs from EPO

EPO is a hormone primarily made by the kidneys. It’s the natural protein that drugs like epoetin are engineered to imitate. The body can make more red blood cells when it binds to EPO receptors in the bone marrow. Some types of anemia benefit from it, but blood doping is problematic. Increased red-cell levels can increase blood viscosity and blood clot risk.

ARA-290 doesn’t work on those receptor pairs because it’s too small to bind so blood counts don’t change much. It clears from the blood in just two minutes, yet the effects last for days to weeks. Researchers believe it flips a switch inside cells rather than remaining in circulation.

EPO (epoetin)ARA-290 (cibinetide)
Size165 amino acids, glycoprotein11 amino acids
ReceptorEPO receptor pair (homodimer)Innate repair receptor (EPOR + CD131)
Red blood cellsRaises haemoglobinNo clinically significant change
Half-lifeHoursAbout 2 minutes

What the Human Trials Show

Bar chart of ARA-290 human trials by number of participants, dose and result
All five published ARA-290 patient trials: 182 people, Phase II only.

Here are all published patient trials, with numbers.
Only the macular oedema study was placebo-controlled.

TrialPopulationnDose and routeDurationMain endpointResult
Heij 2012, Mol Med [4]Sarcoidosis with small-fibre neuropathy symptoms22 (12 drug, 10 placebo)2 mg IV, 3× a week4 weeksNeuropathy symptom score (SFNSL), pain, quality of lifeSFNSL fell 11.5 points vs 2.9 on placebo (p < 0.05). Pain and fatigue improved equally in both groups.
Dahan 2013, Mol Med [5]Sarcoidosis with small nerve fibre loss38 (21 drug, 17 placebo)4 mg SC daily28 daysSymptoms, corneal nerve fibres, walking distanceSFNSL −12.2 vs −3.8 points. Corneal nerve fibre area +14.5% (p = 0.022). 6-minute walk +18.7 m vs −15.1 m (p = 0.049).
Brines 2015, Mol Med [6]Type 2 diabetes with painful neuropathy49 (48 analysed)4 mg SC daily28 days + 28 days follow-upHbA1c, neuropathic symptoms (PainDetect), corneal fibresHbA1c −0.21% vs +0.21% at day 56 (p = 0.002). PainDetect −4.2 vs −0.7 points (p = 0.037). Corneal fibre density up in people with low baseline.
Culver 2017, IOVS [7][8]Sarcoidosis with nerve fibre loss and neuropathic pain641, 4 or 8 mg SC daily vs placebo28 daysCorneal nerve fibre area4 mg: +697 µm² vs placebo (p = 0.012). 1 mg and 8 mg not significant. Pain fell in every group, placebo included.
Lois 2020, J Clin Med [9]Diabetic macular oedema9 (no placebo)4 mg SC daily12 weeksVisual acuity, retinal thicknessNo improvement in vision (−2.9 letters) or retinal thickness. No serious adverse events.

A summary of what it all means

Consistent signal. ARA-290 beat placebo in all three neuropathy trials. Skin biopsies showed more regenerating fibres at 4 mg (GAP-43, p a= 0.035). Patients with the most corneal fibres walked the furthest.

There are some limitations. Pain itself did not clearly beat placebo in the largest trial. Symptoms aren’t caused by corneal fibres. Araim staff coauthored all neuropathy papers. No one has shown that the benefit persists beyond 16 weeks.

ARA-290 dose-ranging trial chart comparing corneal nerve fibre change at three doses versus placebo
The middle dose was the only one that beat placebo on corneal nerve fibre area (Culver 2017, n = 64).

In total: 182 patients, about 110 of them on the drug, mostly for 28 days. No one has taken it for longer than 12 weeks.

Does ARA-290 Work for Your Condition? The Evidence Map

ARA-290 evidence map grading human and animal evidence for neuropathy, sciatica, fibromyalgia, MS and other conditions

The majority of people interested in ARA-290 have one condition in mind.

✅ = controlled human trial

🐭 = animal or lab data only

❌ no published ARA-290 study.

ConditionHuman evidenceAnimal / lab evidenceVerdict
Small-fibre neuropathy (sarcoidosis)3 RCTs, 124 people [4][5][7]Yes✅ Best evidence, still Phase II
Diabetic neuropathy1 RCT, 49 people [6]Diabetic rats [19]✅ Promising, one trial
Nerve damage / nerve injuryIndirect: small-fibre regrowth in neuropathy trialsSciatic crush and nerve injury in rats [11][14]🐭 Animal only for injury
SciaticaNoneSciatic nerve injury and neuritis models [11][13]🐭 Animal only
Multiple sclerosis (MS)NoneEAE rat model [20]🐭 Animal only
FibromyalgiaNoneNone❌ None
Carpal tunnel syndromeNoneNone❌ None
Back painNoneNone for back pain itself❌ None
ArthritisNoneNone found❌ None
Dogs and other petsNoneRodent studies only❌ None
Diabetic macular oedema1 open trial, 9 people [9]Diabetic rat retina [18]Tested; didn’t help

ARA-290 for neuropathy. Human evidence is strong here. It’s narrow and covers small-fibre neuropathy: the burning, tingling, or “feet on fire” type that harms the thinnest pain and temperature nerves. Neuropathy caused by B12 deficiency or chemotherapy, for example, wasn’t tested.

ARA-290 for nerve damage. In rats, ARA-290 calms inflammation in Schwann cells, which protect nerves. In human trials, it has been shown that small fibres in corneas and skin regenerate. There’s no evidence that it fixes a cut or compressed nerve.

ARA-290 for sciatica. Usually sciatica is caused by a pinched nerve root. Rats treated with ARA-290 showed less pain after a nerve injury. No drug can remove the mechanical pressure, and there are no human studies.

ARA-290 for fibromyalgia. The idea hasn’t been tested, but it’s not impossible. Meta-analysis found 49% of fibromyalgia patients had small-fiber damage. This is not evidence, but an argument for a trial.

ARA-290 for MS. In rats with EAE, the standard MS animal model, daily ARA-290 made the disease milder and shorter [20]. There are no human data, and there’s no substitute for disease-modifying therapy.

Carpal tunnel, back pain, arthritis and dogs. None of these have been studied.
Most back pain isn’t neuropathic and is caused by compression at the wrist.
Pain from arthritis starts in cartilage and the joint lining, not in nerves. For joints, check our article peptides for joint pain.

Preclinical Research

ARA-290 preclinical research in animal models of nerve injury, wounds, kidney, heart and retina
Animal findings, each from a single rodent study.

The animal research is broad, as you’d expect for a receptor that responds to injury of any kind. Every finding below comes from rodents Animal.

  • Neuropathic pain: after sciatic nerve injury, ARA-290 gave rats long-lasting relief from touch and cold pain. It also calmed microglia, the spinal-cord immune cells that keep pain signals running [11][12].
  • Diabetic wounds: in diabetic db/db mice, a daily 30 µg/kg dose sped up wound closure and increased new blood vessel growth [15].
  • Kidney: after ischaemia–reperfusion injury in rats, it reduced damage and inflammation, even when given after blood flow returned [16].
  • Heart and ageing: old rats treated for 15 months kept their heart’s pumping function, had less cardiac inflammation and were less frail [17].
  • Retina: in diabetic rats it protected retinal nerve and blood-vessel cells without changing haematocrit [18]. The human macular oedema trial found no such benefit [9].
  • Blood sugar: in type 2 diabetic GK rats, four weeks of treatment cut HbA1c by about 20% by improving insulin release [19].

One caution: two widely cited pHBSP papers have been retracted: a 2012 kidney study and a 2014 insulin-resistance study [24]. If a vendor page cites either, treat its other claims with caution.

Side Effects, Safety and the Cancer Question

Comparison of EPO and ARA-290 side effects, safety and cancer risk data

In the trials, ARA-290 was well tolerated Human:

  • Sarcoidosis: no safety concerns in the IV pilot, and no serious adverse events in the 28-day trial or its 12-week follow-up [4][5].
  • Diabetes: the drug and placebo groups had similar numbers of adverse events. The ARA-290 group had four serious events. One, a worsening of existing kidney disease after a diuretic increase, was judged possibly related. Another, a fatal heart attack in a 70-year-old with severe cellulitis two weeks after the last dose, was judged unrelated [6].
  • Macular oedema: headache, raised triglycerides and colds, but no serious events [9].
  • Blood and antibodies: no clinically significant change in blood counts, and no anti-drug antibodies in the trials that tested for them [6][9].

What hasn’t been studied matters more. There are no data on repeat courses, pregnancy, children or long-term use. None of the trial safety record applies to a research-grade vial of unknown sterility.

Does ARA-290 cause cancer?

There’s no evidence that ARA-290 causes cancer, and none that it’s safe for people who have cancer. The worry comes from EPO. Across 53 trials and 13,933 cancer patients, EPO-type drugs raised deaths during treatment by 17% [22] Human.

Some of that harm likely comes from higher haemoglobin and clotting, which ARA-290 doesn’t cause. The rest is less reassuring. Some tumours carry EPO receptors, and the innate repair receptor’s job is to keep stressed cells alive. ARA-290 has never been tested in people with cancer. The main sarcoidosis trial excluded anyone who’d had a serious cancer in the previous five years [8].

Who the trials excluded

The trial safety data don’t cover several groups, because researchers left them out [8]:

  • People with cancer, active or within the past five years.
  • Pregnant or breastfeeding women.
  • Anyone who had used EPO or other red-cell-stimulating drugs in the previous two months.
  • People with other causes of nerve-fibre loss (except well-controlled diabetes), or with significant abnormalities in their lab results or heart tests.

Kidney function deserves a note too, given the one possibly related case of worsening kidney disease [6]. ARA-290 isn’t named on the WADA Prohibited List, but section S2 covers EPO-receptor agonists and substances with similar effects.

{{IMG:ara-290-legal-status-timeline}}

No regulator has approved ARA-290. In May 2017, Araim announced US orphan drug designations for sarcoidosis and its nerve pain, US fast track status, and EU orphan designations [23]. Those designations help a drug through development. They don’t approve it.

Araim said broader neuropathy trials would follow, but none did. No Phase III was ever registered, and the last cibinetide trial, a macular oedema study in Belfast, began in 2016. Araim appears to have shut down, and no company is known to be developing the drug. Small biotechs often stall here because Phase III costs far more than Phase II. It doesn’t mean the drug failed.

For buyers, that means three things:

  • You can’t get pharmaceutical-grade ARA-290 on prescription.
  • Every vial online is a research chemical labelled “not for human use”.
  • The only quality check between the factory and your vial is the vendor’s certificate of analysis (COA).

Buying ARA-290: How to Check a Vial

ARA-290 vendor COA check comparing identity testing, purity, content and endotoxin across four vendors

An 11-amino-acid peptide is cheap to make and easy to fake. An HPLC test shows that the powder is mostly one clean substance, but not which substance. Proving identity takes either mass spectrometry, which weighs the molecule, or a retention-time match against a reference standard. Look for four things:

IdentityMass spec: a monoisotopic mass of about 1,256.6 Da, with peaks near m/z 1,257.6 and 629.3. Or a stated match to a reference standard.
Purity of at least 98%Measured by HPLC. Mannitol and other sugar peaks are normal fillers, not impurities.
Milligrams measuredThe actual content of the vial, not just the label claim.
Sterility and endotoxinScreens for bacterial contamination. Check that the lot number matches the vial.

We checked four US vendors’ public certificates on 24 September 2026:

VendorVialPrice$/mgCOA lab and lotPurityIdentity test
NextGen Peptides16 mg$60$3.75ILS Laboratories, lot ARA16-01 (Aug 2026)99.62%Reference-standard match, not mass spec. Also 16.59 mg measured; sterility, endotoxin and heavy metals passed.
Ascension Peptides10 mg$70 (list $79.99)$7.00MZ Biolabs, lot 53-12250129 (Mar 2026)99.93%Mass spec. 1,256.66 Da measured vs 1,256.60 expected.
Elite Edge Biotech5 mg$49.90 (list $99.99)$9.98MZ Biolabs, lot 2026-07-22 (Aug 2026)97.43%Partly. Mass spec named as the method, but no spectrum shown.
Limitless Biotech8 or 16 mgLogin required–No COA on the public product page–None shown. “Identity verification” claimed.

No certificate covers everything. NextGen’s is the most complete: it measures content, sterility, endotoxin (0.124 EU/mL) and heavy metals, and it’s the cheapest per mg. It confirms identity by reference standard rather than mass spec, though. Its product page also lists the wrong sequence and molecular weight (both belong to BPC-157), a copy-paste slip that the COA contradicts. Ascension’s is the only certificate that proves identity by mass. Elite Edge’s lot tested at 97.43%, with a 2.1% impurity peak, below the 98% we look for. Our guide on how to read a peptide COA explains each line.

Most complete COA
NextGen Peptides
ARA-290 · 16 mg vial
$60
$3.75/mg, the lowest we found
  • ILS Labs: 99.62% HPLC
  • 16.59 mg measured in a 16 mg vial
  • Sterility, endotoxin and heavy metals passed
View at NextGen
Identity by mass spec
Ascension Peptides
ARA-290 · 10 mg vial
$70$79.99
$7.00/mg
  • MZ Biolabs: 99.93% HPLC
  • 1,256.66 Da measured (expected 1,256.60)
  • No content or endotoxin data
View at Ascension
Smallest vial
Elite Edge Biotech
ARA-290 · 5 mg vial
$49.90$99.99
$9.98/mg
  • MZ Biolabs: 97.43% HPLC
  • Mass spec named, spectrum not shown
  • Highest price per mg
View at Elite Edge

Lots change, so check the COA for yours. Our best peptide vendors list and our guide to peptide scams to avoid explain how we vet sellers. Comparing repair peptides? See BPC-157 for nerve and tendon repair, the KLOW peptide blend, or our hub on peptides for healing.

Sources

  1. Brines M, et al. Erythropoietin mediates tissue protection through an erythropoietin and common β-subunit heteroreceptor. PNAS. 2004. doi:10.1073/pnas.0406491101 Animal/Lab
  2. Brines M, et al. Nonerythropoietic, tissue-protective peptides derived from the tertiary structure of erythropoietin. PNAS. 2008. doi:10.1073/pnas.0805594105 Animal/Lab
  3. Collino M, Thiemermann C, Cerami A, Brines M. Flipping the molecular switch for innate protection and repair of tissues. Pharmacol Ther. 2015. doi:10.1016/j.pharmthera.2015.02.005 Review
  4. Heij L, et al. Safety and efficacy of ARA 290 in sarcoidosis patients with symptoms of small fiber neuropathy: a randomized, double-blind pilot study. Mol Med. 2012. doi:10.2119/molmed.2012.00332 Human
  5. Dahan A, et al. ARA 290 improves symptoms in patients with sarcoidosis-associated small nerve fiber loss and increases corneal nerve fiber density. Mol Med. 2013. doi:10.2119/molmed.2013.00122 Human
  6. Brines M, et al. ARA 290, a nonerythropoietic peptide engineered from erythropoietin, improves metabolic control and neuropathic symptoms in patients with type 2 diabetes. Mol Med. 2015. doi:10.2119/molmed.2014.00215 Human
  7. Culver DA, et al. Cibinetide improves corneal nerve fiber abundance in patients with sarcoidosis-associated small nerve fiber loss and neuropathic pain. Invest Ophthalmol Vis Sci. 2017. doi:10.1167/iovs.16-21291 Human
  8. ClinicalTrials.gov. NCT02039687: Phase 2 dose-ranging study of ARA 290 in sarcoidosis (sponsor: Araim Pharmaceuticals). Accessed 24 September 2026. clinicaltrials.gov/study/NCT02039687 Human
  9. Lois N, et al. A Phase 2 clinical trial on the use of cibinetide for the treatment of diabetic macular edema. J Clin Med. 2020. doi:10.3390/jcm9072225 Human
  10. Cerit H, et al. Testing the antidepressant properties of the peptide ARA290 in a human neuropsychological model of drug action. Eur Neuropsychopharmacol. 2015. doi:10.1016/j.euroneuro.2015.09.005 Human
  11. Swartjes M, et al. ARA290 produces long-term relief of neuropathic pain: an experimental study in rats and β-common receptor knockout mice. Anesthesiology. 2011. doi:10.1097/ALN.0b013e31822fcefd Animal
  12. Swartjes M, et al. ARA 290 produces long-term relief of neuropathic pain coupled with suppression of the spinal microglia response. Mol Pain. 2014. doi:10.1186/1744-8069-10-13 Animal
  13. Pulman KG, et al. The erythropoietin-derived peptide ARA290 reverses mechanical allodynia in the neuritis model. Neuroscience. 2013. doi:10.1016/j.neuroscience.2012.12.022 Animal
  14. Liu G, et al. ARA290 inhibits activation of NLRP3 inflammasome in Schwann cells after sciatic nerve injury. Eur J Pharmacol. 2025. doi:10.1016/j.ejphar.2025.177610 Animal
  15. Bitto A, et al. Activation of the EPOR-β common receptor complex by cibinetide ameliorates impaired wound healing in mice with genetic diabetes. Biochim Biophys Acta Mol Basis Dis. 2018. doi:10.1016/j.bbadis.2017.12.006 Animal
  16. van Rijt WG, et al. Renoprotective capacities of non-erythropoietic EPO derivative, ARA290, following renal ischemia/reperfusion injury. J Transl Med. 2013. doi:10.1186/1479-5876-11-286 Animal
  17. Winicki NM, et al. A small erythropoietin derived non-hematopoietic peptide reduces cardiac inflammation, attenuates age associated declines in heart function and prolongs healthspan. Front Cardiovasc Med. 2022. doi:10.3389/fcvm.2022.1096887 Animal
  18. McVicar CM, et al. Intervention with an erythropoietin-derived peptide protects against neuroglial and vascular degeneration during diabetic retinopathy. Diabetes. 2011. doi:10.2337/db11-0026 Animal
  19. Muller C, et al. ARA290 improves insulin release and glucose tolerance in type 2 diabetic Goto-Kakizaki rats. Mol Med. 2016. doi:10.2119/molmed.2015.00267 Animal
  20. Chen H, et al. Therapeutic effects of nonerythropoietic erythropoietin analog ARA290 in experimental autoimmune encephalomyelitis rat. J Neuroimmunol. 2014. doi:10.1016/j.jneuroim.2014.01.006 Animal
  21. Grayston R, et al. A systematic review and meta-analysis of the prevalence of small fiber pathology in fibromyalgia. Semin Arthritis Rheum. 2019. doi:10.1016/j.semarthrit.2018.08.003 Human (not ARA-290)
  22. Bohlius J, et al. Recombinant human erythropoiesis-stimulating agents and mortality in patients with cancer: a meta-analysis of randomised trials. Lancet. 2009. doi:10.1016/S0140-6736(09)60502-X Human (EPO)
  23. Araim Pharmaceuticals. Cibinetide (ARA 290) regenerates small nerve fibers and improves neuropathic clinical symptoms in the orphan disease of sarcoidosis. Press release, PR Newswire, 8 May 2017. prnewswire.com
  24. Retracted papers: Mol Med 2012, “Delayed administration of pHBSP attenuates acute kidney injury” (PMID 22415011), and Br J Pharmacol 2014, “A non-erythropoietic peptide derivative of erythropoietin decreases susceptibility to diet-induced insulin resistance in mice” (PMID 25164531). Both are flagged as retracted in PubMed.
  25. DrugBank. Cibinetide (DB13006), clinical trials listing. Accessed 24 September 2026. go.drugbank.com/drugs/DB13006
  26. Vendor certificates reviewed 24 September 2026: NextGen Peptides (ILS Laboratories COA-2026-SGKPSI, lot ARA16-01, 24 August 2026); Ascension Peptides (MZ Biolabs lot 53-12250129, signed 5 March 2026); Elite Edge Biotech (MZ Biolabs lot 2026-07-22, signed 12 August 2026).