ARA-290 (Cibinetide)

Most people who look up ARA-290 want help with nerve pain, the burning, tingling or pins-and-needles kind that comes from damage to the tiny nerve fibers in the skin. That's called small fiber neuropathy, and it's the condition ARA-290 was tested for in people. Searches for ARA-290 and neuropathy sit right beside searches for its dosage, and people also ask about it for sciatica and fibromyalgia, which nobody has studied it for.

The human studies were in adults with sarcoidosis, an inflammatory disease that can damage those small nerve fibers, and one more was in adults with type 2 diabetes and painful nerve damage.

The second reason people give is inflammation. In mouse and lab-dish work, ARA-290 calmed immune cells and protected transplanted tissue from inflammatory damage. In rats with a form of type 2 diabetes, four weeks of daily doses lowered blood sugar. Both of those findings belong to the animals, and no human study has shown a blood sugar effect.

What makes ARA-290 unusual is that people have actually taken it in studies with a dummy injection for comparison. In the first small pilot, people with sarcoidosis-related nerve damage reported better symptom scores and less pain than people on the dummy, along with better physical functioning on a standard quality-of-life questionnaire. In the diabetes study, symptom scores improved too, and its authors called for more research. Those are small studies, and they're more than most compounds on this site have.

Erythropoietin is the hormone that tells your body to make red blood cells. It also turns out to protect tissue that's injured or inflamed, and it does those two jobs with different parts of the molecule. ARA-290 is modeled on the tissue-protecting part, so in principle it keeps the repair signal and leaves the red blood cell job alone.

The analogy is a key cut for one lock. The proposed lock is a receptor called the innate repair receptor, which shows up on injured or inflamed tissue rather than on healthy tissue. The idea is that ARA-290 acts where something's wrong and stays quiet where nothing is. The researchers who proposed that receptor are the same group who ran the sarcoidosis studies, so the idea hasn't had much independent checking yet.

The most concrete finding is from the eye. In one of the sarcoidosis studies, people on ARA-290 had more nerve fibers in the cornea, the clear front of the eye, at the end of a month. That's a count of fibers rather than a questionnaire about how someone feels, which is why people point to it. In diabetic mice, it also reduced damage in nerve fibers that were already injured without changing blood sugar, which suggests the nerve effect doesn't depend on better blood sugar control.

ARA-290 is sold as a freeze-dried powder that you mix with bacteriostatic water (sterile water with a preservative, so one vial can be drawn from more than once) and inject under the skin. The 10 mg vial is the size you'll see most, with 16 mg next, and a 16 mg vial holds exactly four 4 mg doses. Of the 37 vendors we track with ARA-290 in stock, none sells it as a nasal spray or capsule.

Unlike most research peptides, ARA-290 has an amount that comes from human studies. Two published studies used 4 mg once a day under the skin for 28 days, one in adults with sarcoidosis-related nerve damage and one in adults with type 2 diabetes and painful nerve damage. The sarcoidosis study also tested 1 mg and 8 mg a day, and only the 4 mg group showed a clear change in nerve fibers. Vendor pages often give 1 to 2 mg a day instead, with no study behind that figure. The ARA-290 dosage page has every pattern with its source and the units to draw.

A mixed vial keeps 28 days in the fridge. At 4 mg a day a 16 mg vial is gone in 4 days, so the clock doesn't come into play. The whole 28-day course at that amount is 112 mg, which is why the number of vials matters more than the price of one.

ARA-290 has more human data than most research peptides, but not much more. The studies were small and lasted about a month, and they didn't report serious problems, which tells you about a month and not about longer use. Nobody has published a study of repeat courses.

The question people ask first is about red blood cells, since erythropoietin raises them. ARA-290 was designed to avoid that, and in the rat study it didn't change the share of blood made up of red cells. What people report day to day is mostly redness or soreness where they injected, which they handle by rotating the spot.

There's no information on pregnancy or breastfeeding. Since a research vial isn't a regulated product, the everyday risk is what's actually in it, which is why we check vendors for independent lab testing and published certificates of analysis. A mixed vial that turns cloudy or changes color gets thrown out.

One thing nobody has settled is what to do after the first month. No study or label sets a repeat course, and the diabetes study simply followed people for another month without treatment. People who don't notice a change after 28 days sometimes ask about going higher, and the one study that tested 8 mg a day saw a smaller change in nerve fibers than the 4 mg group did, so a bigger amount isn't the obvious next step.

The FDA hasn't approved ARA-290 for anything, and we found no approved ARA-290 product in any country. It was developed by Araim Pharmaceuticals under the name cibinetide, and the program hasn't produced an approved drug. A registered trial in people with prediabetes and early type 2 diabetes was run in Sweden, and we couldn't find its results published. In the US it's sold as a research compound, labeled for research use, and buying it for that purpose is legal.

We haven't written a head-to-head page for ARA-290 yet. The compound people most often mention beside it is BPC-157, the repair peptide asked about for injuries and gut trouble, and for the immune side people look at Thymosin Alpha-1. Neither has been studied for nerve pain the way ARA-290 has.

When you compare ARA-290 prices, compare the cost per milligram and price the whole course. At 4 mg a day for 28 days you need 112 mg, so a cheap vial that's small costs more by the end. The 16 mg vial holds exactly four 4 mg doses, so a course is seven of them with nothing left over. A 10 mg vial gives two 4 mg doses with 2 mg stranded, and over a full course that adds up to 14 vials and 28 mg you paid for and didn't use. Look for a vendor that publishes independent lab results for the batch you're buying.

It's sold for research, and the human studies behind it are small, short and run with the company that makes it.