ARA 290
unknown riskAlso: Cibinetide · ARA290 · ERY290
ARA 290 is a non-hematopoietic analog of erythropoietin engineered to activate tissue-protective but not erythropoiesis pathways. It has Orphan Drug designation for sarcoidosis-associated neuropathy and has demonstrated efficacy in diabetic neuropathy trials.
Reported Benefits
Diabetic Neuropathy
Phase 2 trial showed improved nerve fiber density and pain scores in T2DM patients.
Sarcoidosis Neuropathy
Randomized trial demonstrated improved corneal nerve fiber density and pain.
Anti-inflammatory
Activates anti-inflammatory innate repair receptor (IRR) complex.
Mechanism of Action
ARA 290 was engineered by removing the erythropoiesis-stimulating receptor-binding residues from erythropoietin while retaining the tissue-protective signaling domain. It activates the innate repair receptor (IRR) — a heterodimer of EPOR and beta-c — which mediates anti-inflammatory, anti-apoptotic, and neuroprotective signaling.
Key Clinical Studies
Brines M et al. (2014)
RCT · 40 diabetic patients
Improved corneal nerve fiber density after 28 days
Heij L et al. (2012)
Phase 2 RCT · Sarcoidosis patients
Improved corneal nerve fiber density in sarcoidosis
Overview
ARA 290 represents a clever approach to drug development: taking erythropoietin (EPO) — a well-characterized protein hormone with powerful tissue-protective properties — and engineering away the hematopoietic (red blood cell stimulating) activity while preserving the protective signaling. This eliminates EPO’s significant cardiovascular risks in non-anemic patients.
The Two Faces of Erythropoietin
Native EPO has two receptor binding sites: one that activates EPOR homodimers (causing erythropoiesis and the associated thrombosis risk), and one that activates the IRR heterodimer (tissue protection). ARA 290 selectively activates only the IRR pathway — a mechanistic refinement that took years to characterize.
Neuropathy Evidence
The diabetic and sarcoidosis neuropathy data is meaningful. Corneal confocal microscopy — measuring small nerve fiber density in the cornea as a proxy for systemic small fiber neuropathy — showed objective improvements in nerve fiber density, not just patient-reported pain scores. This objective endpoint strengthens the evidence quality.
Development Status
ARA 290 holds Orphan Drug designation for sarcoidosis neuropathy and has completed Phase 2 trials. Regulatory approval pathway remains active but uncertain as of 2025.
✦ Sponsored
Stop Guessing About Your Health. Start Optimizing It.
Advanced diagnostics and licensed medical providers delivering personalized longevity care to uncover root causes, optimize health, and track progress virtually or in person.
Learn More →
Regulatory Status
Research OnlyOrphan drug designation for sarcoidosis neuropathy; Phase 2 complete; no approval
Safety Profile
Side Effects
- •Injection site reactions (mild)
- •No hematopoietic effects by design
Contraindications
- •None established
Drug Interactions
- •None established
Primary Uses
Related Peptides
Used For
Planning a protocol?
Use the AI Stack Builder to generate a phased schedule, compatibility analysis, and monitoring checklist.
Weekly Briefing
Regulatory updates + new study breakdowns.
For Practitioners
Do you prescribe ARA 290?
Get in front of patients who've already researched this protocol and are ready to consult. Featured listings from $199/mo.
Get Listed →