ARA-290
Synthetic 11-amino-acid peptide derived from the helix-B domain of erythropoietin, studied in clinical trials for neuropathic and small-fiber nerve injury.
Overview
ARA-290, also known as cibinetide, is a synthetic 11-amino-acid peptide derived from the helix-B domain of erythropoietin (EPO). It was designed to activate the so-called innate repair receptor, a complex of the EPO receptor with the beta-common receptor, while avoiding meaningful erythropoietic activity.
The peptide has been studied in clinical trials for conditions involving nerve damage and neuropathic pain, including sarcoidosis-associated small-fiber neuropathy, and has attracted interest for effects on corneal nerve fibers relevant to ocular surface health. It remains an investigational agent.
Mechanism
Classical EPO signaling through EPO-receptor homodimers drives red blood cell production. Signaling through the heteromeric innate repair receptor complex is instead linked to tissue-protective and anti-inflammatory effects in neurons and other cell types.
ARA-290 is proposed to engage this repair signaling, reducing neuroinflammation and supporting regeneration of small nerve fibers, including corneal nerves; this rationale underlies the exploration of neuropathic and ocular applications.
Dosing
In published clinical studies, ARA-290 has been administered by subcutaneous injection on defined multi-week schedules. No product is approved, and regimens differ between trials.
- Subcutaneous injection used in clinical studies
- Typical study designs involve repeated dosing over several weeks
- Doses were fixed per protocol in each trial; no universal dosing exists
Expected Effects
- Improvements in symptoms of small-fiber neuropathy, including pain, reported in trials in sarcoidosis patients
- Increased corneal nerve fiber density reported in some studies
- Reductions in neuropathic pain reported in some trial populations
- Findings require confirmation in larger studies
Side Effects & Tolerability
In published trials, ARA-290 was generally described as well tolerated, without the erythropoietic effects of EPO. Mild injection-site and other minor adverse events were reported; long-term safety data are limited.
Storage
Store lyophilized peptide frozen, desiccated, and protected from light. Reconstituted solutions should be kept refrigerated and used within the supplier's stated stability period.