ARA-290 Guide
EPO-Derived Peptide for Neuropathic Pain
Complete ARA-290 guide covering innate repair receptor mechanism, neuropathic pain treatment, MCAS mast cell stabilization, diabetic neuropathy dosing.
EPO-Derived Innate Repair Receptor Activator for Neuropathic Pain, MCAS & Tissue Protection
ARA-290 (cibinetide) is an 11-amino acid peptide derived from erythropoietin's helix B surface that selectively activates the innate repair receptor (IRR) without triggering red blood cell production. It is the most clinically advanced peptide for neuropathic pain associated with sarcoidosis and autoimmune-related small fiber neuropathy, with Phase 2 trial data demonstrating both symptomatic pain relief and structural nerve regeneration.
What Is ARA-290?
ARA-290 is a rationally designed 11-amino acid peptide derived from the helix B surface peptide (HBSP) region of erythropoietin — a region of EPO that is structurally distinct from the erythropoiesis-stimulating domain. By selectively engaging the beta common receptor (βcR) component of the innate repair receptor (IRR) — a heterodimer of EPO receptor and βcR — ARA-290 activates tissue-protective and nerve-repair signaling without any red blood cell stimulating activity, eliminating EPO's cardiovascular risks (thrombosis, polycythemia).
In the landmark Leiden University Phase 2 trial (Brines et al., 2014), ARA-290 4 mg daily for 28 days in sarcoidosis patients with small fiber neuropathy produced statistically significant reductions in neuropathic pain (VAS scores), improvements in autonomic function (heart rate variability), and — critically — measurable increases in corneal nerve fiber density on confocal microscopy. This structural regeneration endpoint was the first demonstration of an investigational drug growing peripheral nerve fibers in humans.
Beyond neuropathic pain, ARA-290 stabilizes mast cells via IRR expressed on mast cell surfaces, reduces systemic inflammatory cytokines (IL-6, TNF-α, IL-8), and is explored for diabetic peripheral neuropathy, long COVID small fiber neuropathy, and MCAS with neuropathic overlap. Its subcutaneous route and well-tolerated safety profile make it practical for clinical use and research-use protocols.
Guide FAQs
Complete ARA-290 guide covering innate repair receptor mechanism, neuropathic pain treatment, MCAS mast cell stabilization, diabetic neuropathy dosing.
Yes. Shotlee supports tracking Ara 290 doses, side effects, and health metrics. It is free to use.
PubMed, ClinicalTrials.gov, and the FDA website are the most reliable sources for current Ara 290 research and regulatory updates. Peer-reviewed journals including the New England Journal of Medicine, The Lancet, and JAMA publish the most impactful clinical trial results. This guide is updated regularly to reflect the latest available evidence. Use Shotlee to track your personal protocol outcomes alongside the published research.
Before starting Ara 290, establish baseline measurements including body weight, waist circumference, blood pressure, and relevant lab work with your healthcare provider. Download Shotlee and begin logging your baseline metrics at least one week before starting treatment. This pre-treatment data provides the comparison point needed to objectively evaluate your treatment response over time. Additionally, discuss potential side effects and management strategies with your prescriber so you are prepared for the initial adaptation phase.
Evidence-based lifestyle modifications that complement Ara 290 protocols include: maintaining adequate protein intake (1.2-1.6g per kg body weight per day) to preserve lean mass, performing resistance training two to three times per week, staying well hydrated with at least eight glasses of water daily, prioritizing seven to nine hours of quality sleep, managing stress through regular physical activity or mindfulness practices, and eating smaller more frequent meals during dose titration phases. Track these lifestyle factors alongside your Ara 290 data in Shotlee to identify which combinations drive your best results.
Track Your Ara 290 Protocol in Shotlee
Free dose logging, side effect tracking, and health metric monitoring for your complete protocol.