🧠Neuropathic Pain Research💉4 mg/day Protocol📋Phase 2 Studied

ARA-290 Tracker App

Log 4 mg Daily Doses, Monitor Pain Scores, and Track Neuropathy Symptom Response

ARA-290 (cibinetide) is an 11-amino-acid peptide derived from the helix B surface region of erythropoietin — the part of EPO responsible for tissue protection rather than red blood cell production. It is a selective agonist of the innate repair receptor (IRR), a heterodimer expressed in damaged tissue that drives neuroprotection, anti-inflammation, and metabolic repair without the erythropoietic risks of full EPO. Phase 2 data in sarcoidosis showed significant improvement in small fibre neuropathy and neuropathic pain. Shotlee tracks your 4 mg daily protocol, VAS pain scores, nerve function tests, and sleep quality.

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Medication Levels
7 Days2 Weeks1 Month90 Days
CURRENT LEVEL
5.42mg
Mar 6
Today
ACTIVE MEDICATIONS
TirzepatideRetatrutide
0mg2.7mg5.4mg
18
Total Injections
💉 All time
122/78
Average BP
🩺 mmHg
8.4
Avg Mood
😊 /10
Health Chart
1mAll
218.6lb
↓ 8.4 lb · 3.7%
WeightInjectionsBPMood
2282222162102277.5mg7.5mg4mg10mg218
Feb 6Feb 14Feb 22Mar 2Today
Photos
12 photos · 2w streak
Week 1
Week 7
Today
Scheduled Reminders
Weight
Due today
Mood
Done
Blood Pressure
Tomorrow
Body Measurements
In 3 days
Dashboard
Your complete health overview in one place
🔥
14-day streak
Logged 18 of 18 scheduled shots
Next Shot Reminder
ACTIVE MEDICATIONS
TirzepatideB12
TIRZEPATIDE
🔥 14
2
days away
Thursday · 7.5mg
Medication Supply
Tirzepatide
6.2 / 10 mg · Vial
~42 days left · Mar 15
B12
4.4 / 5 ml · Vial
~88 days left · May 8
Retatrutide
1.2 / 5 mg · Vial
~6 days left · refill soon
Medication Levels
7 Days2 Weeks1 Month90 Days
CURRENT LEVEL
5.42mg
Mar 6
Today
ACTIVE MEDICATIONS
TirzepatideRetatrutide
0mg2.7mg5.4mg
18
Total Injections
💉 All time
122/78
Average BP
🩺 mmHg
8.4
Avg Mood
😊 /10
Health Chart
1mAll
218.6lb
↓ 8.4 lb · 3.7%
WeightInjectionsBPMood
2282222162102277.5mg7.5mg4mg10mg218
Feb 6Feb 14Feb 22Mar 2Today
Photos
12 photos · 2w streak
Week 1
Week 7
Today
Scheduled Reminders
Weight
Due today
Mood
Done
Blood Pressure
Tomorrow
Body Measurements
In 3 days
01BACKGROUND

What Is ARA-290 (Cibinetide)?

ARA-290 is an 11-amino-acid cyclic peptide derived from the helix B surface of erythropoietin (EPO). Standard EPO activates both homodimeric EPO receptors (driving red blood cell production) and heterodimeric innate repair receptors (IRR; driving tissue protection). ARA-290 was engineered to selectively activate only the IRR — achieving EPO's neuroprotective and anti-inflammatory tissue effects without stimulating erythropoiesis or carrying EPO's cardiovascular risk profile.

The IRR is expressed in neurons, immune cells, and metabolic tissue under conditions of stress or damage. ARA-290 activation of the IRR promotes neuronal survival, suppresses inflammatory cytokine production in damaged tissue, and has demonstrated insulin-sensitising effects in preclinical metabolic models. Phase 2 trials in sarcoidosis-associated small fibre neuropathy — a condition with very limited treatment options — showed significant reductions in neuropathic pain (VAS) and corneal nerve fibre density improvement over 28 days of 4 mg daily subcutaneous dosing.

⚠️
Research Peptide — Phase 2 Data Only
ARA-290 (cibinetide) is not approved for human use by the FDA or EMA. Available evidence is from Phase 1 and Phase 2 clinical trials. Consult a licensed physician before considering any peptide protocol.
02DOSING

Clinical Trial Protocol

4 mg
Subcutaneous injection, once daily for 28 days

Dose and duration used in the Phase 2 sarcoidosis/small fibre neuropathy trials. Administered subcutaneously in the abdomen or thigh. Some research protocols extend beyond 28 days based on individual response.

03MECHANICS

Mechanism of Action

1
Selectively binds and activates the innate repair receptor (IRR) — a heterodimer of the EPO receptor and CD131 (bc chain) — expressed in damaged neural and metabolic tissue under stress.
2
Activates JAK2/STAT3 and PI3K/Akt signalling cascades downstream of IRR, promoting neuronal survival, reducing apoptosis, and supporting axonal regeneration in small fibre neuropathy.
3
Suppresses NF-kB-driven pro-inflammatory cytokine production (TNF-a, IL-1b, IL-6) in damaged tissue without broad systemic immunosuppression.
4
Sensitises peripheral insulin signalling in metabolic tissue — demonstrated in preclinical diabetic models and observed as secondary outcomes in Phase 2 diabetic neuropathy cohorts.
04KEY NUMBERS

Phase 2 Trial Highlights

📈
Pain Reduction (VAS)
0Sig.
Sarcoidosis Phase 2: significant reduction in VAS neuropathic pain scores vs placebo at 28 days of 4 mg daily subcutaneous dosing.
💪
Corneal Nerve Fibres
0Increased
In-vivo corneal confocal microscopy showed increased corneal nerve fibre density — an objective small fibre regeneration endpoint — in the ARA-290 group vs placebo.
🏆
Insulin Sensitivity
0Improved
Secondary metabolic endpoints in diabetic neuropathy cohorts showed improved insulin sensitivity, consistent with IRR activation effects on peripheral metabolic tissue.
05WHAT TO TRACK

What to Track in Shotlee

Capture every ARA-290 protocol datapoint — pain scores, nerve function tests, sleep, energy, and injection logs.

01
🩹
Pain Scores (VAS)
Log daily neuropathic pain intensity using a 0–10 Visual Analogue Scale. VAS is the primary outcome measure in ARA-290 Phase 2 trials — replicate that precision in your personal log.
02
Neuropathy Symptoms
Record symptom type (burning, tingling, numbness, shooting pain) and severity daily. Symptom pattern changes over the 28-day protocol reveal your neuropathy response profile.
03
🔬
Nerve Function Tests
Log results from nerve conduction studies, quantitative sensory testing (QST), or corneal confocal microscopy if available. These are the objective neuropathy outcome markers.
04
💉
Injection Log
Record every ARA-290 injection: date, dose (mg), site (abdomen/thigh), and any local reactions. Log the full 28-day cycle without gaps.
05
😴
Sleep Quality
Score sleep quality (0–10) and note neuropathic symptoms that disrupt sleep. Neuropathic pain is a major sleep disruptor — improving pain should correlate with better sleep scores.
06
🔋
Energy
Log daily energy and fatigue ratings. ARA-290's IRR mechanism affects metabolic tissue — track energy alongside pain to capture the full IRR activation profile.
06TIMELINE

ARA-290 / Cibinetide Development Timeline

2007–2010
ARA-290 (cibinetide) first described as a selective non-erythropoietic EPO analogue targeting the innate repair receptor. Preclinical neuroprotection data published.
2012–2014
Phase 1 safety data established in healthy volunteers. Phase 2 proof-of-concept trial in sarcoidosis-associated small fibre neuropathy initiated.
2014–2016
Phase 2 sarcoidosis/SFN trial results published: significant VAS pain reduction, improved corneal nerve fibre density, and insulin sensitisation signals at 4 mg/day.
2020s
Continued research interest in diabetic neuropathy, metabolic disease, and chronic pain applications. No FDA approval as of 2026. Research use only.
07DEEP DIVE

ARA-290 for Small Fibre Neuropathy: What the Phase 2 Data Shows

Small fibre neuropathy (SFN) — a condition characterised by damage to unmyelinated C fibres and thinly myelinated Ad fibres — is notoriously difficult to treat. Standard analgesics provide limited relief; disease-modifying options are almost nonexistent. The ARA-290 Phase 2 data in sarcoidosis-associated SFN is significant because it showed both subjective pain reduction (VAS) and objective nerve regeneration (corneal confocal microscopy) in a 28-day trial.

If you are tracking ARA-290 for neuropathic pain, the most important metrics are daily VAS pain scores from day 1, symptom type and location, and any available nerve function testing. Shotlee lets you log all of these in one place, building the same kind of longitudinal record used in clinical trials.

Replicate Trial-Quality Tracking in Shotlee
The Phase 2 ARA-290 trials used daily VAS pain scores as the primary endpoint. Use Shotlee to log your daily VAS from day 1 of your protocol — the same rigour applied in clinical trials.
08FAQ

Protocol FAQs

ARA-290 is studied for neuropathic pain (particularly small fibre neuropathy in sarcoidosis), diabetic neuropathy, neuroprotection, anti-inflammatory effects, and insulin sensitisation. Phase 2 data showed significant VAS pain reduction and corneal nerve fibre improvement in sarcoidosis-SFN. It is not approved for human use.

Phase 2 trials used 4 mg subcutaneously once daily for 28 days. Some research protocols extend the duration beyond 28 days, but 4 mg/day is the established Phase 2 dose. Track every injection in Shotlee.

EPO activates both its own homodimeric receptor (stimulating red blood cell production) and the innate repair receptor (tissue protection). ARA-290 selectively activates only the innate repair receptor, providing EPO's neuroprotective and anti-inflammatory tissue effects without erythropoiesis or associated cardiovascular risks.

The most relevant outcomes are daily VAS pain scores, neuropathic symptom type and severity (burning, tingling, numbness), sleep quality, and any available nerve function testing (QST, nerve conduction, corneal confocal microscopy). Log all of these in Shotlee from day 1 of your protocol.

No. ARA-290 (cibinetide) is not approved by the FDA or EMA as of 2026. It has completed Phase 2 trials in sarcoidosis-associated small fibre neuropathy with positive results, but no regulatory submission has been completed. It remains a research peptide.

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Track Your ARA-290 Protocol in Shotlee

Log 4 mg daily doses, record VAS pain scores, track neuropathy symptoms, and document nerve function results — all free in Shotlee.

📚References & sources

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