ARA-290
ARA-290 (Cibinetide — EPO Helix-B Surface Peptide)
Evidence & Status
- Preliminary / Experimental
- Preliminary
At a Glance
A non-erythropoietic peptide derived from the tissue-protective region of erythropoietin (EPO), engineered to retain EPO's nerve-protective effects without stimulating red blood cell production. Studied in small fiber neuropathy and sarcoidosis-related nerve damage.
Plain English
Researchers study ARA-290 because erythropoietin — best known as the hormone that stimulates red blood cell production — also protects nerve tissue through a separate receptor. Scientists specifically engineered ARA-290 to target only this nerve-protective pathway, avoiding the blood cell stimulation that makes full EPO inappropriate for non-anemia applications. It has been studied in clinical trials for small fiber neuropathy, a painful nerve condition associated with sarcoidosis and other diseases, with promising preliminary results in reducing neuropathic pain.
Overview
ARA-290, also called cibinetide, is an 11-residue synthetic nonerythropoietic peptide modeled on the EPO helix-B surface. Small controlled studies reported symptom and corneal nerve-fiber outcomes in sarcoidosis-associated small-fiber neuropathy, but these findings do not establish broad efficacy across neuropathy causes. Lack of erythropoietic activity does not establish absence of all thrombotic or other risks.
Research Summary
A randomized double-blind pilot in sarcoidosis patients with small-fiber-neuropathy symptoms evaluated 2 mg IV three times weekly for four weeks. A separate blinded placebo-controlled study evaluated daily SC administration for 28 days in sarcoidosis-associated small-nerve-fiber loss and reported symptom and corneal nerve-fiber endpoints. NCT02039687 is a completed 64-participant randomized phase II study with posted results. These limited, population-specific findings do not establish broad efficacy across neuropathy causes.
Research Areas
- Small fiber neuropathy
- Sarcoidosis
- Nerve regeneration
- EPO tissue-protective pathways
- Corneal nerve fiber density
Safety & Risks
Serious Risks
- Long-term safety profile unknown beyond Phase II trial duration
- Theoretical immune modulation at high doses
- Insufficient data for chronic use beyond 90 days
Reported Side Effects
- Short controlled studies reported limited safety data; long-term safety is not established
- Mild injection site reactions
- Transient fatigue (uncommon)
Legal Status by Region
- United States
- Investigational; no FDA approval or orphan-designation statement is made here
- United Kingdom
- Investigational
- Australia
- Investigational
- Canada
- Investigational
Citations & Sources
- Safety and efficacy of ARA 290 in sarcoidosis patients with symptoms of small fiber neuropathy: a randomized, double-blind pilot study.
Molecular Medicine · 2012
PMID 23168581 · DOI 10.2119/molmed.2012.00332
- ARA 290 improves symptoms in patients with sarcoidosis-associated small nerve fiber loss and increases corneal nerve fiber density.
Molecular Medicine · 2013
PMID 24136731 · DOI 10.2119/molmed.2013.00122
- A Study of ARA 290 in Subjects With Neuropathy Due to Sarcoidosis.
ClinicalTrials.gov
Registry NCT02039687
- Cibinetide ligand record.
IUPHAR/BPS Guide to PHARMACOLOGY
Regulatory IUPHAR/BPS Ligand ID 9677
- Cibinetide substance record.
NIH NCATS
Regulatory NCATS 9W5677JKDA