Better Evidence, Dead Programme

ARA-290

Also known as Cibinetide

Summary coverage

At a glance

What it is: Two small RCTs with objective imaging endpoints, and no active trials left.

Evidence: Small human studiesHow the tiers workARA-290 has meaningfully better evidence than most of the amber tier here, and the app should say so. Why this tier

Half-life: Not established in available literature
Routes: Intravenous, Subcutaneous
Category: Healing
FDA: Not nominated; As of 3 August 2026. What that means
WADA: We do not state a status
Amino acids: 11

Putting ARA-290 on a schedule, with the vial it comes from and a log of each dose, happens in the app: Claritide for iPhone.

Evidence

Why this tier

ARA-290 has meaningfully better evidence than most of the amber tier here, and the app should say so. A double-blind placebo-controlled pilot (Heij et al., Mol Med 2012, PMID 23168581, n=22, 2 mg intravenously three times weekly for 4 weeks) showed significant improvement in small-fibre neuropathy symptom score at week 4 plus SF-36 pain and physical functioning gains, with no safety concerns raised. A 2013 Phase 2 (n=36, 4 mg subcutaneously daily for 28 days) improved cold and heat pain thresholds, thermal sensory limen, six-minute walk distance and corneal small-nerve-fibre density on in-vivo confocal microscopy, an objective imaging endpoint, which is rare in this library. Registered trials NCT02070783 and NCT02039687 are completed, NCT01933529 is listed as unknown, NCT06626971 is terminated. There are no active trials, and the developer is reported to have closed, which we could not confirm from a filing.

Overview

What it is

ARA-290 is an eleven-amino-acid peptide derived from erythropoietin that activates the innate repair receptor without raising red-cell mass the way EPO does. It has better evidence than most compounds in the amber tier of this library: two small randomised controlled trials with objective endpoints, including corneal nerve-fibre imaging. There are no active trials. Both facts are signals.

Mechanism

How it works

Erythropoietin has two distinct activities. One drives red blood cell production through the classical EPO receptor. The other is tissue-protective, acting through a different receptor complex usually called the innate repair receptor. ARA-290 is a short peptide derived from the region of EPO responsible for the second activity and not the first, which is the point of the design. It activates repair signalling in damaged tissue without the haematocrit rise, thrombosis risk and doping profile that make EPO itself unusable for this purpose.

Dosing

Commonly researched ranges

These are figures reported in published literature and practitioner protocols: a commonly researched range, not a recommendation. Claritide does not tell you what to take.

Pilot RCT (intravenous)2 mg
Three times weekly for 4 weeks
Heij et al., Mol Med 2012 (PMID 23168581), in sarcoidosis patients with small-fibre neuropathy symptoms.
Phase 2 dose arms (subcutaneous)1–8 mg
Once daily for 28 days
NCT02039687 randomised 1, 4 and 8 mg once daily for 28 days; 4 mg is the working dose and the one that produced significant corneal nerve-fibre regeneration, and NCT01933529 ran 4 mg alone. Three registered Phase 2 trials by this route make it the best-evidenced compound in the healing set. The 2 mg figure above it is intravenous and belongs to a different study.

Phase	Amount	Frequency	Timing	Note
Pilot RCT (intravenous)	2 mg	Three times weekly for 4 weeks	Not established in available literature	Heij et al., Mol Med 2012 (PMID 23168581), in sarcoidosis patients with small-fibre neuropathy symptoms.
Phase 2 dose arms (subcutaneous)	1–8 mg	Once daily for 28 days	Not established in available literature	NCT02039687 randomised 1, 4 and 8 mg once daily for 28 days; 4 mg is the working dose and the one that produced significant corneal nerve-fibre regeneration, and NCT01933529 ran 4 mg alone. Three registered Phase 2 trials by this route make it the best-evidenced compound in the healing set. The 2 mg figure above it is intravenous and belongs to a different study.

Cycle guidance: The trial protocols are fixed 28-day courses. No cycling schedule is published beyond that.
Goals: Recovery

Legal standing

Where this sits with the FDA

Dated, sourced, and separate from whether it works. Removal from a warning list is not permission to compound.

Not nominatedas of 3 August 2026 · US

ARA-290 is not on any FDA compounding list and has no approval. Its registered trials are completed or terminated with none active, and the developer is reported to have closed. We could not confirm that from a filing.

Primary source

Sport

WADA status

The 2026 Prohibited List entered force on 1 January 2026.

We do not state a status

Not named on the 2026 Prohibited List. Note that erythropoietin and its analogues are prohibited under S2; ARA-290 is designed not to have the erythropoietic activity, and we could not determine how it is classified. We do not state a status.

We looked and could not resolve it. This is not the same as "not prohibited". Treat it as unresolved and check with your federation before competing.

Reconstitution

Mixing recipes our sources document

Concentration (mg/mL) = vial mg ÷ diluent mL. On a U-100 barrel, 1 unit = 0.01 mL.

Not established in available literature. Use the calculator with the figures printed on your own vial.
Open the calculator

Expectations

Week by week

What our material describes people reporting. Individual responses vary widely.

1
Week 4
In the pilot randomised trial, significant improvement in the Small Fiber Neuropathy Screening List score (p<0.05), plus improvements in SF-36 pain and physical functioning.
2
Day 28 (Phase 2)
Improvements in cold and heat pain thresholds, thermal sensory limen, six-minute walk distance, and corneal small-nerve-fibre density measured by in-vivo confocal microscopy.

Tolerability

Side effects

Grouped by how often our sources report them. Percentages appear only where a published trial figure exists.

Rare

No safety concerns raised in the pilot trialThe authors of the 2012 pilot stated that no safety concerns were raised. That is a 22-person trial over 4 weeks, which is a narrow window to make a safety claim through.

Safety

Contraindications and interactions

Do not use if

Not established in available literature.

Interactions

Not established in available literature.

Absence from this list does NOT mean safety. It means lack of research.

Handling

Storage and cost

Storage: Our sources publish no vial and diluent pairing or beyond-use window for ARA-290.
Cost: Not established in available literature

Deep dive

ARA-290 in full

Limited coverage, but better evidence than most of this tier

ARA-290, also called cibinetide, is an eleven-amino-acid peptide derived from erythropoietin. It activates the innate repair receptor, the tissue-protective arm of EPO signalling, without the red-cell-mass effects of EPO itself. That separation is the entire design intent.

The trials

Pilot randomised controlled trial. Heij et al., Molecular Medicine 2012, PMID 23168581. Sarcoidosis patients with symptoms of small-fibre neuropathy, double-blind and placebo-controlled, 22 participants (12 treated, 10 placebo), 2 mg intravenously three times weekly for 4 weeks. Significant improvement in the Small Fiber Neuropathy Screening List score at week 4 (p<0.05), plus improvements in SF-36 pain and physical functioning. No safety concerns raised.

Phase 2, 2013. 36 participants, 4 mg subcutaneously daily for 28 days against placebo. Improvements in cold and heat pain thresholds, thermal sensory limen, six-minute walk distance, and corneal small-nerve-fibre density measured by in-vivo confocal microscopy.

That last endpoint is worth pausing on. It is an objective anatomical measurement of nerve fibres, imaged directly. Most of what this library reports is symptom scores and self-report. Two small randomised trials with an imaging endpoint is genuinely better evidence than the majority of the amber tier here.

Human doses across the programme ran 1 to 8 mg/day, with 4 mg/day the most tested, typically over 28 days.

And it stopped

NCT02070783 completed. NCT02039687 completed. NCT01933529 is listed as unknown. NCT06626971 is terminated. There are no active trials. The developer is reported to have closed, which we could not confirm from a corporate filing.

A dead programme is itself a signal, and it is an ambiguous one. Drugs stop for lack of funding, for commercial reprioritisation, for a failed larger trial that never got published, and sometimes for reasons that have nothing to do with the science. What is not ambiguous is that nobody is currently generating new evidence about this compound, so what you see above is what there will be.

References

Sources

1
Heij et al., 2012 · Safety and efficacy of ARA-290 in sarcoidosis patients with symptoms of small fiber neuropathy, Mol Med
PMID 23168581 Source
2
Phase 2 of ARA-290, 28 days subcutaneous, with corneal confocal microscopy endpoint
Source
3
NCT02039687 · the subcutaneous dose arms: 1, 4 and 8 mg once daily for 28 days (dose review, 2026-08-17)
Source
4
NCT01933529 · 4 mg subcutaneously daily, the working dose (dose review, 2026-08-17)
Source
5
NCT02070783 · the 2 mg figure, given intravenously. Recorded here so it is not read as a subcutaneous dose (dose review, 2026-08-17)
Source

Every record in this library is free to read, and it stays free. Your own schedule, vials and log live in the app: Claritide for iPhone.