# ARA-290

Non-erythropoietic EPO-derived peptide for small-fibre neuropathy pain.

- Page: https://peprank.xyz/peptides/ara-290
- Category: Neuroprotection & repair (Research peptide)
- Also known as: cibinetide; helix-B surface peptide analogue
- Routes: Injection
- Sequence: QEQLERALNSS (N-terminal pyroglutamate (cibinetide; EPO helix-B derived))
- Safety tier: Strict: Caution · Balanced: Caution · Evidence only: Caution
- Risk axes (0 none to 3 severe): Seen harm 1, Mechanism 1, Data gap 2, Silent harm 1, Product 3
- Positive: 56% of 40 graded reports glowing or positive, shrunk toward the 49% all-report average by 8 reports' weight
- Rank: #5 of 61 research peptides
- Graded reports: 40 (Glowing 10, Positive 13, Mixed 3, Nothing 8, Negative 4, Bad reaction 2)
- Evidence: Human RCTs — Sarcoidosis small-fibre neuropathy, n=22 and n=64; diabetes; no serious adverse events
- Access: Grey market
- Onset: Days to two weeks: most responders notice less pain or returning sensation by day 3-13; trials measured at 4 weeks.
- Lasts: cumulative; relief usually fades over weeks to a few months after a course ends
- Cost per month: ≈ €180–630 (researchers' estimate)
- Dose users report: 2–4 mg/day (median 4 mg, n=17)
- Updated: 2026-10-30

## What users report

Results are split in the neuropathy communities. About half report clear relief, often within 1-2 weeks: nerve pain or numbness easing in small-fibre, diabetic, chemo, long-COVID and sciatica/stenosis cases, though much of the praise comes from stacks with BPC-157/TB-500, KPV or KLOW. Roughly 20% feel nothing even after months at 4-8 mg/day, and about 15% get worse for a while, usually a painful nerve flare when ramping the dose, worst in people with allodynia or autoimmune neuropathy. Relief often fades weeks after stopping, and cost is a constant complaint.

**Effects:** less neuropathic burning/tingling; possible small-nerve fibre regrowth (corneal density in trials); sciatica relief (anecdotal)

**Downsides:** expensive; benefit fades after stopping; transient nerve flare when ramping dose; gels in bacteriostatic water

**Risks:** Generic: grey-market purity; Theoretical only: acts on the EPO-receptor/CD131 'innate repair receptor'; trials showed no erythropoiesis or safety signal

**Typical use:** 1-4 mg/day subQ for 4-8 weeks (trials used 4 mg/day for 28 days); reconstitute with sterile water or PBS.

**Getting it:** Never approved and the sponsor (Araim) stalled; sold as a research chemical, occasionally resold through clinics at a large markup.

**Stacked with:** BPC-157 + TB-500 (The most common pairing for sciatica, disc and post-surgical nerve pain; several users credit the combination over ARA-290 alone.); KPV / KLOW (Added for inflammation in stenosis, MCAS and long-COVID neuropathy; makes it hard to tell which peptide did the work.); GHK-Cu (One long-term user ran it intranasally with GHK-Cu for stenosis nerve pain, with the combination lasting about 12 hours per dose.)

## Risk profile

- **Seen harm 1/3:** Across small RCTs, SAEs fell only on drug arms (suicidal ideation at 8 mg; worsening renal function judged possibly related; a cellulitis followed by fatal MI judged unrelated), a small and heterogeneous imbalance; one first-hand report describes allodynia worsening enough to seek care.
- **Mechanism 1/3:** Engineered from erythropoietin to act on the EPO-receptor/CD131 'innate repair receptor' without raising red cells; trials showed no erythropoiesis, so EPO's thrombotic and tumour concerns are speculative here.
- **Data gap 2/3:** Roughly 100-150 people dosed in total, none for longer than four weeks, across trials of 22-64; never approved.
- **Silent harm 1/3:** Reported harms (nerve-pain flares, headaches, welts) are felt within days.
- **Product 3/3:** A grey-market injectable research chemical, sometimes resold through clinics.
- **Never if:** Pregnancy or breastfeeding (no human reproductive data)

## Top reports

- Glowing, neuroprotection: “Ara-290 has helped my pain an almost unbelievable amount. I was starting to believe I might never regain somewhat normal function in my hands. For years my hands were limited in function due to severe neuropathic pain, I still have significant pain, but much more function” — [@SplendidSpeseia on X](https://x.com/SplendidSpeseia/status/1938756494452764693)
- Glowing, recovery: “I have seen really great results. My neuropathy was very bad and it has improved significantly. I have tried almost everything and this was the most helpful by far. Whether it lasts I’ll have to see.” — [r/neuropathy](https://www.reddit.com/r/neuropathy/comments/hreepv/ara290_peptide_any_experience_reports/fyle9ze/)
- Glowing, recovery: “I started ARA 290 23 days ago. I’m also taking NAD and GLOW. My neuropathy pain is gone.” — [r/neuropathy](https://www.reddit.com/r/neuropathy/comments/1o33123/peptide_ara290/ofyav0d/)
- Glowing, recovery: “I’m now 90% better than I was before these cycles and I’m confident it’s been ara290 and/or KPV. So much so I’m stocking up for the next 5/10 years.” — [r/Biohacking](https://www.reddit.com/r/Biohacking/comments/1uvgolz/ara290_anyone_with_experience_with_this/p4cwuiq/)
- Glowing, neuroprotection, 8 mg/day: “ARA-290 at 8mg once per day allowed me to use my hands normally with no adaptive devices and greatly reduced need for pain aids. The pain is still noticable, esp with heavy use of arms, but reduced to the point it rarely impedes daily activities anymore.” — [@SplendidSpeseia on X](https://x.com/SplendidSpeseia/status/2011575774801744140)

## Cheapest in Europe

- [Condor Research](https://condorresearch.com/product/ara-290-cibinetide/) (SK): ARA-290 (Cibinetide) 10mg, €55, €5.50/mg
- [Modern Peptides EU](https://modernpeptides.eu/product/ara-290-2/) (DE): ARA-290, €56, €5.60/mg (contents not stated on the page)

## Studies

- [Safety and efficacy of ARA 290 in sarcoidosis patients with symptoms of small fiber neuropathy: a randomized, double-blind pilot study](https://pmc.ncbi.nlm.nih.gov/articles/PMC3563705/) (rct, n=22, 2012): IV ARA 290 2 mg three times weekly for 4 weeks improved small-fibre neuropathy symptom scores and SF-36 pain vs placebo, with no safety concerns.
- [ARA 290 improves symptoms in patients with sarcoidosis-associated small nerve fiber loss and increases corneal nerve fiber density](https://pmc.ncbi.nlm.nih.gov/articles/PMC3883966/) (rct, n=38, 2013): 4 mg/day subQ for 28 days improved neuropathic symptoms, corneal small-nerve-fibre density and 6-minute walk distance vs placebo.
- [Cibinetide improves corneal nerve fiber abundance in patients with sarcoidosis-associated small nerve fiber loss and neuropathic pain (phase 2b)](https://doi.org/10.1167/iovs.16-21291) (rct, n=64, 2017): 4 mg/day for 28 days increased corneal and skin nerve-fibre regrowth; pain improved in all arms including placebo, so the pain benefit itself was not significant.
- [ARA 290, a nonerythropoietic peptide engineered from erythropoietin, improves metabolic control and neuropathic symptoms in patients with type 2 diabetes](https://pmc.ncbi.nlm.nih.gov/articles/PMC4365069/) (rct, n=49, 2015): 4 mg/day subQ for 28 days improved PainDetect neuropathy scores and HbA1c vs placebo, with no safety issues.
- [A phase 2 clinical trial on the use of cibinetide for the treatment of diabetic macular edema](https://pmc.ncbi.nlm.nih.gov/articles/PMC7408632/) (open-label, n=9, 2020): 12 weeks at 4 mg/day was safe with no antibodies, but did not improve vision or retinal thickness on average.

## Sources

- [Safety and efficacy of ARA 290 in sarcoidosis small fiber neuropathy: randomized pilot (Mol Med 2012)](https://pmc.ncbi.nlm.nih.gov/articles/PMC3563705/)
- [ARA 290 improves symptoms and corneal nerve fiber density in sarcoidosis (Mol Med 2013)](https://pmc.ncbi.nlm.nih.gov/articles/PMC3883966/)