What it is
ARA-290, generic name cibinetide, is a peptide of eleven amino acids lifted from a specific region of erythropoietin — the hormone that tells the marrow to make red blood cells.
The design idea is a good one, and it is worth understanding because it is not marketing. Erythropoietin does two quite separate things: it drives red cell production, and it protects tissue and nerves from injury. The second effect is desirable in its own right, but you cannot exploit it by giving erythropoietin, because the first effect thickens the blood and raises the risk of clots. ARA-290 is taken from a surface of the molecule involved in the protective signalling and not in the blood-forming one — an attempt to keep half of a hormone's behaviour and discard the other half.
It was developed by Araim Pharmaceuticals and investigated for small-fibre neuropathy: damage to the fine nerves that carry pain and temperature, in sarcoidosis and in diabetes.
It has a real trial programme
This entry is unusual for this library, so the distinction should be stated clearly. Most compounds here have a literature and no trials, or trials that predate registration, or registrations filed by people who never ran anything. ARA-290 has four interventional registrations on ClinicalTrials.gov as of 2026-09-13:
| Registration | Sponsor | Phase | n | Status |
|---|---|---|---|---|
| NCT02070783 — cognitive and neural effects | Leiden University Medical Center | 1/2 | 36 | Completed |
| NCT02039687 — corneal nerve fibre density and neuropathic symptoms in sarcoidosis | Araim Pharmaceuticals | 2 | 64 | Completed, results posted |
| NCT01933529 — prediabetes and type 2 diabetes | Claes-Göran Östenson | 2 | 24 | Unknown |
| NCT06626971 — diabetic macular oedema | Belfast Health and Social Care Trust | 2 | 9 | Terminated |
62 PubMed records name the compound, four of them carrying the randomized-controlled-trial publication type.
That is a genuinely better starting position than almost anything else in this library. Which is precisely why the next section matters.
The posted results, read rather than counted
NCT02039687 is the trial that decides how this compound should be described. It is randomized, quadruple-masked, placebo-controlled, with 64 participants in four arms of sixteen — 1 mg, 4 mg or 8 mg of ARA-290 given subcutaneously each day for 28 consecutive days, against a formulation-buffer placebo. (Those figures are the protocol's, reported here as the registry records them.)
Its results are posted on ClinicalTrials.gov, which is rare enough to be worth saying twice. Here is the primary outcome — change in corneal nerve fibre area, in µm², over 28 days, mean with standard deviation:
| Arm | Mean change | SD |
|---|---|---|
| 1 mg/day | −64.3 | 759.9 |
| 4 mg/day | +533.8 | 1110.02 |
| 8 mg/day | +203.8 | 641.2 |
| Placebo | −170.0 | 633.0 |
Three things are visible in that table and none of them appear on a vendor page.
There is no dose-response. The 4 mg arm changed most; the 8 mg arm changed less than half as much; the 1 mg arm went the same way as placebo. If the compound were driving the effect, doubling the dose should not halve the result.
The variation dwarfs the effect. Every standard deviation is larger than its own arm's mean change, and in the 4 mg arm the spread is about twice the average. Individual participants were moving in both directions by hundreds of µm².
No p-value is posted for the primary outcome. There is no analysis in the record turning these numbers into a statistical claim.
The secondary outcomes point in different directions
Intra-epidermal nerve fibre density — the skin-biopsy count of the same small nerve fibres, and the more established of the two measures — came out as follows, in fibres per millimetre: placebo +0.8, 1 mg +0.5, 4 mg +0.4, 8 mg −0.3. On this measure placebo did better than every drug arm.
The six-minute walk test is the trial's most favourable number and deserves to be given fairly: +19.3, +17.7 and +18.2 metres in the three drug arms against +1.2 metres on placebo. That is a consistent pattern across all three doses, which is the opposite of what the primary outcome showed. It is also a secondary outcome, in a trial whose primary did not separate, with standard deviations of 38 to 79 metres and no posted analysis.
One more line in the participant-flow data is worth noting: withdrawals rose with the dose — 0 of 16 at 1 mg, 1 of 16 at 4 mg, 3 of 16 at 8 mg, and 0 of 16 on placebo. With numbers this small that is not evidence of harm, but it is the direction one would watch in a larger study.
The trial that stopped, and why the reason is interesting
The Belfast diabetic macular oedema study, NCT06626971, is recorded as terminated with this explanation: expiry of study drug — no replacement available. Nine participants had enrolled.
Registries seldom state a reason that concrete. It is not a safety termination and not a futility termination; it is a supply failure. A trial that ends because nobody could provide more of the drug describes the compound's commercial position more honestly than any press release: somewhere between an active research programme and a shelved one.
Where it stands
There is no approved product. Drugs@FDA and DailyMed both returned nothing for cibinetide on 2026-09-13. No phase 3 appears in the registry, roughly a decade after the phase 2 completed.
The fair summary is narrower than either the marketing or the cynical reading. ARA-290 is a rationally designed peptide that reached properly controlled human trials and reported its numbers — and those numbers did not show what they needed to show. That is a more respectable place to be than most of this library, and it is still not evidence of benefit.
For the other compounds sold on repair and anti-inflammatory claims, see BPC-157, LL-37 and the licensed immune peptide thymosin alpha-1; for the broader question these entries keep returning to, peptides for joints and tendons.