Ara-290

ARA-290 (cibinetide) is a synthetic 11-amino-acid peptide modelled on part of erythropoietin (EPO), the hormone that drives red blood cell production. It was designed by Michael Brines, Anthony Cerami and colleagues to act on the innate repair receptor, a pairing of the EPO receptor with CD131 (the beta common receptor), without stimulating red cell production itself (Brines et al., PNAS 2008). Most laboratory work is in rats and mice, in models of nerve injury, nerve pain, diabetes and ageing. Small placebo-controlled trials in people all had authors from the developing company. Three were in sarcoidosis with small nerve fibre loss (22, 38 and 64 patients) and one in type 2 diabetes with nerve pain (49 patients), each lasting four weeks. They tracked symptom scores and nerve fibre counts in the cornea, with mixed results: in the largest trial the main nerve measure differed from placebo at only one of three dose levels, and pain scores fell in every group, including placebo (Culver et al., 2017). A 12-week study of nine people with diabetic macular oedema found no change in vision or retinal thickness. No trial has been independently repeated, cibinetide is not an approved medicine, and long-term safety is unknown. Supplied for laboratory research use only.