ARA-290 is the compound on this site with the least doubt about its numbers and the most awkward arithmetic. Its doses come from four registered trials with named institutional sponsors and five clinical-trial-tagged publications, which is more than almost anything else on this map can claim. What makes it awkward is the scale: the published amounts are whole milligrams given daily, and the vials are 5 and 10 mg. A vial of most compounds here is a month or more of the amounts that circulate for it. A vial of this one is days. This page reports the trial figures, works out what they mean for a vial and a syringe, and states what the trials did and did not show. It reports and does not recommend.
The ARA-290 calculator runs the concentration and unit sums for any vial and volume, and the all-compounds chart sets these figures beside every other compound's.
The molecule
ARA-290, generic name cibinetide, is an 11-amino-acid peptide whose sequence is taken from the helix B region of erythropoietin — the part of the hormone that faces outward in the folded protein and does not participate in the receptor binding that drives red blood cell production. The design intent was to keep erythropoietin's tissue-protective signalling through the innate repair receptor while removing the haematopoietic effect that limits erythropoietin's use. Molecular weight 1257.3 (PubChem CID 91810664, read 2026-09-21).
That origin is why the clinical programme is in neuropathy rather than anaemia, and why its endpoints are nerve-fibre measures rather than haemoglobin.
What the trials state
| Study | Subjects | Dose, route and duration | What it reported | Opened |
|---|---|---|---|---|
| Culver, IOVS, PMID 28475703 (2017) | 64, sarcoidosis-associated small nerve fibre loss with neuropathic pain; phase 2b | 1, 4 or 8 mg/day, 28 days, vs placebo | Corneal nerve fibre area at day 28: placebo-corrected 109 (1 mg), 697 (4 mg, p = 0.012), 431 (8 mg). Pain in moderate-severe subjects p = 0.157 | 2026-09-21 |
| Brines, Mol Med, PMID 25387363 (2015) | Type 2 diabetes with painful neuropathy; phase 2 | 4 mg/day subcutaneous, self-administered, 28 days, followed a further month | HbA1c and lipid profile improved over 56 days; PainDetect improved significantly; no safety issues identified | 2026-09-21 |
| Dahan, Mol Med, PMID 24136731 (2013) | Documented sarcoidosis-associated small nerve fibre loss | Daily subcutaneous, 28 days, blinded and placebo-controlled (amount not in the abstract) | Neuropathic symptoms improved; corneal small nerve fibre density increased; 6-minute walk distance increased | 2026-09-21 |
| Heij, Mol Med, PMID 23168581 (2012) | 22 sarcoidosis patients with small fibre neuropathy, 12 drug and 10 placebo | 2 mg intravenous, three times weekly, 4 weeks | Neuropathy screening score improved significantly vs placebo; pain and fatigue improved equivalently in both groups | 2026-09-21 |
| Cerit, Eur Neuropsychopharmacol, PMID 26431906 (2015) | 36 healthy participants, double-blind parallel group | 2 mg, single dose, assessed one week later | Some changes in emotional processing; concluded the effects do not unequivocally support an antidepressant-like profile | 2026-09-21 |
Two things are worth reading off that table directly. The dose-ranging trial found its result in the middle group and not in the highest one, so more was not better across the range tested. And the largest trial in the set is 64 people — this is a phase 2 programme, not a phase 3 one, and nothing in it has produced an approval.
The arithmetic, and why this vial is different
One U-100 unit is a hundredth of a millilitre. On most pages on this site the interesting question is whether a draw is large enough to read. Here it is whether a draw fits in the syringe at all.
| Vial | Water | Concentration | 2 mg reads as | 4 mg reads as | 8 mg reads as |
|---|---|---|---|---|---|
| 5 mg | 1 mL | 5,000 mcg/mL | 40 units | 80 units | more than the vial holds |
| 5 mg | 2 mL | 2,500 mcg/mL | 80 units | more than one syringe | more than the vial holds |
| 10 mg | 1 mL | 10,000 mcg/mL | 20 units | 40 units | 80 units |
| 10 mg | 2 mL | 5,000 mcg/mL | 40 units | 80 units | more than one syringe |
| 10 mg | 3 mL | 3,333 mcg/mL | 60 units | more than one syringe | more than one syringe |
A U-100 syringe holds 100 units, which is 1 mL. Every cell reading "more than one syringe" is a draw that exceeds that. This is the inversion: for a microgram-scale compound, adding water buys readability at no cost, and the standing advice on most of these pages is that more water is the safer arithmetic. For ARA-290 at 4 and 8 mg, adding water runs the draw past what a single syringe holds, so the two considerations pull against each other instead of together.
How long a vial lasts
The number of amounts a vial holds is set by the milligrams and never by the water:
| Published figure | 5 mg vial | 10 mg vial |
|---|---|---|
| 4 mg/day (Brines 2015) | 1 day, 1 mg left | 2.5 days |
| 8 mg/day (Culver 2017, highest arm) | not one full day | 1.25 days |
| 1 mg/day (Culver 2017, lowest arm) | 5 days | 10 days |
| 2 mg IV ×3 weekly (Heij 2012) | 2 doses, 1 mg left | 5 doses |
A 28-day course at the 4 mg figure is 112 mg of peptide — eleven 10 mg vials. That number is arithmetic and is stated because it is the sort of thing that is easy not to notice when a figure is quoted as "4 mg a day" and a vial is quoted as "10 mg".
What is not established
No ARA-290 or cibinetide product is approved. DailyMed held no label for either name on 2026-09-21. The most recent registration, an investigator-led phase 2 study of ARA290 in diabetic macular oedema at the Belfast Health and Social Care Trust (NCT06626971), is recorded as terminated with nine participants enrolled; the registry entry gives the status without a stated reason.
The trial evidence is consistent in direction on nerve-fibre measures and weaker on symptoms: in the 22-patient intravenous study, the neuropathy screening score separated from placebo while pain and fatigue improved in both arms equally, and in the phase 2b trial the pain endpoint did not reach significance. A reader should also note that four of the five tagged publications share authors with the company that sponsored the largest registration, which is ordinary for a phase 2 programme and is still worth knowing.
Finally, the trial figures are for a manufactured investigational product with known content and purity. They are amounts, not a property of anything sold in a vial, and nothing here establishes what is in any particular vial.
The mechanism and the evidence file are covered in Medibact's ARA-290 guide. For the opposite end of the evidence range, the Pinealon dosage page documents a compound whose only published human figure is a capsule, and the all-compounds chart shows how wide that range is across the set.