ARA-290

A synthetic 11-amino-acid peptide rationally designed from erythropoietin's helix-B domain by Araim Pharmaceuticals. ARA-290 selectively activates the Innate Repair Receptor (IRR), a heterodimer of the EPO receptor and CD131 (β-common receptor), which is upregulated at sites of tissue injury. Critically, it produces zero erythropoietic activity — no increase in hematocrit, hemoglobin, or thrombotic risk.

It has been studied in multiple completed Phase 2 human trials for sarcoidosis-associated small fiber neuropathy, type 2 diabetic neuropathy, and diabetic macular edema, with consistent positive results. Holds FDA orphan drug and fast track designations.

ARA-290 has the most robust human clinical dataset among niche tissue-repair peptides. A pilot trial in 22 sarcoidosis patients (Heij et al., 2012) showed significant improvement in neuropathic symptom scores with 2 mg IV 3x/week. A Phase 2 trial in 49 type 2 diabetes patients (Brines et al., 2015) demonstrated significant improvement in HbA1c (p=0.002) and neuropathic pain scores with 4 mg SC daily for 28 days.

A Phase 2b dose-ranging study in 64 sarcoidosis patients (Culver et al., 2017) showed 4 mg SC daily produced a 23% increase in corneal nerve fiber area versus placebo (p=0.012). A diabetic macular edema pilot (Lois et al., 2020) confirmed safety over 12 weeks. Mechanism involves selective IRR activation, PI-3K/Akt signaling, NF-κB inhibition, and TRPV1 channel antagonism.