ARA-290

ARA-290 is an 11-amino acid peptide derived from the helical region of erythropoietin (EPO) that selectively activates the innate repair receptor (IRR) — a heterodimeric receptor complex formed between EPO receptor and the common beta chain (βcR). Unlike full-length EPO, which activates both the hematopoietic receptor (raising red blood cell count) and the IRR, ARA-290 is engineered to exclusively activate the IRR. This receptor mediates tissue protection and repair independently of red blood cell stimulation. In nervous tissue, ARA-290 reduces inflammatory cytokine production, promotes neuronal survival, restores small fibre nerve density (critical for pain perception and autonomic function), and reduces neuropathic pain signalling. The IRR is also present in other tissues, giving ARA-290 systemic tissue-protective properties.

Developed by Araim Pharmaceuticals (subsequently acquired). Phase 2 trials in patients with small fibre neuropathy (a painful nerve condition common in diabetes) demonstrated statistically significant improvements in pain scores and objective small fibre nerve density measurements at 4 mg/day subcutaneous. A Phase 2 trial in sarcoidosis-associated small fibre neuropathy (2016, Annals of Internal Medicine) showed significant pain reduction and nerve fibre density improvement. The unique mechanism — promoting nerve repair through EPO's tissue-protective pathway without haematopoietic effects — makes ARA-290 a genuinely novel option for neuropathic conditions and recovery contexts where nerve damage is present.

4–12 weeks