An EPO-derived peptide studied in people for small-fiber neuropathy: burning, tingling, and nerve pain. It activates the body’s repair receptor without raising red blood cells.
Reviewed by Dr. Jason Wright, D.O. · September 23, 2026
The science
How it works
Activates the repair receptor
It binds the innate repair receptor, the tissue-protective side of EPO signaling, which calms inflammation and supports healing.
No effect on red blood cells
It is built from a small piece of EPO that skips the receptor that raises red blood cell counts and clotting risk.
Regrows small nerve fibers
In trials, small nerve fibers measured in the cornea, a window onto the body’s small nerves, increased after 28 days.
Brief exposure, lasting signal
It clears the blood within minutes, but the repair signaling it starts continues afterward.
Studied in small Phase 2 trials in sarcoidosis and type 2 diabetes. It was never taken to Phase 3, and its original developer has since closed.
Dosing
Your dosing plan
Dr. Wright sets your exact dose within this range at your visit.
Trial protocol
FormSubcutaneous
Dose4 mg (0.67 mL, 67 units)
ScheduleOnce daily for 28 days
Based onPhase 2 trials, pharmacy labeling
Lower-dose option
FormSubcutaneous
Dose1.2 mg (0.2 mL, 20 units)
ScheduleOnce daily
Based onClinical practice
Vials needed
Form—
DoseAbout 4 vials for the 28-day trial protocol
ScheduleAbout 25 days per vial at the lower dose
Based on30 mg per vial
Side effects
Side effects and what to expect
Redness at the injection siteCommon · First weeks
Rotate sites.
HeadacheUncommon · First week
Usually passes.
FatigueUncommon · First week
Usually passes.
Allergic reactionRare · Any time
Stop and contact the practice.
A note from Dr. Wright
ARA-290 is one of the few peptides with human trials in nerve pain, and neuropathy patients don’t have many good options. I use it in a defined 28-day course and judge it by how your symptoms change.
Dr. Jason Wright, D.O. · Board certified, American Board of Cosmetic Surgery
Cost & access
Getting started with ARA-290
ARA-290
30 mg in a 5 mL vial (6 mg/mL), ready to inject · Labeled in your name
Adults with small-fiber neuropathy symptoms such as burning, tingling, numbness, or nerve pain, including from diabetes. It supports, and doesn’t replace, treatment of the underlying cause.
What did the trials show?
In small Phase 2 trials in sarcoidosis, 4 mg daily for 28 days improved nerve pain scores and increased small nerve fibers measured in the cornea. A trial in type 2 diabetes also showed improvements in neuropathy symptoms and blood sugar control.
Why several vials?
The trial dose, 4 mg a day, uses a 30 mg vial in about a week. The lower-dose option stretches a vial to most of a month.
Does it raise my blood count like EPO?
No. It was designed specifically to avoid that effect.
Do I need tests first?
Neuropathy has many causes. We review your history and recent labs, such as A1c and B12, before starting.
Research
Supporting studies
ARA-290 improved symptoms and increased corneal nerve fibers in sarcoidosis
