Recovery · Reference
KPV vs ARA-290: Two Anti-Inflammatory Peptides, Different Targets, Evidence and Cost
This page explains each on its own terms, puts them side by side, covers what the research does and does not show, where each stands with the FDA, how each is dosed, what each costs at Pepti, and who tends to suit which.
Treatments mentioned
KPV and ARA-290 are both described as anti-inflammatory peptides, but they come from different hormones, target different tissues, and have very different evidence behind them. KPV is a three-amino-acid fragment of alpha-MSH, described as damping inflammatory signalling inside cells, with its strongest work in mouse colitis models and no human trials at all. ARA-290, also called cibinetide, is an eleven-amino-acid piece of erythropoietin engineered to keep its tissue-protective effect without raising red blood cells, and it has small randomised phase 2 human trials in small-fibre neuropathy. Both are prescription-only, compounded by a licensed US pharmacy, and neither is FDA approved.
This page explains each on its own terms, puts them side by side, covers what the research does and does not show, where each stands with the FDA, how each is dosed, what each costs at Pepti, and who tends to suit which.
KPV vs ARA-290
The short answer
| If your main goal is | The usual prescription | What is in it | Price |
|---|---|---|---|
| Broad inflammation, especially gut-related | KPV | 10 mg KPV in a 5 mL vial (2 mg/mL) | $229/mo |
| Burning, tingling or numbness from small nerve fibre damage | ARA-290 | 10 mg ARA-290 in a 5 mL vial (2 mg/mL) | $219/mo |
| Inflammation plus immune and gut support | FORTIFY Blend | Thymosin alpha-1, BPC-157, KPV and LL-37 | $289/mo |
| Inflammation plus tissue repair and skin | KLOW Blend | GHK-Cu, KPV, BPC-157 and TB-500 | $259/mo |
| A soft-tissue injury rather than inflammation or nerves | BPC-157 | 5 mg BPC-157 in a 5 mL vial | $209/mo |
Every figure is an all-in monthly price covering the medication, physician review, refill management and shipping. There is no separate membership fee. Current pricing always lives on each product page; the table is a guide to which product fits which goal.
KPV vs ARA-290
KPV on its own terms
What it is
KPV is a tripeptide, lysine-proline-valine, the last three amino acids of alpha-melanocyte-stimulating hormone (alpha-MSH). Alpha-MSH is best known for driving pigmentation, but it also works as an anti-inflammatory signal. A 2008 review in Endocrine Reviews describes the three-amino-acid tail keeping much of that anti-inflammatory activity in cell and animal models, while pigmentation depends on a different part of the hormone. KPV does not cause tanning. The full reference is at what is KPV.
How KPV is described to work
- Entry through PepT1. A 2008 paper in Gastroenterology reported that KPV is carried into intestinal cells by PepT1, the transporter the gut uses to absorb small peptides, and that its effect depended on that transporter.
- NF-kB and MAPK. Inside the cell it is described as interfering with the two main pathways that turn an inflammatory trigger into a response.
- Lower cytokines. In cell and mouse work, less TNF-alpha, IL-6, IL-1 beta and IL-8.
- No melanocortin-1 receptor needed. A 2012 study in human bronchial cells described it acting through a route that did not depend on the receptor that drives pigmentation.
What human data exists for KPV
Study Model What was reported 2008, Inflammatory Bowel Diseases Mice with chemical and chronic colitis Less weight loss and less inflammation in tissue 2008, Gastroenterology Mice given KPV in drinking water Reduced severity in two colitis models, tied to PepT1 2017, Molecular Therapy Mice, KPV in targeted nanoparticles Reduced colitis at a far lower dose 2013, PLoS One Mice after brain injury Smaller lesions and fewer inflammation markers There are no randomised controlled trials of KPV in humans and no published human trials of any design. The evidence is cell lines, including human ones, and mouse models.
KPV vs ARA-290
ARA-290 on its own terms
What it is
ARA-290 is an eleven-amino-acid peptide whose sequence was taken from one surface of erythropoietin, the kidney hormone that tells bone marrow to make red blood cells. The 2008 PNAS paper that introduced it is titled "Nonerythropoietic, tissue-protective peptides derived from the tertiary structure of erythropoietin." Erythropoietin had been studied for nerve, heart and kidney protection but at useful doses it thickens the blood. ARA-290 does not bind the receptor pair that drives red cell production, so it does not raise haemoglobin. Its international name is cibinetide. The full reference is at what is ARA-290.
How ARA-290 is described to work
- The "innate repair receptor." It is described as engaging only a receptor pairing of one erythropoietin receptor with the beta-common receptor (CD131), switched on in injured or inflamed tissue. In a 2011 Anesthesiology study it reduced pain-related behaviour after nerve injury in rats and normal mice, but did nothing in mice lacking the beta-common receptor.
- Calming nerve-tissue inflammation. A 2014 paper in Molecular Pain reported five doses after nerve injury in rats reduced pain-related behaviour for up to twenty weeks and suppressed spinal cord microglia.
- Small nerve fibre regrowth. In the human trials, corneal nerve fibre density or area increased in treated patients.
What human data exists for ARA-290
Study Who What was reported 2012, Molecular Medicine 22 people with sarcoidosis and small-fibre neuropathy, intravenous, four weeks Symptom questionnaire improved more than placebo; pain intensity and fatigue improved equally in both groups 2013, Molecular Medicine Sarcoidosis, 28 days daily subcutaneous, blinded Improved symptoms, more corneal nerve fibres, longer six-minute walk 2015, Molecular Medicine Type 2 diabetes with painful neuropathy, 28 days subcutaneous Improved neuropathy symptom scores; improved HbA1c and lipids versus placebo 2017, Investigative Ophthalmology and Visual Science 64 people with sarcoidosis, three doses, 28 days Only the middle dose beat placebo on corneal nerve fibre area; pain reduction was not statistically significant The trials were small, four weeks long and run by the developer, and pain-intensity scores did not clearly separate from placebo. No phase 3 trial has been completed.
KPV vs ARA-290
Head to head
| KPV | ARA-290 | |
|---|---|---|
| Built from | Alpha-MSH (last three amino acids) | Erythropoietin (an eleven-amino-acid surface) |
| Main described mechanism | Damping NF-kB and cytokine output inside cells | Engaging a tissue-repair receptor in injured tissue |
| Where the work is strongest | Gut inflammation in mice | Small nerve fibres in people |
| Human trials | None | Randomised phase 2 trials in sarcoidosis and type 2 diabetes neuropathy |
| Route studied | Mostly oral in mice | Daily subcutaneous in the 2013 and 2015 trials |
| Strongest finding | Reduced colitis in several mouse models | Objective nerve fibre regrowth on corneal scans |
| What is not shown | Any effect in people | Pain relief beyond placebo |
| Typical directions at Pepti | 0.25 mL (25 units) once daily, Monday to Friday | 0.25 mL (25 units) once daily, Monday to Friday |
| Amount per dose | 0.5 mg | 0.5 mg |
| Price at Pepti | $229 a month | $219 a month |
The real difference is what kind of inflammation, and how much is known
"Anti-inflammatory" covers both, which is why they get compared. A practical split: where the problem is inflammation without a nerve-damage picture, KPV is generally the more direct discussion; where it is burning, tingling and numbness from small nerve fibre damage, ARA-290 is. On evidence, ARA-290 is unusual among compounded peptides in having randomised human trials, though small ones with surrogate endpoints; KPV has none.
KPV vs ARA-290
Who suits which
KPV
KPV is the usual discussion when the complaint is inflammation that will not settle, especially gut-related, which fits where its animal work is strongest. It is also one of four actives in the FORTIFY, ELEVATE and KLOW blends. More detail: KPV benefits, KPV dosage and KPV vs BPC-157.
ARA-290
ARA-290 suits someone with symptoms of small-fibre neuropathy whose cause has been looked into, who understands that the trials were in sarcoidosis and type 2 diabetes only and lasted four weeks. It is not a painkiller. More detail: ARA-290 benefits and ARA-290 dosage.
Can you take KPV and ARA-290 together?
They act through different pathways and no study has tested the combination. Starting with one makes it easier to tell what is doing what. Your physician sets your directions after reviewing your intake.
KPV vs ARA-290
When neither is the right first step
| Situation | What makes more sense |
|---|---|
| A diagnosed inflammatory disease on prescribed treatment | Your specialist; neither replaces that treatment |
| Neuropathy that has not been worked up | Checking causes first, such as B12, thyroid and glucose; methylcobalamin if B12 is the issue |
| A tendon, ligament or muscle injury | BPC-157, TB-500 or the BPC-157 + TB-500 stack |
| Immune function rather than inflammation | Thymosin Alpha-1 |
| Type 2 diabetes and weight are the drivers | Semaglutide or tirzepatide, which have large human trials for glucose and weight |
KPV vs ARA-290
Where each stands with the FDA
| KPV | ARA-290 (cibinetide) | |
|---|---|---|
| 2023 | Placed in Category 2 | Not in Category 2 |
| 2026 | Removal from Category 2 announced 15 April, effective 22 April | Category 3, "nominated without adequate support," on the list dated 14 May 2026 |
| Advisory committee | 23 July 2026: 8 to 6, one abstention, to recommend adding it to the 503A Bulks List, against FDA staff advice | Not scheduled |
| Final FDA determination | Pending | Not yet evaluated |
Category 3 is a paperwork category, not a safety finding: the nomination did not include enough information to evaluate. A committee vote is a recommendation, not a decision. Both remain legal to prescribe and dispense as compounded medications, and compounded medications are not FDA approved. Are peptides FDA approved explains the difference.
KPV vs ARA-290
Dosing, side by side
Both are injected under the skin (subcutaneously) into the abdomen or thigh, rotating sites, once daily Monday through Friday. Both vials are 2 mg/mL, so the same volume carries the same amount. This is arithmetic only, on a U-100 insulin syringe where 1 unit is 0.01 mL:
| Units | mL | KPV or ARA-290 (2 mg/mL) |
|---|---|---|
| 10 | 0.10 | 0.2 mg |
| 20 | 0.20 | 0.4 mg |
| 25 (typical printed directions for both) | 0.25 | 0.5 mg |
At 0.25 mL a dose, each 5 mL vial holds 20 doses, about four weeks, which happens to match the four-week treatment length of the ARA-290 trials. The trials dosed daily at amounts set by the sponsor, which are not the same as a compounded prescription's directions. Your directions are printed on the vial, and your physician sets them after reviewing your intake. Both ship refrigerated with ice packs, sterile syringes and alcohol prep pads; refills run every 28 days, one vial per fill.
Bloodwork is not required for any Pepti treatment. If your physician wants labs for your care, they'll ask through your account.
KPV vs ARA-290
Side effects
KPV. Animal work has not reported toxicity at the doses studied. Clinically: injection-site redness, mild soreness or bruising, and in some people mild nausea or a transient headache early on. With no human trials, "well tolerated" means nothing concerning has emerged, not tested and shown safe. Anyone on immunosuppressants or biologics should say so. More: KPV side effects.
ARA-290. Across the human trials, investigators reported no safety concerns from clinical or laboratory checks, and a twelve-week study found no antibodies against the peptide. It did not affect blood counts. Clinically: injection-site redness, soreness or bruising. Because one trial reported changes in HbA1c, anyone on insulin or other glucose-lowering medication should tell their physician.
For both, stop and contact your care team for any reaction that is severe or spreading. Difficulty breathing or swelling of the face or throat needs emergency care: call 911.
KPV vs ARA-290
Who should not take either, or should discuss it first
| Situation | Why |
|---|---|
| Pregnancy or breastfeeding | Not used; safety data is absent |
| On immunosuppressants or biologic therapy | Especially for KPV; raise it at intake |
| On insulin or glucose-lowering medication | Especially for ARA-290, because of the HbA1c finding |
| Tested athletes | ARA-290 is named as a prohibited peptide in the anti-doping literature; check your sport's current list for both |
KPV vs ARA-290
What the evidence shows, honestly
ARA-290 has what KPV lacks: randomised, placebo-controlled human trials, with a consistent signal on small nerve fibre regrowth and neuropathy symptom questionnaires in two specific populations. It does not have proof of pain relief beyond placebo, or of benefit in any other condition. KPV has a coherent mechanism and consistent mouse colitis data, but nothing in people. Neither is established as a treatment for any inflammatory or nerve condition.
KPV vs ARA-290
Where to get KPV or ARA-290 prescribed
Neither can be bought legitimately without a prescription. Sites selling them "for research use only" are not accountable for what is in the vial: identity, purity, sterility and concentration are untested. The prescription route:
- Complete a free online intake covering your history, medications and what you want help with.
- A physician licensed in your state reviews it, usually within 24 hours.
- If it is appropriate, a PCAB-accredited, FDA-registered US 503A pharmacy compounds it to that prescription. Lot test results are published at /quality/lab-results.
- It ships refrigerated with your directions printed on the vial.
- Your care team stays reachable for questions and side effects.
Pepti is cash-pay and does not bill insurance. Step-by-step: how to get KPV prescribed online. ARA-290 details are on the ARA-290 page.
References
What this is based on.
References
- Dahan A, Dunne A, Swartjes M et al.. ARA 290 improves symptoms in patients with sarcoidosis-associated small nerve fiber loss and increases corneal nerve fiber density · Mol Med (2013) · PMID 24136731
- Heij L, Niesters M, Swartjes M et al.. Safety and efficacy of ARA 290 in sarcoidosis patients with symptoms of small fiber neuropathy: a randomized, double-blind pilot study · Mol Med (2012) · PMID 23168581
- Brines M, Patel NS, Villa P et al.. Nonerythropoietic, tissue-protective peptides derived from the tertiary structure of erythropoietin · Proc Natl Acad Sci U S A (2008) · PMID 18676614
- Swartjes M, Morariu A, Niesters M et al.. ARA290, a peptide derived from the tertiary structure of erythropoietin, produces long-term relief of neuropathic pain: an experimental study in rats and β-common receptor knockout mice · Anesthesiology (2011) · PMID 21873879
- Swartjes M, van Velzen M, Niesters M et al.. ARA 290, a peptide derived from the tertiary structure of erythropoietin, produces long-term relief of neuropathic pain coupled with suppression of the spinal microglia response · Mol Pain (2014) · PMID 24529189
- van Velzen M, Heij L, Niesters M et al.. ARA 290 for treatment of small fiber neuropathy in sarcoidosis · Expert Opin Investig Drugs (2014) · PMID 24555851
- Brines M, Dunne AN, van Velzen M et al.. ARA 290, a nonerythropoietic peptide engineered from erythropoietin, improves metabolic control and neuropathic symptoms in patients with type 2 diabetes · Mol Med (2015) · PMID 25387363
- Cerit H, Veer IM, Dahan A et al.. Testing the antidepressant properties of the peptide ARA290 in a human neuropsychological model of drug action · Eur Neuropsychopharmacol (2015) · PMID 26431906
- Dahan A, Brines M, Niesters M et al.. Targeting the innate repair receptor to treat neuropathy · Pain Rep (2016) · PMID 29392190
- Culver DA, Dahan A, Bajorunas D et al.. Cibinetide Improves Corneal Nerve Fiber Abundance in Patients With Sarcoidosis-Associated Small Nerve Fiber Loss and Neuropathic Pain · Invest Ophthalmol Vis Sci (2017) · PMID 28475703
- Thomas A, Knoop A, Schänzer W et al.. Characterization of in vitro generated metabolites of selected peptides <2 kDa prohibited in sports · Drug Test Anal (2017) · PMID 28941172
- Brines M, Culver DA, Ferdousi M et al.. Corneal nerve fiber size adds utility to the diagnosis and assessment of therapeutic response in patients with small fiber neuropathy · Sci Rep (2018) · PMID 29549285
Citations are provided for educational purposes. They do not constitute medical advice. Always discuss any peptide protocol with your prescribing physician.
Common questions
KPV vs ARA-290, answered.
KPV is a three-amino-acid fragment of alpha-MSH described around damping inflammatory signalling, mostly in gut models. ARA-290 is an eleven-amino-acid fragment of erythropoietin described around a tissue-repair receptor in injured nerve tissue. They share the "anti-inflammatory" label and little else.
No study has compared them. KPV is generally the more direct discussion for inflammation without nerve involvement; ARA-290 is the one studied in neuropathy.
ARA-290 is the one studied in people with small-fibre neuropathy, and its trials found improved symptom questionnaires and nerve fibre regrowth but not pain intensity clearly beyond placebo. KPV has not been studied for nerve pain.
ARA-290. It has randomised phase 2 trials in sarcoidosis and type 2 diabetes. KPV has no human trials of any design.
No. It was engineered not to bind the receptor pair that drives red cell production, and the trials found no effect on blood counts.
No. Pigmentation from alpha-MSH depends on a part of the hormone KPV does not contain, and cell work describes KPV acting without the pigment receptor.
No study has tested the combination, and there is no established interaction list. Your physician sets your directions after reviewing your intake.
At Pepti, KPV is $229 a month and ARA-290 is $219 a month, all-in, including the medication, physician review, refill management and shipping. There is no membership fee and no insurance billing.
Pepti's typical printed directions for both are 0.25 mL (25 units) under the skin once daily, Monday through Friday. Both vials are 2 mg/mL, so that is 0.5 mg a dose. Your own directions are printed on the vial.
Yes, with a valid prescription, as compounded medications. Neither is FDA approved. KPV was recommended for the 503A Bulks List by the advisory committee in July 2026; ARA-290 sits in Category 3, not yet evaluated.
No. Bloodwork is not required for any Pepti treatment. If your physician wants labs for your care, they'll ask through your account. The free assessment goes to a physician licensed in your state. A consultation does not guarantee a prescription.
Next step
See what a physician recommends for you.
A licensed physician in your state reviews your intake and decides what is appropriate. A consultation does not guarantee a prescription.