Side-by-side · Research reference

ARA 290vsTesamorelin

Side-by-side comparison across mechanism, dosage, evidence, side effects, administration, and stack synergies. Citations on every claim where available.

APhase 2HUMAN-REVIEWED17/59 cited

BFDA-ApprovedFlagship27/68 cited

ARA 290

EPO-Derived Peptide · Innate Repair Receptor Agonist

4 mgDaily doseBrines 2015 Culver 2017

28 daysPhase 2 durationCulver 2017

Non-erythropoieticSafety profileBrines 2015 Liu 2014

SQ · DailyBrines 2015 Culver 2017

Tesamorelin

GHRH Analogue · FDA-Approved

2 mgDaily doseEGRIFTA® (tesamorelin for inje 2010

15–20%VAT reductionFalutz 2010

~26 minHalf-lifeEGRIFTA® (tesamorelin for inje 2010

SQ · Abdomen · Once Daily

01Mechanism of Action

Parameter

ARA 290

Tesamorelin

Primary target

Innate repair receptor (EPO receptor / CD131 heterodimer)

Hypothalamic GHRH receptorsEGRIFTA® (tesamorelin for inje 2010

Pathway

EPO/CD131 → JAK2 activation → PI3K/AKT, MAPK signaling → anti-inflammatory, anti-apoptotic cascades

GHRH → Pituitary GH release → Liver IGF-1 synthesisFalutz 2007

Downstream effect

Tissue protection, nerve fiber regeneration, suppression of inflammatory macrophage activation, altered T-cell differentiation (↑Treg, ↑Th2, ↓Th1)Liu 2014 Culver 2017

Increased GH pulsatility, elevated IGF-1, lipolysis of visceral adipose tissueFalutz 2010

Feedback intact?

N/A — does not interact with hematopoietic EPO receptorLiu 2014

Yes — physiological pulsatility preserved

Origin

11-amino-acid sequence from EPO helix B, engineered to eliminate hematopoietic activity while retaining tissue-protective properties

Synthetic 44-AA GHRH analogue with trans-3-hexenoic-acid modification for stabilityEGRIFTA® (tesamorelin for inje 2010

Antibody development

Not reported in clinical trials

~50% after 26 wks (non-neutralising in most)Sévigny 2018

02Dosage Protocols

Parameter

ARA 290

Tesamorelin

Standard dose (Phase 2)

4 mg / dayBrines 2015 Culver 2017

Sarcoidosis SFN and diabetic neuropathy trials.

—

Frequency

Once daily

Self-administered subcutaneously.

Once daily (morning or pre-sleep)

Aligns with natural GH pulse.

Duration

28 days (Phase 2)Culver 2017

Corneal nerve improvements observed by day 28.

12–52 weeks

VAT returns within months of stopping.

Evidence basis

Phase 2 RCTsCulver 2017 Brines 2015

64-subject sarcoidosis trial, type 2 diabetes trial.

RCT / FDA-approvedFalutz 2007 Falutz 2010

Route

SubcutaneousBrines 2015

—

Timing

Any time of day

No circadian dependence reported.

Empty stomach, pre-sleep preferred

Standard dose

—

2 mg / dayEGRIFTA® (tesamorelin for inje 2010

FDA-approved protocol.

Lower / starter dose

—

1 mg / dayFalutz 2010

1 mg still produces significant IGF-1 elevation.

Reconstitution

—

Sterile water per labeling

Preserved at 2–8 °C after reconstitution.

Half-life

—

~26 min (plasma)EGRIFTA® (tesamorelin for inje 2010

Modified vs native GHRH (7 min t½).

03Metabolic / Fat Loss Evidence

Parameter

ARA 290

Tesamorelin

Primary effect

Improved metabolic control (HbA1c, fasting glucose)Brines 2015

Secondary to neuropathy treatment; direct lipolytic effects not established.

—

HbA1c

Significant reduction vs placebo

Observed in type 2 diabetes + neuropathy trial.

—

Fasting glucose

Improved in ARA 290 group

—

Body composition

Not directly quantified

Fat loss not a primary endpoint; metabolic improvements may reflect insulin sensitivity.

—

Primary fat target

—

Visceral adipose tissue (VAT) — abdominal

Quantified reduction

—

15–20% VAT ↓Falutz 2010

By CT at 26 weeks (Falutz et al., NEJM).

IGF-1 impact

—

+66 ng/mL (2 mg dose) · +81% mean elevationFalutz 2007

Effect on lean mass

—

Modest lean mass preservation / slight increase

Insulin sensitivity

—

Neutral to slight impairment (monitor HbA1c)Clarke 2018

Triglycerides

—

Significant TG reduction noted in Phase 3Falutz 2010

Glucose metabolism

—

Generally neutral; 4.5% HbA1c elevation riskClarke 2018

Effect reversibility

—

VAT returns within months of stopping

Key publication

—

Falutz et al. NEJM 2007 · Falutz JCEM 2010 · FDA approval 2010Falutz 2007 Falutz 2010 EGRIFTA® (tesamorelin for inje 2010

04Side Effects & Safety

Parameter

ARA 290

Tesamorelin

Injection site reaction

Mild, transient

Erythema, pruritus, redness (common)

Hematopoiesis

None — non-erythropoietic

Distinguishes ARA 290 from native EPO.

—

Cardiovascular

No thrombotic events or hypertension reported

—

Immunogenicity

No antibody formation reported

—

Tolerability

Well-tolerated in Phase 2 trialsCulver 2017 Brines 2015

—

Fluid retention / Edema

—

Peripheral edema, arthralgia, carpal tunnel (GH-axis effect)

Glucose intolerance

—

HbA1c ↑ in 4.5% vs 1.3% placebo; HbA1c ≥6.5% hazard OR 3.3Clarke 2018

IGF-1 elevation

—

Dose-dependent; supraphysiological levels = discontinue

Cancer risk

—

Contraindicated in active malignancy (GH/IGF-1 axis); theoretical tumour growth riskEGRIFTA® (tesamorelin for inje 2010

Antibody formation

—

~50% at 26 weeks; non-neutralising in most; rare hypersensitivity (<1%)Sévigny 2018

GI symptoms

—

Nausea, diarrhea (mild, transient)

Pregnancy / OB

—

ContraindicatedEGRIFTA® (tesamorelin for inje 2010

Absolute Contraindications

ARA 290

·Hypersensitivity to ARA 290

Tesamorelin

·Active malignancy or history of treated cancer
·Pregnancy
·Hypersensitivity to tesamorelin or mannitol
·Disruption of hypothalamic-pituitary axis (trauma, tumour, radiation)

Relative Contraindications

ARA 290

·Active malignancy (theoretical EPO-axis concern; not observed in trials)

Tesamorelin

·Untreated diabetes (monitor HbA1c)
·Severe carpal tunnel syndrome
·Acute critical illness

05Administration Protocol

Parameter

ARA 290

Tesamorelin

1. Preparation

Reconstitute lyophilised powder per manufacturer instructions. Use sterile technique.

Add 2.1 mL sterile water to 2 mg lyophilised vial. Roll gently — do not shake. Solution should be clear.

2. Injection site

Subcutaneous — abdomen, thigh, or upper arm. Rotate sites to avoid lipohypertrophy.

Subcutaneous — abdomen preferred. Rotate sites (avoid same spot within 2 cm). Avoid navel and waistband area.

3. Timing

Once daily, any time of day. Self-administered in Phase 2 trials.Brines 2015

Once daily. Preferred: evening, 2–3 hrs post-meal, before sleep — aligns with natural GH secretion pulse.

4. Dosing

4 mg daily for 28 days (Phase 2 protocol). Duration for chronic use not established.Culver 2017

Lyophilised: room temp, light-protected. Reconstituted: refrigerate 2–8 °C, use within 21 days.

5. Storage

Lyophilised: store at controlled room temperature. Reconstituted: refrigerate, use within specified timeframe.

27–31G, 4–8 mm insulin syringe. Pinch skin, 45° angle for lean individuals.

06Stack Synergy

ARA 290

+ BPC-157

Moderate

View BPC-157 →

ARA 290 targets the innate repair receptor (EPO/CD131) for nerve regeneration and anti-inflammatory signaling, while BPC-157 promotes angiogenesis and tissue repair through distinct mechanisms (likely involving VEGF, growth hormone receptor pathways). Combined, they may address both neuroinflammation and structural tissue repair in neuropathy or injury models. No direct clinical data; mechanistic overlap in tissue protection.

ARA 290: 4 mg SQ · daily
BPC-157: 250–500 mcg SQ · daily
Frequency: Once daily, same or separate injections
Primary benefit: Nerve regeneration, pain reduction, tissue healing

Tesamorelin

+ Ipamorelin

Strong

View Ipamorelin →

Tesamorelin (GHRH analogue) and ipamorelin (GHRP / ghrelin mimetic) act on two distinct receptor systems to amplify GH release synergistically — GHRH receptor + ghrelin receptor. This dual-axis stimulation produces a more robust, sustained GH pulse than either alone while maintaining physiological pulsatility. Ipamorelin is highly selective with minimal cortisol or prolactin elevation, making it the preferred GHRP pairing.

Tesamorelin: 2 mg SQ · evening
Ipamorelin: 200–300 mcg SQ · same injection
Frequency: Once daily, pre-sleep
Primary benefit: Maximal GH pulsatility, fat loss, recovery, sleep quality

Raun 1998