The erythropoietin analog ARA 290 for treatment of sarcoidosis-induced chronic neuropathic pain

Abstract

Introduction: Sarcoidosis is a multi-system inflammatory disorder that may affect the peripheral nerves causing neuropathic pain. Chronic neuropathic pain is a debilitating disease and current treatment options are either of limited efficacy or are hampered by the development of serious side effects. A novel pharmacological treatment option is the non-hematopoietic erythropoietin analog ARA 290, a small peptide acting at the innate repair receptor, which is a heteromer of the erythropoietin receptor and β-common receptor. ARA 290 was recently granted designation as Orphan Drug Product by the FDA, for treatment of neuropathic pain in sarcoidosis patients. Areas covered: This report reviews the pathophysiology of sarcoidosis and, to understand the mechanistic pathway of ARA 290, the role of the innate repair receptor in inflammation and its natural and synthetic ligands, erythropoietin and ARA 290. The results of two proof-of-concept studies are presented that show the ability of ARA 290 to induce analgesia greater than placebo in patients with sarcoidosis-induced chronic moderate to severe neuropathic pain, without safety issues. Expert opinion: ARA 290 is a promising novel therapeutic option in the treatment of neuropathic pain in sarcoidosis. Further studies are designed to obtain additional proof of ARA 290's analgesic efficacy and ability to increase the quality of life in afflicted patients.