CN-105, an Apolipoprotein E Mimetic Peptide, and Its Impact on Postoperative Delirium in Elderly Patients: Insights from the Phase 2 MARBLE Study - Summary - MDSpire

CN-105, an Apolipoprotein E Mimetic Peptide, and Its Impact on Postoperative Delirium in Elderly Patients: Insights from the Phase 2 MARBLE Study

  • By

  • Noah J. Timko

  • Mary Cooter Wright

  • Melody R. Smith

  • Piper C. Boykin

  • Jacqueline M. Emerson

  • Marty G. Woldorff

  • Sarada Eleswarpu

  • J. Taylor Herbert

  • Eugene W. Moretti

  • Michael J. Devinney

  • Chakib M. Ayoub

  • Frank W. Rockhold

  • David Ryu

  • Ayesha Syed

  • Keith W. VanDusen

  • Thomas Bunning

  • Bethany J. Hsia

  • Michael P. Bolognesi

  • William A. Jiranek

  • Henrik Zetterberg

  • Kaj Blennow

  • Janet L. Huebner

  • Zhong Li

  • Tyler H. Reekes

  • Jeffrey N. Browndyke

  • Daniel T. Laskowitz

  • Miles Berger

  • MARBLE Study Investigators

  • Michael R. Abern

  • Leah C. Acker

  • Samuel B. Adams

  • Peter J. Allen

  • Cindy L. Amundsen

  • Oke A. Anakwenze

  • Pallavi Avasarala

  • Matthew D. Barber

  • Andrew Berchuck

  • Daniel G. Blazer

  • Rachele Brassard

  • Brian E. Brigman

  • W.M. Bullock

  • Roberto Cabeza

  • Morgan A. Caldwell

  • Soren K. Christensen

  • Catharina C. Eisdorfer

  • Lori Cole-Freiburger

  • Brian J. Colin

  • Mitchell W. Cox

  • Donna M. Crabtree

  • Thomas A. D’Amico

  • Brittany A. Davidson

  • James K. DeOrio

  • Mark E. Easley

  • Clay Elliott

  • Detlev Erdmann

  • Melissa M. Erickson

  • Alisan Fathalizadeh

  • Michael N. Ferrandino

  • Robert D. Fitch

  • Howard W. Francis

  • Matthew Fuller

  • John C. Haney

  • David H. Harpole

  • Bonita L. Hilliard

  • Julia Hoang

  • Jeffrey C. Gadsden

  • Mark J. Gage

  • Arun Ganesh

  • Jaleesa Garner

  • Jeffrey R. Gingrich

  • Summer Granger

  • Rachel A. Greenup

  • Christine Ha

  • Ashraf S. Habib

  • Ralph Abi Hachem

  • Ashley E. Hall

  • Matthew G. Hartwig

  • Laura J. Havrilesky

  • Mitchell T. Heflin

  • Tarrah Henley

  • Scott T. Hollenbeck

  • Thomas J. Hopkins

  • Brant A. Inman

  • David W. Jang

  • Russel R. Kahmke

  • Isaac O. Karikari

  • Nicholas Kathrein

  • Amie Kawasaki

  • Deborah R. Kaye

  • Hadiza S. Kazaure

  • Josiane Kerbage

  • Jacob A. Klapper

  • Christopher S. Klifto

  • Rebecca Klinger

  • Stuart J. Knechtle

  • Sandhya A. Lagoo-Deenadayalan

  • Billy Y. Lan

  • Paula S. Lee

  • Walter T. Lee

  • Howard Levinson

  • Brian D. Lewis

  • Michael E. Lidsky

  • Janice Lim

  • Michael E. Lipkin

  • Andrew J. Liu

  • Christopher R. Mantyh

  • Jeffrey R. Marcus

  • Hector F. Martinez-Wilson

  • Shelley R. McDonald

  • Jennifer L. McNally

  • Nitin L. Mehdiratta

  • John Migaly

  • Timothy E. Miller

  • Suhail K. Mithani

  • Sean P. Montgomery

  • Paul J. Mosca

  • Judd W. Moul

  • David M. Murdoch

  • Devika Naphade

  • Christine L. Nelson

  • Thomas L. Novick

  • Daniel P. Nussbaum

  • Brian J. Ohlendorf

  • Steven A. Olson

  • Isaac Oyediran

  • Theodore N. Pappas

  • John J. Park

  • Ashley B. Parker

  • Andrew C. Peterson

  • Christy E. Peterson

  • Brett T. Phillips

  • Thomas J. Polascik

  • Peter T. Potash

  • Glenn M. Preminger

  • Rebecca A. Previs

  • Kadiyala V. Ravindra

  • Sydney M. Record

  • Aparna S. Rege

  • Kristen M. Rezak

  • Kenneth C. Roberts

  • Cary N. Robertson

  • Daniel J. Rocke

  • David S. Ruch

  • Sean P. Ryan

  • Charles D. Scales

  • Randall P. Scheri

  • Angeles A. Secord

  • Keri A. Seymour

  • Ankeet M. Shah

  • Kevin N. Shah

  • Nazema Y. Siddiqui

  • Geoffroy C. Sisk

  • Shayan Smani

  • Kevin W. Southerland

  • Courtney H. Stanczak

  • Michael T. Stang

  • Samuel D. Stanley

  • Niccolò Terrando

  • Julie K. M. Thacker

  • Brittany N. Thomas

  • Jake P. Thomas

  • Yanne Toulgoat-DuBois

  • Daniel C. Villalobos

  • Anthony G. Visco

  • Alison C. Weidner

  • John Whittle

  • David A. Williams

  • Megan Wong

  • Mamata Yanamadala

  • Rosa O. Yang

  • Christopher C. Young

  • Mary Yurashevich

  • Sabino Zani

  • Daphne Zhu

  • April 3, 2026

  • 0 min

Share

Objective:

To assess the safety and feasibility of CN-105 for reducing delirium incidence and severity and neuroinflammation after noncardiac or nonintracranial surgery in older adults.

Key Findings:
  • CN-105 was safely administered with no significant adverse events reported.
  • The trial was not powered to investigate dose-specific effects.
  • The study followed CONSORT guidelines and received external regulatory oversight.
Interpretation:

CN-105 shows promise as a potential intervention for reducing postoperative delirium through modulation of neuroinflammation, although further studies are needed to establish efficacy.

Limitations:
  • The trial was single-center, limiting generalizability.
  • Not powered to assess dose-specific effects.
Conclusion:

The MARBLE trial indicates that CN-105 is safe for use in older adults undergoing surgery, warranting further investigation into its efficacy in reducing postoperative delirium.

Original Source(s)

CN-105, an Apolipoprotein E Mimetic Peptide, and Its Impact on Postoperative Delirium in Elderly Patients: Insights from the Phase 2 MARBLE Study

  • by Noah J. Timko, Mary Cooter Wright, Melody R. Smith, Piper C. Boykin, Jacqueline M. Emerson, Marty G. Woldorff, Sarada Eleswarpu, J. Taylor Herbert, Eugene W. Moretti, Michael J. Devinney, Chakib M. Ayoub, Frank W. Rockhold, David Ryu, Ayesha Syed, Keith W. VanDusen, Thomas Bunning, Bethany J. Hsia, Michael P. Bolognesi, William A. Jiranek, Henrik Zetterberg, Kaj Blennow, Janet L. Huebner, Zhong Li, Tyler H. Reekes, Jeffrey N. Browndyke, Daniel T. Laskowitz, Miles Berger, MARBLE Study Investigators, Michael R. Abern, Leah C. Acker, Samuel B. Adams, Peter J. Allen, Cindy L. Amundsen, Oke A. Anakwenze, Pallavi Avasarala, Matthew D. Barber, Andrew Berchuck, Daniel G. Blazer , Rachele Brassard, Brian E. Brigman, W.M. Bullock, Roberto Cabeza, Morgan A. Caldwell, Soren K. Christensen, Catharina C. Eisdorfer, Lori Cole-Freiburger, Brian J. Colin, Mitchell W. Cox, Donna M. Crabtree, Thomas A. D’Amico, Brittany A. Davidson, James K. DeOrio, Mark E. Easley, Clay Elliott, Detlev Erdmann, Melissa M. Erickson, Alisan Fathalizadeh, Michael N. Ferrandino, Robert D. Fitch, Howard W. Francis, Matthew Fuller, John C. Haney, David H. Harpole, Bonita L. Hilliard, Julia Hoang, Jeffrey C. Gadsden, Mark J. Gage, Arun Ganesh, Jaleesa Garner, Jeffrey R. Gingrich, Summer Granger, Rachel A. Greenup, Christine Ha, Ashraf S. Habib, Ralph Abi Hachem, Ashley E. Hall, Matthew G. Hartwig, Laura J. Havrilesky, Mitchell T. Heflin, Tarrah Henley, Scott T. Hollenbeck, Thomas J. Hopkins, Brant A. Inman, David W. Jang, Russel R. Kahmke, Isaac O. Karikari, Nicholas Kathrein, Amie Kawasaki, Deborah R. Kaye, Hadiza S. Kazaure, Josiane Kerbage, Jacob A. Klapper, Christopher S. Klifto, Rebecca Klinger, Stuart J. Knechtle, Sandhya A. Lagoo-Deenadayalan, Billy Y. Lan, Paula S. Lee, Walter T. Lee, Howard Levinson, Brian D. Lewis, Michael E. Lidsky, Janice Lim, Michael E. Lipkin, Andrew J. Liu, Christopher R. Mantyh, Jeffrey R. Marcus, Hector F. Martinez-Wilson, Shelley R. McDonald, Jennifer L. McNally, Nitin L. Mehdiratta, John Migaly, Timothy E. Miller, Suhail K. Mithani, Sean P. Montgomery, Paul J. Mosca, Judd W. Moul, David M. Murdoch, Devika Naphade, Christine L. Nelson, Thomas L. Novick, Daniel P. Nussbaum, Brian J. Ohlendorf, Steven A. Olson, Isaac Oyediran, Theodore N. Pappas, John J. Park, Ashley B. Parker, Andrew C. Peterson, Christy E. Peterson, Brett T. Phillips, Thomas J. Polascik, Peter T. Potash, Glenn M. Preminger, Rebecca A. Previs, Kadiyala V. Ravindra, Sydney M. Record, Aparna S. Rege, Kristen M. Rezak, Kenneth C. Roberts, Cary N. Robertson, Daniel J. Rocke, David S. Ruch, Sean P. Ryan, Charles D. Scales, Randall P. Scheri, Angeles A. Secord, Keri A. Seymour, Ankeet M. Shah, Kevin N. Shah, Nazema Y. Siddiqui, Geoffroy C. Sisk, Shayan Smani, Kevin W. Southerland, Courtney H. Stanczak, Michael T. Stang, Samuel D. Stanley, Niccolò Terrando, Julie K. M. Thacker, Brittany N. Thomas, Jake P. Thomas, Yanne Toulgoat-DuBois, Daniel C. Villalobos, Anthony G. Visco, Alison C. Weidner, John Whittle, David A. Williams, Megan Wong, Mamata Yanamadala, Rosa O. Yang, Christopher C. Young, Mary Yurashevich, Sabino Zani, Daphne Zhu

  • April 3, 2026

Related Content

APOE Utilization Tied to Most AD Cases

Apolipoprotein E ε3 and ε4 genotypes account for most Alzheimer's disease and nearly half of all-cause dementia.*

Cognition-Affecting Drugs Often Start in Acute Care

Older patients frequently continued these medication classes 1 year after initiation

Predicting chronic subdural hematoma risk in elderly patients with mild traumatic brain injury