CN-105_Dosage, benefits & legal status
Also known as CN105, CN 105, Ac-VSRRR-NH2
A five-amino-acid mimic of the part of apolipoprotein E that calms inflammation in the injured brain. Two small randomized trials, in brain bleeds and in surgery, found trends that were not significant.
Common vial size is what vendors typically sell, not a recommendation. Enter your own vial in the calculator.
What is CN-105?
Plain language first. The technical label stays, but it never stands alone.Overview
After a bleed into the brain, the brain's own support cells become inflamed and cause further damage over the following days; CN-105 is meant to calm them. In the 60-patient S-CATCH trial, 77.8% on CN-105 against 66.7% on placebo had a favorable outcome at 90 days (P=.35), and in 186 older surgical patients delirium occurred in 19.3% against 26.5% (P=.29). Neither difference was statistically significant, and no phase 3 trial has been announced.
CN-105 is an N-acetylated, C-amidated pentapeptide (Ac-VSRRR-NH2) designed by linearizing the receptor-binding face of the apolipoprotein E helix (apoE residues 130 to 149), and it crosses the blood-brain barrier after intravenous dosing. It is proposed to act through apoE receptors such as LRP1 on microglia and astrocytes to damp glial activation and secondary injury; a 2022 paper also reports nicotinic receptor antagonism. Invented at Duke University (co-inventor Daniel Laskowitz) and licensed to AegisCN, it holds an FDA orphan designation for intracerebral hemorrhage and has reached phase 2b.
What it's used for
Not available. A trial drug given by drip in the hospital, mainly for bleeding inside the brain (intracerebral hemorrhage), and also tested to prevent delirium after surgery.
How does CN-105 work?
What it does in the body, and where.CN-105 mimics the part of apolipoprotein E that calms the brain's immune cells, in a piece small enough to reach the brain from a vein.
- 01Injury sparks inflammationAfter a bleed or other brain injury, microglia and astrocytes switch on and release inflammatory cytokines, adding secondary damage to the first injury.
- 02ApoE's calming faceNatural apolipoprotein E damps this response through the receptor-binding region of its helix, but the whole protein is too large to cross the blood-brain barrier. CN-105 lays that face out as a five-residue chain; it reaches about 5 times the brain exposure of earlier apoE mimetics and is described as about 10 times as potent as one of them, COG1410.
- 03Proposed effectIt is thought to act through apoE receptors such as LRP1 on glial cells, and a 2022 paper reports it also blocks nicotinic receptors to curb excitotoxic damage. In mice with brain bleeds it reduced swelling and microglial activation without shrinking the bleed. Benefit in people is unproven.
A schematic of the compound's mechanism, not a diagnostic image.
What else is it used for?
Each group carries its own evidence level.Approved means regulators have cleared it for that purpose. Investigational means it is in trials. Early research means it is being studied and is not established.
Brain bleeds, randomized (S-CATCH)
Investigational- Human trial60 patients treated within 12 hours: favorable 90-day outcome 77.8% against 66.7% (P=.35); serious adverse events 26.7% against 30%.
- No dataA single-center phase 2b; the authors suggest a phase 3 focused on medium-sized bleeds deep in the brain.
Brain bleeds, open-label (CATCH)
Investigational- Human trial38 patients at 6 US sites: lower 30-day disability scores than 33 matched registry controls (OR 2.69, 95% CI 1.31 to 5.51).
- No dataWithout a placebo group the comparison is hypothesis-generating; 3 patients (8%) died of the bleed within 6 days.
Delirium after surgery (MARBLE)
Investigational- Human trial186 adults aged 60 and over: grade 2 or higher adverse events 76.6% against 87.8% (P=.10) and a median of 1 against 2 per patient (P=.03), the primary endpoint; serious adverse events 8.0% against 22.4% (P=.007).
- Human trialDelirium 19.3% against 26.5% (P=.29); cognition at 6 weeks and spinal fluid cytokines did not differ.
- Human trialSpinal fluid levels rose with dose and ran about 3 to 4% of plasma levels.
- No dataThree escalating doses were randomized 3 to 1 against placebo, and the trial was not powered for delirium.
Mouse brain-bleed model
Early research- Animal studyThree IV doses of 0.05 mg/kg within 24 hours improved motor recovery on days 1 to 5 and spatial memory on days 29 to 32.
- Animal studyBrain swelling and microglial activation fell and more hippocampal neurons survived; the bleed itself did not shrink.
MARBLE is often described as a delirium trial, but its primary endpoint was safety; delirium was a secondary outcome (19.3% against 26.5%, P=.29). Its publication date is reported as April 1, 2026; JAMA Network Open published it online on April 3, 2026. The 'approximate 25% relative risk reduction' in the Duke announcement is arithmetic on a nonsignificant result whose confidence interval (0.41 to 1.30) also allows harm. Enrollment is quoted as 203 (consented), 189 (randomized) or 186 (analyzed), and the primary P value as 0.025 on the registry and .03 in the paper. The lead program is intracerebral hemorrhage, not delirium: the 2015 orphan designation, CATCH and S-CATCH are all in brain bleeds, and S-CATCH is phase 2 on its registry page but phase 2b in the paper. The CATCH odds ratio of 2.69 compares treated patients with registry controls, not with placebo.
The published record
Papers and trials about CN-105
14 papers tagged human · 7 not reviews or lab · 4 clinical trial publications
6 registered trials · 2 with posted results
Furthest stage reached: Phase 2, results posted
Counted from Europe PMC indexing, not read by a person; a human tag can land on reviews, commentary or lab papers; clinical trial publications is the narrower count.
At a glance
Four things to know about CN-105
Evidence
Investigational
Category
Healing and recovery
Common vial
Varies
Half-life
About 3.6 hours
How much, and do you cycle it?
The range, and whether you take breaks.1.0 mg/kg every 6 hours, up to 13 doses over 72 hours (phase 2 trials), every 6 hours for up to 3 days. One course of up to 3 days Trial dose
Given every 6 hours for up to 13 doses after the bleed or around surgery, then stopped.
About 3.6 hoursHuman study
In 48 healthy adults, the median terminal half-life was about 3.6 hours after single or repeated doses, with no significant build-up. In CATCH, 1.0 mg/kg every 6 hours reached steady state after the fourth dose, with little build-up over 13 doses (exposure ratio 1.3). In MARBLE, spinal fluid levels 24 hours after surgery were about 3 to 4% of plasma levels and rose with dose.
Source: Guptill JT et al., J Clin Pharmacol 2017;57(6):770-776 (phase 1, 48 healthy adults)
You can compare this against the whole library to see where it sits.
How is it given?
Dosing context and source notes.Given in hospital from a prepared product, so there is nothing to mix.
Label dose: 1 mg/kg per dose. James ML et al., Neurocritical Care 2022 (CATCH)
1.0 mg/kg as a 30-minute intravenous infusion every 6 hours, starting within 12 hours of the bleed, for up to 13 doses (72 hours) or until discharge, in CATCH and S-CATCH. MARBLE tested 0.1, 0.5 and 1 mg/kg, the first dose within an hour before surgery. The trial supply was a frozen solution of 12.5 mg/mL, 50 mg to a vial, stored at -70°C. The MARBLE protocol describes 1 mg/kg as 24 to 100 times the effective dose in mouse models. Trial-only and dosed by body weight, so the calculator cannot produce a draw.
How do you store it?
Before mixing, and after.Given in a hospital or trial clinic, so the pharmacy stores it.
CN-105 goes into a vein and is prepared by hospital, clinic or trial pharmacy staff, following the product label or the trial protocol. Some products like this are ready-made solutions and others are powders mixed just before use, often with hours rather than weeks of shelf life once prepared. It is not a medicine people store at home.
What are the side effects and cautions?
Known cautions and warnings for this compound.Solubility, computed: 100% charged residues, 20% hydrophobic. Water usually sufficient.
A first-pass rule from peptide manufacturers' guidance. It does not account for disulfide bridges, salt form or how the powder was dried, and it predicts what should be easy rather than what will happen in your vial.
Who should avoid it
- Not studied in pregnancy or breastfeeding
- Not studied in children: trials enrolled adults (healthy volunteers 18 to 50, brain-bleed patients 30 to 80 in CATCH, surgical patients 60 and over)
- Not studied beyond 12 hours after a bleed, or in brainstem or cerebellar bleeds (CATCH took only bleeds above the tentorium)
- Not studied in heart or brain surgery: MARBLE enrolled noncardiac, nonintracranial operations
- Use outside a trial: it is not made or sold commercially
Stop and get help
- New or worsening weakness, confusion, drowsiness or a severe headache, signs the bleed may be growing (as it did in 9 of 38 people in CATCH)
- Swelling of the face or throat, or trouble breathing during the infusion
Common effects
- Grade 2 or higher adverse events in 76.6% against 87.8% on placebo in MARBLE (186 older surgical patients, P=.10), with a median of 1 against 2 such events per patient (P=.03); together these were the trial's primary endpoint
- Serious adverse events in 8.0% against 22.4% on placebo in MARBLE (P=.007), with no deaths
- Serious adverse events in 26.7% against 30% in S-CATCH; neurological worsening in the hospital 0% against 10%
- In the open-label CATCH trial, 31 of 38 (82%) had treatment-emergent adverse events and 3 died of the bleed within 6 days; investigators judged serious events unlikely to be drug-related
Where this page says nothing is established, that means nobody has studied it, not that a compound is safe.
Is CN-105 approved?
And where the numbers on this page come from.No. CN-105 is not approved anywhere and is currently in company-run clinical trials. There is no legal route to obtain it outside a trial.
- Approval statusInvestigational
- RouteInto a vein (30-minute infusion), trial only
- Checked16 October 2026
- DoseFrom published clinical trials. Not approved by a regulator for this dose.
- Vial sizeFrom what vendors typically list; not a recommendation.
- SourcesTimko NJ et al., JAMA Network Open 2026;9(4):e262289 (MARBLE)MARBLE author manuscript (UCL Discovery)MARBLE protocol and statistical analysis planClinicalTrials.gov, MARBLE (NCT03802396)Cheong TM et al., Neurocritical Care 2026 (S-CATCH)James ML et al., Neurocritical Care 2022;36(1):216-225 (CATCH)CATCH preprint (medRxiv 2020)Lei B et al., Scientific Reports 2016;6:34834FDA GSRS substance record, CN-105 (UNII W525NLS74J)FDA orphan drug designation, CN-105ClinicalTrials.gov, phase 1 (NCT02670824)ClinicalTrials.gov, CN-CATCH (NCT06255977)Duke School of Medicine news (April 3, 2026)Patsnap Synapse, CN-105
What has happened recently
Not approved anywhere. The FDA granted orphan drug designation for treatment of intracerebral hemorrhage on January 13, 2015, to AegisCN of Raleigh, North Carolina, a startup with Duke University that licenses CN-105 and sponsored, supplied or funded its US and Singapore trials; no fast track or breakthrough designation has been found. Human testing began with a US phase 1 in 48 healthy adults (December 2015 to August 2016), followed by the open-label CATCH trial in 38 people with brain bleeds (2017 to 2020), the randomized S-CATCH phase 2b in Singapore (60 people, 2019 to 2022, published June 23, 2026) and the MARBLE delirium trial at Duke (186 analyzed, 2019 to 2022, published April 3, 2026). In China, a phase 1 in healthy volunteers led by Beijing Tiantan Hospital researchers was published in 2022 (Clin Ther 2022;44(5):744-754), CN-CATCH (NCT06255977, an estimated 240 brain-bleed patients at Beijing Tiantan, started August 2022) was last known to be recruiting, and a drug database lists Guangdong Xipeng Tuling Biotechnology as running phase 2 work in brain bleeds and ischemic stroke. A drug database updated in October 2026 lists the US developers as inactive, though AegisCN funded the S-CATCH trial, published in June 2026. No phase 3 has been registered or announced.
You can compare this against the whole library, or read how to check a seller.
What else is like CN-105?
Others in Healing and recovery, side by side.If you're weighing CN-105, it's worth reading Eptifibatide, Lacripep, and Linaclotide (Linzess) in the same class.
A five-amino-acid mimic of the part of apolipoprotein E that calms inflammation in the injured brain. Two small randomized trials, in brain bleeds and in surgery, found trends that were not significant.
- Dose
- 1.0 mg/kg every 6 hours, up to 13 doses over 72 hours (phase 2 trials)
- How often
- Every 6 hours for up to 3 days
A hospital antiplatelet drug that blocks the platelet fibrinogen receptor. FDA-approved since 1998; the Integrilin brand is gone, generics remain.
- Dose
- 180 mcg/kg bolus, then 2 mcg/kg/min (label)
- How often
- Continuous infusion for up to 72 to 96 hours
A short piece of a human tear protein, given as eye drops to help the cornea renew itself and its nerves regrow. Its first trial missed its main goal; a nerve-damage trial began in 2026.
- Dose
- One drop of 4 µM solution in both eyes three times a day (phase 2 trial)
- How often
- Three times a day
An approved oral peptide for constipation that works in the gut and barely reaches the blood.
- Dose
- 72, 145 or 290 mcg once daily (label)
- How often
- Once daily
Guides for this compound
- How to Reconstitute a Peptide
Mix peptide powder with bacteriostatic water, step by step.
- How to Read an Insulin Syringe
Read the units, convert to millilitres, and draw the exact dose.
- mcg vs mg: The Peptide Dosing Mistake to Avoid
Your vial says mg and your protocol says mcg. Here is the conversion and how to check it.
- How to Read a Peptide COA
What the purity number does and does not tell you, and how to spot an edited report.
- How to Vet a Peptide Vendor
Independent COAs, HPLC purity, and the red flags that mean walk away.
Sources
- Timko NJ et al., JAMA Network Open 2026;9(4):e262289 (MARBLE)(2026)Published online April 3, 2026. 186 analyzed: grade 2 or higher adverse events 76.6% against 87.8% (P=.10) and a median of 1 against 2 per patient (P=.03), the primary endpoint; delirium 19.3% against 26.5%, RR 0.73 (0.41 to 1.30), P=.29.
- MARBLE author manuscript (UCL Discovery)(2026)Serious adverse events 8.0% against 22.4% (P=.007); median spinal fluid levels at 24 hours 4.8, 29.1 and 60.2 ng/mL by dose; AegisCN supplied the drug and had no role in analysis.
- MARBLE protocol and statistical analysis plan(2022)Ac-VSRRR-NH2 as a frozen 12.5 mg/mL solution, 50 mg a vial, stored at -70°C, made by University of Iowa Pharmaceuticals; 1 mg/kg is 24 to 100 times the mouse therapeutic dose.
- ClinicalTrials.gov, MARBLE (NCT03802396)(2024)Phase 2, completed December 2022; 203 consented; results first posted September 4, 2024.
- Cheong TM et al., Neurocritical Care 2026 (S-CATCH)(2026)60 randomized within 12 hours in Singapore: favorable 90-day outcome (mRS 0 to 3) 77.8% against 66.7%, P=.35; serious adverse events 26.7% against 30%.
- James ML et al., Neurocritical Care 2022;36(1):216-225 (CATCH)(2022)38 patients, open-label, 6 US sites: OR 2.69 (1.31 to 5.51) for lower 30-day mRS against 33 matched registry controls.
- CATCH preprint (medRxiv 2020)(2020)Peak level after dose 1, 5,610 ng/mL; exposure ratio dose 13 to dose 1, 1.3; 3 deaths, all from the bleed; hematoma growth in 9.
- Lei B et al., Scientific Reports 2016;6:34834(2016)Mice with brain bleeds given 0.05 mg/kg IV: better motor and memory recovery, less brain swelling and microglial activation, bleed size unchanged.
- FDA GSRS substance record, CN-105 (UNII W525NLS74J)(2026)Ac-Val-Ser-Arg-Arg-Arg-NH2; C28H55N15O7, MW 713.83; CAS 1632243-07-2; recorded as an apoE mimetic.
- FDA orphan drug designation, CN-105(2015)Treatment of intracerebral hemorrhage, designated January 13, 2015, sponsor AegisCN; not approved.
- ClinicalTrials.gov, phase 1 (NCT02670824)(2016)48 healthy adults at Duke: single doses of 0.01 to 1.0 mg/kg, then repeat 1.0 mg/kg; 36 on drug, 12 on placebo.
- ClinicalTrials.gov, CN-CATCH (NCT06255977)(2024)Phase 2 in China, about 240 brain-bleed patients, 0.1, 0.3 or 1.0 mg/kg against saline; status unknown.
- Duke School of Medicine news (April 3, 2026)(2026)Announces MARBLE; describes AegisCN as a startup with Duke and a larger trial as warranted.
- Patsnap Synapse, CN-105(2026)Marks the US developers, Cerenova and AegisCN, inactive (record updated October 10, 2026); the Chinese phase 1 and phase 2 trials are on a separate Synapse record for Guangdong Xipeng Tuling (secondary source).
Beyond these, 31 records are indexed. Browse the records