Certainty index

Very low certainty

The Institute has very little confidence in the effect estimate. The true effect is likely to be substantially different from the estimate. In this series a very low rating most often reflects an absence of controlled human evidence rather than conflicting evidence.

Graded outcomes

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Table 1. Outcomes and syntheses graded at very low certainty, on this page.

Document	Type	Effect or conclusion as recorded
Ecnoglutide in type 2 diabetes	Evidence extract	−1.8 % HbA1c reported at 24 weeks
Sermorelin in ageing	Evidence extract	No randomised human evidence identified
CJC-1295 in ageing	Evidence extract	No randomised human evidence identified
CJC-1295 in lean-mass preservation	Evidence extract	No randomised human evidence identified
Ipamorelin in lean-mass preservation	Evidence extract	No randomised human evidence identified
Hexarelin in cardiovascular	Evidence extract	No randomised human evidence identified
GHRP-2 in lean-mass preservation	Evidence extract	No randomised human evidence identified for a body-composition outcome
GHRP-6 in wound healing	Evidence extract	No randomised human evidence identified
IGF-1 LR3 in lean-mass preservation	Evidence extract	No randomised human evidence identified for this analogue
IGF-1 LR3 in gh axis	Evidence extract	No randomised human evidence identified for this analogue
BPC-157 in mucosal barrier	Evidence extract	A phase 2 programme in ulcerative colitis was conducted and results were not published in a peer-reviewed journal in a form the Institute could verify
BPC-157 in soft-tissue injury	Evidence extract	No randomised controlled human trial identified
BPC-157 in wound healing	Evidence extract	No randomised controlled human trial identified
BPC-157 in knee osteoarthritis	Evidence extract	No randomised controlled human trial identified
TB-500 in soft-tissue injury	Evidence extract	No randomised controlled human trial identified
TB-500 in wound healing	Evidence extract	Clinical trials of the full-length thymosin beta-4 protein were conducted in epidermolysis bullosa and in dry-eye disease; results did not support marketing authorisation
TB-500 in cardiovascular	Evidence extract	No randomised controlled human trial identified
Thymosin beta-4 in cardiovascular	Evidence extract	Phase 1 safety study completed; no efficacy conclusion
GHK-Cu in ageing	Evidence extract	No randomised human evidence for any systemic ageing endpoint
KPV in mucosal barrier	Evidence extract	No randomised controlled human trial identified
KPV in wound healing	Evidence extract	No randomised controlled human trial identified
Semax in cognition	Evidence extract	Russian clinical studies report functional improvement after ischaemic stroke and in cognitive disorders
Semax in sleep	Evidence extract	No assessable randomised evidence identified
Selank in cognition	Evidence extract	Russian clinical studies report anxiolytic effect comparable to benzodiazepines without sedation or withdrawal
DSIP in sleep	Evidence extract	Small historical studies reported inconsistent effects on sleep architecture; the effect that gave the peptide its name has not been reliably reproduced
DSIP in cognition	Evidence extract	No assessable evidence identified
DSIP in alcohol use disorder	Evidence extract	Small historical reports in withdrawal syndromes; not assessable
Epithalon in ageing	Evidence extract	Russian observational and small controlled reports describe mortality and functional differences over multi-year follow-up
Epithalon in cognition	Evidence extract	No assessable evidence identified
Epithalon in immune modulation	Evidence extract	No assessable evidence identified
Thymalin in immune modulation	Evidence extract	Russian clinical reports describe immunological and clinical effects across a wide range of conditions
Thymalin in ageing	Evidence extract	No assessable evidence identified
LL-37 in immune modulation	Evidence extract	No randomised human evidence for systemic immune effects
MOTS-c in type 2 diabetes	Evidence extract	No randomised controlled human trial identified
MOTS-c in obesity	Evidence extract	No randomised controlled human trial identified
MOTS-c in ageing	Evidence extract	No randomised controlled human trial identified
MOTS-c in mitochondrial disease	Evidence extract	No randomised controlled human trial identified
NAD+ (nicotinamide adenine dinucleotide) in ageing	Evidence extract	No randomised controlled human trial of administered NAD+ on any ageing endpoint identified
NAD+ (nicotinamide adenine dinucleotide) in alcohol use disorder	Evidence extract	No assessable randomised evidence identified
NAD+ (nicotinamide adenine dinucleotide) in cognition	Evidence extract	No assessable randomised evidence identified

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