Independent · non-commercial · publishes on a quarterly cycle|Current cycle 2026 Q3
Compound Evidence InstituteEvidence synthesis · established 2023Graded assessments of compounds, trials, methods and supply
Document set current to 30 July 2026
Indication assessment · §2

Immune modulation and adjunctive immunotherapy — evidence across compounds

Every compound the Institute assesses in immune modulation and adjunctive immunotherapy, with its certainty rating.

Document identifier
CEI-IN-28/2
Series
Indication assessment
Version
1.0
Published
27 Apr 2026
Last reviewed
27 Apr 2026
Next review
27 Apr 2028
Identifier
10.71829/cei.ind.28
Certainty
Not rated
Cycle
2026 Q2
ICD-11
4A00
Category
Immunological

§2Evidence across compounds

Every compound the Institute assesses in this indication, with the effect as recorded, the certainty rating and the contributing trials. Effects are reported on the anchor outcome where the contributing trials measured it and on the outcome the trial actually reported where they did not.

Table 1. Compounds assessed in immune modulation and adjunctive immunotherapy, ordered by certainty.

CompoundEffect as recordedInterval as reportedCertaintyTrials
Thymosin alpha-128-residue N-acetylated thymic polypeptideMeta-analyses of hepatitis B trials report higher sustained virological response with thymosin alpha-1 as monotherapy or adjunct; a large Chinese randomised trial in sepsis reported a mortality difference that a subsequent larger trial did not confirmhepatitis B: pooled odds ratio approximately 1.7 (95 % CI 1.1 to 2.7) across small trials; sepsis: discordant resultsModerate4
EpithalonSynthetic tetrapeptideNo assessable evidence identifiedVery low0
GlutathioneEndogenous tripeptide thiol antioxidantNo assessable randomised evidence for immune outcomesVery low0
LL-3737-residue cationic antimicrobial host-defence peptideNo randomised human evidence for systemic immune effectsVery low0
ThymalinThymic peptide extract of undefined compositionRussian clinical reports describe immunological and clinical effects across a wide range of conditionsnot extractable to the Institute's standardVery low1
Estimates in this table are not on a common scale and must not be subtracted from one another. Where a comparison between two compounds has been made directly, it appears in a synthesis and not here.
Compounds assessed in Immune modulationPoint estimates with confidence intervals for each contributing study, plotted against the line of no effect.0.00.20.40.60.81.0Standardised direction and relative magnitudeCompoundEffect as recordedThymosin alpha-1Moderate certaintyMeta-analyses of hepatitis B…EpithalonVery low certaintyNo assessable evidence identifiedGlutathioneVery low certaintyNo assessable randomised evidence…LL-37Very low certaintyNo randomised human evidence for…ThymalinVery low certaintyRussian clinical reports describe…
Moderate or high certaintyLow or very low certainty
Figure 1. Illustrative. Compounds assessed in this indication, plotted on a common standardised axis so that direction and relative magnitude can be compared at a glance. The estimates are not on a common natural scale and the intervals are the Institute's standardised representation of the reported precision rather than published confidence intervals.

§2.1Syntheses bearing on this indication

References cited on this page

References are numbered in order of first citation in this document. Each superscript in the text links to its entry below.

  1. Garaci E, Pica F, Serafino A, Balestrieri E, Matteucci C, Moroni G, Sorrentino R, Zonfrillo M, Pierimarchi P, Sinibaldi-Vallebona P. Thymosin α1 and cancer: action on immune effector and tumor target cells. Annals of the New York Academy of Sciences 2007;1112:225–234. doi:10.1196/annals.1415.025 · PMID 17567944
  2. D’Hondt M, Bracke N, Taevernier L, Gevaert B, Verbeke F, Wynendaele E, De Spiegeleer B. Related impurities in peptide medicines. Journal of Pharmaceutical and Biomedical Analysis 2014;101:2–30. doi:10.1016/j.jpba.2014.06.012 · PMID 25044089

Identifiers are reproduced only where the Institute holds them. Where a digital object identifier or PubMed identifier is not shown, the Institute has recorded the journal and year and has not constructed an identifier.

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