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
Compound monograph · §3

Thymosin alpha-1 — clinical evidence

Assessed outcomes with certainty ratings, contributing trials and the reasoning for each rating.

Document identifier
CEI-MN-040/3
Series
Compound monograph
Version
4.2
Published
23 Jan 2026
Last reviewed
23 Jan 2026
Next review
23 Jan 2028
Identifier
10.71829/cei.mono.40
Certainty
Moderate
Cycle
2026 Q1

§3Clinical evidence

Assessed outcomes for Thymosin alpha-1Point 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 magnitude of the recorded effectIndicationEffect as recordedImmune modulation4 trials · ModerateMeta-analyses of hepatitis B trials…Cognition0 trials · Not ratedNo evidence identified
Moderate or high certaintyLow or very low certainty
Figure 3. Illustrative. Assessed outcomes 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, not the published confidence intervals. Published intervals appear in the per-indication extracts and in the text below.

§3.1Immune modulation and adjunctive immunotherapy

Anchor outcome. CD4 and CD8 counts.

Effect as recorded. Meta-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 confirm; hepatitis B: pooled odds ratio approximately 1.7 (95 % CI 1.1 to 2.7) across small trials; sepsis: discordant results.[1,2]

Certainty. Moderate certainty Rated moderate for the immune-reconstitution effect on lymphocyte subsets, which is consistently reproduced, and low for any clinical outcome, which is not. The Institute separates these two claims deliberately.

Contributing trials. TA1-HBV-1 · TA1-HCV-1 · TA1-VACCINE-ELDERLY · TA1-SEPSIS-CN. Full structured abstracts are published for each.

Full evidence extract for immune modulation and adjunctive immunotherapy · Indication assessment

§3.2Cognitive performance and neuroprotection

Anchor outcome. Domain-specific cognitive test scores.

Effect as recorded. No evidence identified; —.[2,3]

Certainty. Not rated certainty

Contributing trials. None identified. The rating reflects an absence of controlled evidence rather than conflicting evidence.

Full evidence extract for cognitive performance and neuroprotection · Indication assessment

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
  3. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hróbjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S, McGuinness LA. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71. doi:10.1136/bmj.n71 · PMID 33782057

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