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 · evidence extract

Thymosin alpha-1 in cognitive performance and neuroprotection — evidence extract

The Institute's graded assessment of Thymosin alpha-1 for cognitive performance and neuroprotection, with the contributing trials and the domain-by-domain certainty reasoning.

Document identifier
CEI-MN-040/EV-COGNITIVE
Series
Evidence extract
Version
4.2
Published
23 Jan 2026
Last reviewed
23 Jan 2026
Next review
23 Jan 2028
Identifier
10.71829/cei.mono.40
Certainty
Not rated
Cycle
2026 Q1

§1Evidence extract: Cognitive performance and neuroprotection

§1.1Question and anchor outcome

Population
Domain-specific cognitive function or protection against cognitive decline, assessed by standardised neuropsychological batteries or clinical dementia rating.
Intervention
Thymosin alpha-1, subcutaneous
Comparator
As used in each contributing trial; reported per trial rather than pooled across comparator types
Anchor outcome
Domain-specific cognitive test scores

Additional outcomes the Institute extracts for this indication: Clinical Dementia Rating sum of boxes; Biomarker change (amyloid, tau, neurofilament light).

§1.2Contributing trials

No trial has been identified for Thymosin alpha-1 in cognitive performance and neuroprotection. The rating below reflects that absence.

§1.3Certainty assessment

Certainty assessment by domainDowngrading decision recorded for each certainty domain.Certainty domainNo concernSeriousVery seriousEffect on ratingRisk of biasno downgradeInconsistencydowngrade one levelIndirectnessdowngrade one levelImprecisiondowngrade one levelPublication biasdowngrade one levelTotal downgrading: 4 levelsNot rated certainty
Figure 2. Domain-by-domain certainty assessment for Thymosin alpha-1 in cognitive performance and neuroprotection. The starting rating for a body of randomised evidence is high; each serious concern reduces it by one level and each very serious concern by two.

Table 2. Reasoning recorded against each certainty domain.

DomainRatingReasoning
Risk of biasNo concernNo serious concern identified in this domain.
InconsistencySeriousToo few contributing studies to assess consistency formally.
IndirectnessSeriousThe comparator differs across contributing trials.
ImprecisionSeriousThe event count falls below the optimal information size.
Publication biasSeriousToo few contributing studies for a formal assessment; the risk cannot be excluded.
Overall rating: Not rated certainty. No certainty rating applies to this document type, or no effect estimate was assessed.

§1.4What this extract does not establish

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

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.

Nothing published by the Institute is medical advice, a diagnosis, a prescription, a treatment recommendation or a purchasing recommendation. Compounds supplied for research use are not approved for human or veterinary use in any jurisdiction, and a favourable analytical assessment of a supplier is not a statement that any product is safe or effective. The Institute publishes certainty ratings and never recommendations. No telephone number, messaging handle or ordering channel appears anywhere on this site.