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
Evidence synthesis · §4

Human evidence for BPC-157 — summary of findings

Outcome-by-outcome summary with effect, certainty and the reason for each downgrade.

Document identifier
CEI-ES-014/4
Series
Evidence synthesis
Version
3.0
Published
03 Nov 2025
Last reviewed
03 Jul 2026
Next review
03 Jan 2028
Identifier
10.71829/cei.syn.14
Certainty
Very low
Cycle
2025 Q4
Review type
Scoping review
Search executed
08 Aug 2025

§4Summary of findings

§4.1Summary of findings

Table 7. Summary of findings for Human evidence for BPC-157.

OutcomeParticipants (studies)Effect as reportedCertaintyReason for downgrade
Time to return to activityThe outcome the Institute designates as anchor for this indication.— (1)The Institute conducted a systematic search for randomised controlled trials of BPC-157 in any human population and indication and identified no…Very lowrisk of bias, inconsistency, imprecision
Discontinuation for adverse eventsReported as a summary-of-findings row rather than in a tolerability annex, following a public submission.— (1)Reported per contributing trial; see the included-studies tableVery lowinconsistency, publication bias
Serious adverse eventsEvent counts are low; the estimate is imprecise by construction.— (1)Reported per contributing trial; see the included-studies tableVery lowinconsistency, indirectness, publication bias
Any adverse eventAscertained by spontaneous report in the contributing trials.— (1)Reported per contributing trial; see the included-studies tableVery lowrisk of bias, inconsistency
Pain on loadingA secondary outcome for this indication. Its hierarchical position within each contributing trial is recorded on that trial's abstract where the Institute holds it.— (1)Reported as a secondary outcome in a subset of contributing trialsVery lowinconsistency, imprecision
Tendon thickness and structure on ultrasoundA secondary outcome for this indication. Its hierarchical position within each contributing trial is recorded on that trial's abstract where the Institute holds it.— (1)Reported as a secondary outcome in a subset of contributing trialsVery lowinconsistency, imprecision, publication bias
Certainty ratings describe confidence in the effect estimate for the stated outcome. They are not recommendations and do not transfer between outcomes.

§4.2Certainty assessment for the anchor outcome

Certainty assessment by domainDowngrading decision recorded for each certainty domain.Certainty domainNo concernSeriousVery seriousEffect on ratingRisk of biasdowngrade one levelInconsistencydowngrade one levelIndirectnessno downgradeImprecisiondowngrade one levelPublication biasno downgradeTotal downgrading: 3 levelsVery low certainty
Figure 1. Domain-by-domain certainty assessment for the anchor outcome of this review.

Table 8. Reasoning recorded against each certainty domain for the anchor outcome.

DomainRatingReasoning
Risk of biasSeriousThe primary endpoint is patient-reported in a setting where blinding cannot be maintained.
InconsistencySeriousEstimates vary in magnitude across contributing trials beyond what chance would produce.
IndirectnessNo concernNo serious concern identified in this domain.
ImprecisionSeriousA single small trial contributes the whole estimate.
Publication biasNo concernNo serious concern identified in this domain.
Overall: 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.
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