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

Nationally registered neuropeptides and the retrievability of their evidence base — summary of findings

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

Document identifier
CEI-ES-017/4
Series
Evidence synthesis
Version
1.1
Published
13 May 2026
Last reviewed
13 May 2026
Next review
13 Nov 2027
Identifier
10.71829/cei.syn.17
Certainty
Very low
Cycle
2026 Q2
Review type
Methodological review
Search executed
29 Mar 2026

§4Summary of findings

§4.1Summary of findings

Table 7. Summary of findings for Nationally registered neuropeptides and the retrievability of their evidence base.

OutcomeParticipants (studies)Effect as reportedCertaintyReason for downgrade
Domain-specific cognitive test scoresThe outcome the Institute designates as anchor for this indication.— (5)For each compound in this group the Institute was able to establish that a national registration exists and was not able to retrieve a trial report…Very lowinconsistency, indirectness, imprecision
Discontinuation for adverse eventsReported as a summary-of-findings row rather than in a tolerability annex, following a public submission.— (4)Reported per contributing trial; see the included-studies tableVery lowrisk of bias, imprecision
Serious adverse eventsEvent counts are low; the estimate is imprecise by construction.— (4)Reported per contributing trial; see the included-studies tableVery lowinconsistency, publication bias
Any adverse eventAscertained by spontaneous report in the contributing trials.— (4)Reported per contributing trial; see the included-studies tableVery lowrisk of bias, inconsistency, imprecision
Clinical Dementia Rating sum of boxesA secondary outcome for this indication. Its hierarchical position within each contributing trial is recorded on that trial's abstract where the Institute holds it.— (4)Reported as a secondary outcome in a subset of contributing trialsVery lowrisk of bias, indirectness
Biomarker change (amyloid, tau, neurofilament light)A secondary outcome for this indication. Its hierarchical position within each contributing trial is recorded on that trial's abstract where the Institute holds it.— (4)Reported as a secondary outcome in a subset of contributing trialsVery lowindirectness, publication bias
Certainty ratings describe confidence in the effect estimate for the stated outcome. They are not recommendations and do not transfer between outcomes.

§4.2Forest plot

Contributing estimatesPoint estimates with confidence intervals for each contributing study, plotted against the line of no effect.0.50.7511.5Ratio measure, log scale (1 = no effect)Contributing studyEstimate (95 % CI)EPI-RU-ELDERLY · n=not held0.90 (0.66 to 1.14)SELANK-RU-ANXIETY · n=not held0.75 (0.56 to 0.94)SEMAX-RU-COGNITIVE · n=not held0.73 (0.62 to 0.84)SEMAX-RU-STROKE · n=not held1.12 (0.83 to 1.41)THYMALIN-RU-1 · n=not held0.77 (0.65 to 0.88)Pooled estimate0.86 (0.76 to 0.97)
Study estimatePooled estimate
Figure 1. Illustrative. Contributing estimates plotted against the line of no effect. The point estimates and intervals are the Institute's standardised representation of the contributing evidence on a common ratio scale, generated deterministically from the record identifiers; they are not the published estimates, which appear in their own units in the included-studies table and on each trial abstract. The figure is published to convey the dispersion of the evidence base, not to supply a number.

§4.3Certainty assessment for the anchor outcome

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 biasno downgradeTotal downgrading: 3 levelsVery low certainty
Figure 2. 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 biasNo concernNo serious concern identified in this domain.
InconsistencySeriousDirection is consistent; magnitude varies with the intensity of the background intervention.
IndirectnessSeriousThe comparator differs across contributing trials.
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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