Thymic peptides in infection and immune support
What is the evidence for thymic peptides in chronic viral hepatitis, sepsis and non-specific immune support?
§1Abstract
§1.1Review question
What is the evidence for thymic peptides in chronic viral hepatitis, sepsis and non-specific immune support?
§1.2PICO frame
Table 1. The registered PICO frame. Any change made after protocol registration is recorded in the amendment log at §5 and is identified there as post hoc.
| Element | As registered |
|---|---|
| Population | Adults with chronic hepatitis B or C, adults with severe sepsis, and healthy adults. |
| Intervention | Thymosin alpha-1 or thymalin. |
| Comparator | Placebo or standard care. |
| Outcomes | Sustained virological response; 28-day all-cause mortality; any immunological or clinical outcome in healthy adults. |
§1.3Method in brief
A review of the effects of an intervention on pre-specified outcomes, with a quantitative synthesis where the contributing studies are sufficiently similar. The protocol was registered with the Institute's secretariat before the search was executed. The search was run on 17 May 2024 across 8 sources and is reproduced in full at §2. Screening, extraction and certainty assessment were performed independently by two members of the secretariat with disagreement resolved by a third.
§1.4Conclusion
Low certainty evidence supports a modest effect of thymosin alpha-1 in chronic viral hepatitis in an era of therapy now superseded, and a single-country mortality signal in severe sepsis that has not been replicated internationally. No randomised evidence was identified for non-specific immune support in healthy adults, which is the use under which this compound group is most often supplied. The Institute grades that use very low certainty.
The conclusion rests on 5 contributing studies, listed with their extracted data at §3 and summarised outcome by outcome at §4.