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Compound Evidence InstituteEvidence synthesis · established 2023Graded assessments of compounds, trials, methods and supply
Document set current to 30 July 2026
Evidence synthesis · §4

Thymosin beta-4 in cutaneous wound healing and tissue repair: durability of effect — summary of findings

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

Document identifier
CEI-ES-138/4
Series
Evidence synthesis
Version
1.2
Published
10 Oct 2025
Last reviewed
10 Mar 2026
Next review
10 Sep 2027
Identifier
10.71829/cei.syn.138
Certainty
Low
Cycle
2025 Q4
Review type
Intervention review
Search executed
30 Aug 2025

Templated review frame. This review question was generated by crossing an indication with a compound for which contributing trials exist. Its prose frame is templated and is shared with other questions of the same shape. Its included studies, its summary of findings and its certainty rating are computed from the underlying records and are not templated. The Institute publishes these questions because the alternative is to leave a question the document set can answer unanswered, and it labels them because the alternative is to present a templated frame as an authored one.

§4Summary of findings

§4.1Summary of findings

Table 7. Summary of findings for Thymosin beta-4 in cutaneous wound healing and tissue repair: durability of effect.

OutcomeParticipants (studies)Effect as reportedCertaintyReason for downgrade
Time to complete closureThe outcome the Institute designates as anchor for this indication.174 (3)No significant difference from vehicleLowinconsistency, imprecision
Discontinuation for adverse eventsReported as a summary-of-findings row rather than in a tolerability annex, following a public submission.141 (1)Reported per contributing trial; see the included-studies tableLowpublication bias
Serious adverse eventsEvent counts are low; the estimate is imprecise by construction.133 (2)Reported per contributing trial; see the included-studies tableVery lowrisk of bias, imprecision
Any adverse eventAscertained by spontaneous report in the contributing trials.156 (3)Reported per contributing trial; see the included-studies tableVery lowrisk of bias, inconsistency
Percentage area reductionA secondary outcome for this indication. Its hierarchical position within each contributing trial is recorded on that trial's abstract where the Institute holds it.153 (2)Reported as a secondary outcome in a subset of contributing trialsVery lowrisk of bias, indirectness, publication bias
Scar assessment scaleA secondary outcome for this indication. Its hierarchical position within each contributing trial is recorded on that trial's abstract where the Institute holds it.87 (2)Reported as a secondary outcome in a subset of contributing trialsVery lowrisk of bias, imprecision
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.0.50.751Ratio measure, log scale (1 = no effect)Contributing studyEstimate (95 % CI)TB4-PH2-EPIDERMOLYSIS2016 · n=300.84 (0.66 to 1.02)TB4-PH2-DRYEYE2015 · n=720.72 (0.56 to 0.88)TB4-PH2-VENOUSULCER2013 · n=721.11 (0.84 to 1.37)Pooled estimate0.84 (0.74 to 0.95)
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 levelIndirectnessno downgradeImprecisiondowngrade one levelPublication biasno downgradeTotal downgrading: 2 levelsLow 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.
IndirectnessNo concernNo serious concern identified in this domain.
ImprecisionSeriousThe confidence interval spans values that would support different decisions.
Publication biasNo concernNo serious concern identified in this domain.
Overall: Low certainty. Confidence in the effect estimate is limited. The true effect may be substantially different from the estimate.

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. Goldstein AL, Hannappel E, Sosne G, Kleinman HK. Thymosin β4: a multi-functional regenerative peptide. Basic properties and clinical applications. Expert Opinion on Biological Therapy 2012;12(1):37–51. doi:10.1517/14712598.2012.634793 · PMID 22074294
  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

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