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 · §3

Thymosin beta-4 — clinical evidence

Assessed outcomes with certainty ratings, contributing trials and the reasoning for each rating.

Document identifier
CEI-MN-032/3
Series
Compound monograph
Version
2.0
Published
13 Jun 2023
Last reviewed
13 Dec 2023
Next review
13 Dec 2025
Identifier
10.71829/cei.mono.32
Certainty
Low
Cycle
2023 Q2

§3Clinical evidence

Assessed outcomes for Thymosin beta-4Point estimates with confidence intervals for each contributing study, plotted against the line of no effect.0.00.20.40.60.8Standardised direction and relative magnitude of the recorded effectIndicationEffect as recordedWound healing3 trials · LowPhase 2 trials in dry-eye disease…Cardiovascular1 trial · Very lowPhase 1 safety study completed; no…
Moderate or high certaintyLow or very low certainty
Figure 3. Illustrative. Assessed outcomes plotted on a common standardised axis so that direction and relative magnitude can be compared at a glance. The estimates are not on a common natural scale and the intervals are the Institute's standardised representation of the reported precision, not the published confidence intervals. Published intervals appear in the per-indication extracts and in the text below.

§3.1Cutaneous wound healing and tissue repair

Anchor outcome. Time to complete closure.

Effect as recorded. Phase 2 trials in dry-eye disease, epidermolysis bullosa and venous stasis ulcers reported signals on some secondary endpoints without meeting primary endpoints consistently; heterogeneous; no confirmatory result.[1,2]

Certainty. Low certainty A genuine phase 2 clinical programme exists, which distinguishes this compound from most of the repair peptides in this series. It did not produce a confirmatory result and no marketing authorisation followed.

Contributing trials. TB4-PH2-EPIDERMOLYSIS · TB4-PH2-DRYEYE · TB4-PH2-VENOUSULCER. Full structured abstracts are published for each.

Full evidence extract for cutaneous wound healing and tissue repair · Indication assessment

§3.2Atherosclerotic cardiovascular disease and cardiovascular risk reduction

Anchor outcome. Three-point major adverse cardiovascular events (cardiovascular death, non-fatal myocardial infarction, non-fatal stroke).

Effect as recorded. Phase 1 safety study completed; no efficacy conclusion; —.[2,3]

Certainty. Very low certainty Preclinical cardiac-repair findings were not confirmed clinically.

Contributing trials. TB4-PH1-CARDIAC. Full structured abstracts are published for each.

Full evidence extract for atherosclerotic cardiovascular disease and cardiovascular risk reduction · Indication assessment

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
  3. Manning MC, Chou DK, Murphy BM, Payne RW, Katayama DS. Stability of protein pharmaceuticals: an update. Pharmaceutical Research 2010;27(4):544–575. doi:10.1007/s11095-009-0045-6 · PMID 20143256

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.