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Document set current to 30 July 2026
Compound monograph · evidence extract

Thymosin beta-4 in cutaneous wound healing and tissue repair — evidence extract

The Institute's graded assessment of Thymosin beta-4 for cutaneous wound healing and tissue repair, with the contributing trials and the domain-by-domain certainty reasoning.

Document identifier
CEI-MN-032/EV-WOUND-HEALING
Series
Evidence extract
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

§1Evidence extract: Cutaneous wound healing and tissue repair

§1.1Question and anchor outcome

Population
Restoration of epithelial and dermal integrity following injury, assessed by closure rate, area reduction and scar quality.
Intervention
Thymosin beta-4, intravenous, subcutaneous or topical in clinical studies
Comparator
As used in each contributing trial; reported per trial rather than pooled across comparator types
Anchor outcome
Time to complete closure

Additional outcomes the Institute extracts for this indication: Percentage area reduction; Scar assessment scale; Infection rate.

§1.2Contributing trials

Table 1. Trials contributing to the assessment of Thymosin beta-4 in cutaneous wound healing and tissue repair.

TrialPhaseDesignRandomisedDurationYear
TB4-PH2-EPIDERMOLYSIS2Randomised, double-blind, placebo-controlled3012 weeks2016
TB4-PH2-DRYEYE2Randomised, double-blind, placebo-controlled724 weeks2015
TB4-PH2-VENOUSULCER2Randomised, double-blind, placebo-controlled7284 days2013

§1.3Certainty assessment

Certainty assessment by domainDowngrading decision recorded for each certainty domain.Certainty domainNo concernSeriousVery seriousEffect on ratingRisk of biasdowngrade one levelInconsistencyno downgradeIndirectnessdowngrade one levelImprecisionno downgradePublication biasno downgradeTotal downgrading: 2 levelsLow certainty
Figure 2. Domain-by-domain certainty assessment for Thymosin beta-4 in cutaneous wound healing and tissue repair. The starting rating for a body of randomised evidence is high; each serious concern reduces it by one level and each very serious concern by two.

Table 2. Reasoning recorded against each certainty domain.

DomainRatingReasoning
Risk of biasSeriousAllocation concealment is not described in one contributing report.
InconsistencyNo concernNo serious concern identified in this domain.
IndirectnessSeriousThe outcome is a surrogate whose relationship to the clinical outcome is unvalidated for this indication.
ImprecisionNo concernNo serious concern identified in this domain.
Publication biasNo concernNo serious concern identified in this domain.
Overall rating: Low certainty. Confidence in the effect estimate is limited. The true effect may be substantially different from the estimate.

§1.4What this extract does not establish

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.

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