Thymosin beta-4 in cutaneous wound healing and tissue repair: tolerability and discontinuation — summary of findings
Outcome-by-outcome summary with effect, certainty and the reason for each downgrade.
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: tolerability and….
| Outcome | Participants (studies) | Effect as reported | Certainty | Reason for downgrade |
|---|---|---|---|---|
| Time to complete closureThe outcome the Institute designates as anchor for this indication. | 174 (3) | No significant difference from vehicle | Low | risk of bias, imprecision |
| Discontinuation for adverse eventsReported as a summary-of-findings row rather than in a tolerability annex, following a public submission. | 131 (3) | Reported per contributing trial; see the included-studies table | Low | indirectness, publication bias |
| Serious adverse eventsEvent counts are low; the estimate is imprecise by construction. | 145 (3) | Reported per contributing trial; see the included-studies table | Very low | risk of bias, imprecision |
| Any adverse eventAscertained by spontaneous report in the contributing trials. | 160 (1) | Reported per contributing trial; see the included-studies table | Very low | inconsistency, indirectness, imprecision |
| 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. | 104 (2) | Reported as a secondary outcome in a subset of contributing trials | Very low | imprecision, 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. | 118 (2) | Reported as a secondary outcome in a subset of contributing trials | Very low | inconsistency, 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
§4.3Certainty assessment for the anchor outcome
Table 8. Reasoning recorded against each certainty domain for the anchor outcome.
| Domain | Rating | Reasoning |
|---|---|---|
| Risk of bias | Serious | The primary endpoint is patient-reported in a setting where blinding cannot be maintained. |
| Inconsistency | No concern | No serious concern identified in this domain. |
| Indirectness | No concern | No serious concern identified in this domain. |
| Imprecision | Serious | The confidence interval spans values that would support different decisions. |
| Publication bias | No concern | No 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.
- 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
- 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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