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
Certainty index

Very low certainty

The Institute has very little confidence in the effect estimate. The true effect is likely to be substantially different from the estimate. In this series a very low rating most often reflects an absence of controlled human evidence rather than conflicting evidence.

Graded outcomes

14 documents

Table 1. Outcomes and syntheses graded at very low certainty, on this page.

DocumentTypeEffect or conclusion as recorded
Ecnoglutide in type 2 diabetesEvidence extract−1.8 % HbA1c reported at 24 weeks
BPC-157 in mucosal barrierEvidence extractA phase 2 programme in ulcerative colitis was conducted and results were not published in a peer-reviewed journal in a form the Institute could verify
TB-500 in wound healingEvidence extractClinical trials of the full-length thymosin beta-4 protein were conducted in epidermolysis bullosa and in dry-eye disease; results did not support marketing authorisation
Thymosin beta-4 in cardiovascularEvidence extractPhase 1 safety study completed; no efficacy conclusion
Semax in cognitionEvidence extractRussian clinical studies report functional improvement after ischaemic stroke and in cognitive disorders
Selank in cognitionEvidence extractRussian clinical studies report anxiolytic effect comparable to benzodiazepines without sedation or withdrawal
DSIP in sleepEvidence extractSmall historical studies reported inconsistent effects on sleep architecture; the effect that gave the peptide its name has not been reliably reproduced
Epithalon in ageingEvidence extractRussian observational and small controlled reports describe mortality and functional differences over multi-year follow-up
Thymalin in immune modulationEvidence extractRussian clinical reports describe immunological and clinical effects across a wide range of conditions
Human evidence for BPC-157SynthesisThe Institute conducted a systematic search for randomised controlled trials of BPC-157 in any human population and indication and identified no trial that met inclusion criteria for which a…
Clinical evidence for growth-hormone secretagogues supplied for researchSynthesisThe clinical development of every compound in this group was directed at diagnosis of growth-hormone deficiency, at a specific disease indication, or at nothing beyond phase 1. The Institute…
Nationally registered neuropeptides and the retrievability of their evidence baseSynthesisFor each compound in this group the Institute was able to establish that a national registration exists and was not able to retrieve a trial report containing a protocol, a randomisation procedure…
Semax in cognitive performance and neuroprotection: effect on the anchor outcomeSynthesisVery low certainty evidence from 2 contributing trials bears on the effect of Semax on the anchor outcome for cognitive performance and neuroprotection. The estimate the Institute carries in the…
Semax in cognitive performance and neuroprotection: tolerability and discontinuationSynthesisVery low certainty evidence from 2 contributing trials bears on tolerability. Discontinuation for adverse events is reported in the summary-of-findings table alongside the efficacy outcomes rather…
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