PMID-26517783 – Ulinastatin and Thymosin Alpha-1 for Severe Sepsis Meta-Analysis

PMID-26517783 – Ulinastatin and/or Thymosin Alpha-1 for Severe Sepsis: Meta-Analysis

Feng Z et al. "Ulinastatin and/or thymosin α1 for severe sepsis: A systematic review and meta-analysis," Journal of Trauma and Acute Care Surgery, 2016;80(2):335-340. doi:10.1097/TA.0000000000000909

Quick Reference

Property Value
PMID 26517783
DOI 10.1097/TA.0000000000000909
Year 2016
Journal Journal of Trauma and Acute Care Surgery
Study Type Systematic Review / Meta-analysis
Evidence Level I
Sample 10 articles, 12 studies of severe sepsis patients
Peptide(s) Studied Thymosin Alpha-1

Key Findings

  • Thymosin α1 alone significantly reduced 28-day mortality in severe sepsis
  • Combination (ulinastatin + Tα1) reduced both 28-day and 90-day mortality
  • Tα1 monotherapy did NOT significantly reduce 90-day mortality
  • Combined immunomodulatory therapy demonstrated superior outcomes over monotherapy

Study Design

Systematic review and meta-analysis of 10 articles (12 studies) examining ulinastatin and/or thymosin α1 for severe sepsis. Searched multiple databases through September 2015.

Limitations

  • Predominantly Chinese studies; generalizability uncertain
  • Moderate heterogeneity across studies
  • Note: The subsequent TESTS Phase 3 RCT (PMID-39814420, 2025, n=1,089) found NO mortality benefit for Tα1 in sepsis, contradicting this meta-analysis

Clinical Relevance

Historical context for Tα1 in sepsis immunomodulation. The positive signal in this meta-analysis drove the conduct of the definitive TESTS Phase 3 trial, which was negative. This illustrates the importance of large RCTs to confirm meta-analytic signals. Must be interpreted alongside PMID-39814420.

Related

#research #meta-analysis #evidence-level-I