Pr Eric E. GabisonCornea and ocular surface · Paris
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1 · Growth factors & blood derivatives

Thymosin β4 — RGN-259

Review — modulators of corneal healing1 · Growth factors & blood derivatives › Thymosin β4 — RGN-259

Thymosin β4 — RGN-259

Synthetic regenerative peptide (43 aa) · RegeneRx / ReGenTree / HLB Therapeutics · not marketed

Oxford II Investigational Future · mixed pivotal results
Mechanism of actionPeptide that sequesters G-actin: promotes epithelial migration/adhesion, anti-inflammatory effect (↓NF-κB), anti-apoptotic, nerve regeneration and reduced fibrosis (multimodal action).
Indications (trials)Neurotrophic keratopathy (PED) and dry eye disease.
Route & dosage0.1% eye drops, ~4–6×/day for several weeks (preservative-free).
Level of evidenceOxford II but mixed/negative pivotal results · Scale: Investigational (not approved). One positive phase III RCT in neurotrophic disease (2022), but the confirmatory phase III SEER-3 missed its primary endpoint (June 2025) — strong placebo response.
FDANo — investigational (phase III).
EU MANo — investigational.
FranceNot available (trials).
USAPhase III ongoing; not marketed.
AsiaStrong South Korean sponsorship (HLB); not approved.
Key studies: Sosne G, Kleinman HK et al., phase III RCT in neurotrophic keratitis, Int J Mol Sci 2022 — PMID 36613994; SEER-3 (missed primary endpoint, 2025, results not yet published in a peer-reviewed journal); ARISE dry eye program (mixed results, not peer-reviewed published).
See also: Gabison E. “Corneal wound-healing agents”. In: SFO 2023 Report — Médicaments et biothérapies en ophtalmologie, chapter 21. Full text, open access (in French).

Prof. Eric E. Gabison — cornea and ocular surface, Paris