Tranexamic acid (TXA), a drug used to treat heavy menstrual periods, could save the lives of tens of thousands of bleeding accident victims each year and reduce combat deaths, say Cochrane researchers. The researchers carried out a systematic review of trials examining the effectiveness of tranexamic acid (TXA) in patients with bleeding after severe injury.
TXA is an inexpensive drug that reduces clot breakdown. It has been used for many years to reduce heavy menstrual bleeding and is often given during planned surgery to reduce the need for blood transfusion. However, more recently, tranexamic acid has been tested in bleeding trauma patients. Of such patients who die in hospital, nearly half die due to excessive blood loss and most others die from injuries that are worsened by bleeding.
According to the results of the new review, TXA reduces the risk of death in injured patients with severe bleeding by about 10% compared to giving no treatment, which equates to saving over 70,000 lives each year if TXA was used worldwide. The results are based on one large trial involving 20,211 patients and one small trial in 240 patients, both carried out since an earlier, inconclusive review in 2004.
Lead researcher Ian Roberts of the London School of Hygiene & Tropical Medicine in London, UK, said, "TXA reduces the risk of a patient bleeding to death following an injury and appears to have few side effects. It could save lives in both civilian and military settings."
"These results are based on a large number of patients (men and women) who came from many different countries. Given the high quality of the evidence for the benefits of this drug, we recommend it be used more widely in injury victims with bleeding."
A separate Cochrane Systematic Review focused on trials of TXA and other similar drugs in people scheduled for non-urgent surgery showed that TXA was highly effective at reducing blood loss and the need for red blood cell transfusion.