Drug may help staunch bleeding in accident victims and war-wounded troops
January 25, 2011
Tranexamic acid, or TXA, is effective at treating heavy menstrual periods. It's also used during elective surgery to reduce the chance that a blood transfusion will be needed. Researchers have discovered that TXA might also help save the lives of people with severe bleeding from injuries.
In a study called CRASH-2, reported in The Lancet and the Cochrane Database of Systematic Reviews, over 20,000 trauma patients with (or at risk of) serious bleeding injuries were randomly assigned to either TXA or a placebo. Patients were included in the study if the responsible doctor was unsure whether TXA would be beneficial. The study results showed that use of TXA reduced mortality by almost 10 percent compared to a placebo.
TXA, an antifibrinolytic drug, usually slows bleeding by preventing blood clots from breaking down, but just how it reduces mortality is still unknown.
The effectiveness of TXA at reducing the risks associated with severe bleeding might make the drug useful in other situations. For example, traumatic brain injury—common in battlefield situations—is often accompanied by intracranial bleeding and TXA might help treat some types of brain injury. Postpartum bleeding, which accounts for about 100,000 maternal deaths annually, is another possible use for TXA.
Because severe injuries and bleeding trauma kill millions of people worldwide each year, the authors of The Lancet study have suggested that the World Health Organization (WHO) consider placing TXA on its list of essential medicines that meet high-priority health needs.
Sources: "Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial." The Lancet. Published Online June 15, 2010; Roberts I, Shakur H, Ker K, Coats T, on behalf of the CRASH-2 Trial collaborators. "Antifibrinolytic drugs for acute traumatic injury." Cochrane Database of Systematic Reviews 2011, Issue 1. Art. No.: CD004896. DOI: 10.1002/14651858.CD004896.pub3.