ASSESSING THE EFFICIENCY AND SAFETY OF TRANEXAMIC ACID IN THE MANAGEMENT OF ACUTE GASTROINTESTINAL BLEEDING
Main Article Content
Keywords
Tranexamic acid, gastrointestinal bleeding, efficacy, safety, randomized controlled trial.
Abstract
Acute gastrointestinal bleeding (GIB) positions very substantial clinical challenge owing to their possible for rapid deterioration and life-threatening complications. Tranexamic acid (TXA) has emerged as a potential therapeutic agent for managing GIB by its ability to promote clot stabilization and reduce bleeding. However, prior to its widespread use, rigorous assessment of its efficacy and safety is imperative.
Aim: This study intended to evaluate efficiency and safety of tranexamic acid in management of acute gastrointestinal bleeding.
Methods: A randomized controlled trial was conducted, involving individuals presenting through acute gastrointestinal bleeding. Participants were erratically allotted to receive either tranexamic acid or placebo in addition to standard care. The primary outcomes assessed were the rate of bleeding cessation, requirement for blood transfusion, and incidence of adverse events.
Results: An overall of 120 participants were included in research, having 50 allotted to tranexamic acid group and 70 to placebo group. The administration of tranexamic acid resulted in a significantly higher rate of bleeding cessation compared to placebo (p < 0.05). Furthermore, tranexamic acid group exhibited a reduced need for blood transfusion and a comparable occurrence of adverse events associated to placebo group.
Conclusion: The findings of the research indicate that tranexamic acid is efficacious in the management of acute gastrointestinal bleeding, demonstrating a higher rate of bleeding cessation and reduced need for blood transfusion without an enlarged danger of adverse events. These results support the incorporation of tranexamic acid into standard treatment protocols for acute gastrointestinal bleeding
References
2. Dionne JC, Oczkowski SJ, Hunt BJ, Antonelli M, Wijnberge M, Raasveld SJ, Vlaar AP. Tranexamic acid in gastrointestinal bleeding: a systematic review and meta-analysis. Critical Care Medicine. 2022 Mar 1;50(3):e313-9.
3. Bai Z, Wang L, Yu B, Xing D, Su J, Qin H. Efficacy and safety of tranexamic acid in the treatment of gastric cancer complicated with upper gastrointestinal bleeding. American Journal of Translational Research. 2024;16(3):925.
4. Lee PL, Yang KS, Tsai HW, Hou SK, Kang YN, Chang CC. Tranexamic acid for gastrointestinal bleeding: a systematic review with meta-analysis of randomized clinical trials. The American Journal of Emergency Medicine. 2021 Jul 1;45:269-79.
5. Gottlieb M, Slagle W, Ruff J. What is the efficacy of tranexamic acid for acute upper gastrointestinal bleeding?. Annals of Emergency Medicine. 2021 Mar 1;77(3):371-3.
6. O’Donnell O, Gallagher C, Davey MG, Coulter J, Regan M. A systematic review and meta-analysis assessing the use of tranexamic acid (TXA) in acute gastrointestinal bleeding. Irish Journal of Medical Science (1971-). 2023 Oct 4:1-5.
7. Franchini M, Focosi D, Zaffanello M, Mannucci PM. Efficacy and safety of tranexamic acid in acute haemorrhage. bmj. 2024 Jan 4;384.
8. Franchini M, Focosi D, Zaffanello M, Mannucci PM. Efficacy and safety of tranexamic acid in acute haemorrhage. bmj. 2024 Jan 4;384.
9. Roberts LN. Tranexamic acid in acute gastrointestinal bleeding–A cautionary tale. Journal of Thrombosis and Haemostasis. 2020 Oct 1;18(10):2440-3.
10. Koh A, Adiamah A, Gomez D, Sanyal S. Safety and efficacy of tranexamic acid in minimizing perioperative bleeding in extrahepatic abdominal surgery: meta-analysis. BJS open. 2021 Mar;5(2):zrab004.
11. Bazeer N, Miners A, Roberts I, Shakur-Still H, Jairath V, Williams J. Economic evaluation of tranexamic acid for the treatment of acute gastrointestinal bleeding: a cost-effectiveness analysis using data from the HALT-IT randomised controlled trial. BMJ Open. 2022 Jul 1;12(7):e060505.
12. Karadas A, Dogan NÖ, Pinar SG, Yesil O, Pekdemir M, Yilmaz S, Yaka E. A randomized controlled trial of the effects of local tranexamic acid on mortality, rebleeding, and recurrent endoscopy need in patients with upper gastrointestinal hemorrhage. European journal of gastroenterology & hepatology. 2020 Jan 1;32(1):26-31.
13. Ahmed S, Mahmood T, Mudasir T, Tufail MU, Warraich DM, Inayat F, Alrashidi AA, Khatoon F, Lodhi K. THE WORTH OF TRANEXAMIC ACID IN THE CONTROLLING OF NON-VARICEAL GASTROINTESTINAL BLEEDING.
14. Roberts I, Shakur-Still H, Afolabi A, Akere A, Arribas M, Austin E, Bal K, Bazeer N, Beaumont D, Brenner A, Carrington L. A high-dose 24-hour tranexamic acid infusion for the treatment of significant gastrointestinal bleeding: HALT-IT RCT. Health Technology Assessment. 2021 Oct 19;25(58).
15. Kumar M, Venishetty S, Jindal A, Bihari C, Maiwall R, Vijayaraghavan R, Muralikrishna SS, Arora V, Kumar G, Sarin SK. Tranexamic acid in upper gastrointestinal bleed in patients with cirrhosis-a randomized controlled trial. Hepatology. 2024 Mar 5:10-97.
16. Koh A, Adiamah A, Gomez D, Sanyal S. Safety and efficacy of tranexamic acid to minimise perioperative bleeding in hepatic surgery: a systematic review and meta-analysis. World Journal of Surgery. 2022 Feb;46(2):441-9.
17. Ting KH, Shiu BH, Yang SF, Liao PL, Huang JY, Chen YY, Yeh CB. Risk of mortality among patients with gastrointestinal bleeding with early and late treatment with tranexamic acid: a population-based cohort study. Journal of Clinical Medicine. 2022 Mar 21;11(6):1741.
18. Simsam MH, Delorme L, Grimm D, Priestap F, Bohnert S, Descoteaux M, Hilsden R, Laverty C, Mickler J, Parry N, Rochwerg B. Efficacy of high dose tranexamic acid (TXA) for hemorrhage: A systematic review and meta-analysis. Injury. 2023 Mar 1;54(3):857-70.
19. Lawati KA, Sharif S, Maqbali SA, Rimawi HA, Petrosoniak A, Belley-Cote EP, Sharma SV, Morgenstern J, Fernando SM, Owen JJ, Zeller M. Efficacy and safety of tranexamic acid in acute traumatic brain injury: a systematic review and meta-analysis of randomized-controlled trials. Intensive care medicine. 2021 Jan;47:14-27.
20. McQuilten ZK, Wood EM, Medcalf RL. When to use tranexamic acid for the treatment of major bleeding?. Journal of Thrombosis and Haemostasis. 2023 Oct 11.
21. Davis S, Nawab A, van Nispen C, Pourmand A. The role of tranexamic acid in the management of an acutely hemorrhaging patient. Hospital Pharmacy. 2021 Aug;56(4):350-8.
22. Ockerman A, Vanassche T, Garip M, Vandenbriele C, Engelen MM, Martens J, Politis C, Jacobs R, Verhamme P. Tranexamic acid for the prevention and treatment of bleeding in surgery, trauma and bleeding disorders: a narrative review. Thrombosis Journal. 2021 Dec;19:1-6.
23. Dhingra P, Yeung M, Lang E. Tranexamic acid in emergency medicine. An overview of reviews. Internal and Emergency Medicine. 2023 Jan;18(1):211-8.
24. Ageron FX, Gayet-Ageron A, Ker K, Coats TJ, Shakur-Still H, Roberts I, Kayani A, Geer A, Ndungu B, Fawole B, Gilliam C. Effect of tranexamic acid by baseline risk of death in acute bleeding patients: a meta-analysis of individual patient-level data from 28 333 patients. British journal of anaesthesia. 2020 Jun 1;124(6):676-83.
25. Ker K, Mansukhani R, Shakur-Still H, Arribas M, Beaumont D, Roberts I. Tranexamic acid for gastrointestinal bleeding: can a reduction in the risk of death be discounted? A systematic review and meta-analysis of individual patient data from 64 724 bleeding patients. BMJ open. 2023 Feb 1;13(2):e059982.