Use of tranexamic acid in gastrointestinal bleeding and patients with haematological malignancies
Abstract
There has been an explosion of interest in the potential clinical benefits of the antifibrinolytic tranexamic acid (TXA), evaluated through multiple clinical trials in surgery, post-partum haemorrhage, and traumatic bleeding. TXA is a well-defined synthetic analogue of the amino acid lysine and reversibly binds lysine receptor sites on plasminogen, which is the precursor to plasmin formation, an enzyme responsible for clot breakdown. However, there are other clinical settings where the evidence for a role for TXA has been less well studied. These potential indications include two main clinical settings for transfusion of blood components, that is gastrointestinal bleeding and haematological malignancies. Bleeding from the upper gastrointestinal tract accounts for most cases of gastrointestinal bleeding. One feature of gastrointestinal bleeding is re-bleeding which occurs in about 10% of patients with non-variceal bleeding but more commonly in patients with variceal bleeding. Abnormalities of fibrinolysis have been described in liver disease, including changes in markers of fibrinolysis. Although TXA has been reported to reduce death in gastrointestinal bleeding, this is based on eight randomized trials, which are generally small in sample size, enrolling between 47 and 216 patients. In addition, these trials were too small to reliably assess the effect of TXA on thromboembolic events, which is important because patients with acute gastrointestinal bleeding and liver disease…
Read the paper
Related studies
- Diagnosis and management of glutaric aciduria type I – revised recommendations
- EZH2 Codon 641 Mutations are Common in BCL2-Rearranged Germinal Center B Cell Lymphomas
- Consensus guidelines for the diagnosis and management of pyridoxine‐dependent epilepsy due to α‐aminoadipic semialdehyde dehydrogenase deficiency
- Systemic Metabolomic Changes in Blood Samples of Lung Cancer Patients Identified by Gas Chromatography Time-of-Flight Mass Spectrometry
- Human OTULIN haploinsufficiency impairs cell-intrinsic immunity to staphylococcal α-toxin
- Discovery of Novel Recurrent Mutations in Childhood Early T-Cell Precursor Acute Lymphoblastic Leukemia by Whole Genome Sequencing - a Report From the St Jude Children's Research Hospital - Washington University Pediatric Cancer Genome Project
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.