From the Research
Efficacy of Tranexamic Acid in GI Bleeding
- Tranexamic acid (TXA) has been studied for its potential to stop gastrointestinal (GI) bleeding, with evidence suggesting it may be effective in reducing rebleeding and mortality in patients with upper GI bleeding 1, 2, 3, 4.
- A systematic review and meta-analysis of randomized controlled trials found that TXA significantly reduced the rates of continued bleeding, urgent endoscopic intervention, and mortality compared to placebo in patients with upper GI bleeding 2.
- Another study found that TXA may reduce all-cause mortality in patients with upper GI bleeding, but noted that additional evidence is needed to confirm this finding due to limitations in the internal and external validity of included trials 3.
- The HALT-IT trial, a large international randomized controlled trial, aimed to provide reliable evidence on the effects of TXA in acute upper and lower GI bleeding, with primary outcomes including death due to bleeding within 5 days of randomization and secondary outcomes such as rebleeding and thromboembolic events 5.
Safety and Potential Side Effects
- The evidence suggests that TXA does not increase the risk of thromboembolic adverse effects in patients with upper GI bleeding 1, 3.
- However, the effects of TXA on lower GI bleeding warrant further clarification, and additional higher-quality trials are needed to fully understand the efficacy and safety of TXA in GI bleeding 2, 4.
Clinical Implications
- Moderate-quality evidence supports the use of TXA for reducing mortality in patients with upper GI bleeding, with a significant reduction in risk of death compared to placebo 4.
- Early administration of TXA may be recommended for treating upper GI bleeding in the emergency department, but further research is needed to confirm this finding and to fully understand the effects of TXA in GI bleeding 2.