Menstrual Bleeding Drug Could Help Save Trauma Victims

A new study suggests that tranexamic acid (TXA), an antifibrinolytic 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.

Researchers at the Cochrane Injuries Group (CIG; London, United Kingdom) searched CENTRAL, MEDLINE, PubMed, EMBASE, The CIG Specialized Register, and other databases, including all randomized controlled trials of antifibrinolytic agents (aprotinin, TXA, and epsilon-aminocaproic acid) following acute traumatic injury. From the results of the screened electronic searches, bibliographic searches, and contacts with experts, two authors independently selected trials meeting the inclusion criteria, with any disagreements resolved by consensus. In all, four trials met the inclusion criteria.

Two trials with a combined total of 20,451 patients found that TXA reduced the risk of death by 10%; data from one trial involving 20,211 patients found that TXA reduced the risk of death due to bleeding by 15%. There was no evidence that TXA increased the risk of vascular occlusive events or need for surgical intervention. There was no substantial difference in the reception of blood transfusion between the TXA and placebo groups, while the two trials of aprotinin provided no reliable data. The study was published in the January 2011 issue of the Cochrane Database of Systematic Reviews.

"These results are based on a large number of patients 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,” said lead researcher Ian Roberts, MD, of the CIG and the London School of Hygiene & Tropical Medicine (United Kingdom). "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.”

TXA is an antifibrinolytic drug that competitively inhibits the activation of plasminogen to plasmin, a molecule responsible for the degradation of fibrin, the basic framework for the formation of a blood clot in hemostasis. It is used as a first-line nonhormonal treatment for dysfunctional uterine bleeding, as well as heavy bleeding associated with uterine fibroids.

Related Links:
Cochrane Injuries Group
London School of Hygiene & Tropical Medicine