Inexpensive Drug TXA Stops Bleeding in Trauma Victims

Kathleen Blanchard's picture

Researchers have developed a drug that they say should be considered essential for stopping bleeding in accident victims. The medication can stop bleeding, is inexpensive and could save thousands of lives worldwide. TXA (tranexamic acid) was studied and found to reduce death from all causes among trauma victims.

Trauma from accidents starts a cascade of events that increase the risk of bleeding. TXA was found to reduce deaths from all causes by ten percent compared to placebo in the CRASH 2 study. The findings were robust enough to lead Professor Ian Roberts and Dr Haleema Shakur, London School of Hygiene and Tropical Medicine, UK, and colleagues from the CRASH-2 consortium to recommend that TXA be added to the list of essential medicines by the World Health Organization.

TXA could prevent 100,000 deaths from accidents each year

Professor Ian Roberts says, "Each year about 600,000 injured patients bleed to death worldwide. Injuries may be accidental, for example road traffic crashes, or intentional, such as shootings, stabbings or land mine injuries and the majority of deaths occur soon after injury. Although most deaths from injuries are in developing countries, injury is a leading cause of death in young adults throughout the world."


According to estimates from the researchers, TXA could prevent 100,000 deaths annually throughout the world. Of those, 13,000 lives each year would be saved in India and about 12,000 lives saved in China. Roberts says, "It's important to remember that deaths from injuries are increasing around the world and that they usually involve young adults, often the main breadwinner in the family. The impact on the family is devastating."

TXA could also save 2,000 each year in the USA and even more in Europe from fibrinolysis or clot breakdown that leads to hemorrhage in response to trauma and surgery.

The authors of the CRASH-2 study conclude, “Tranexamic acid could be given in a wide range of health-care settings, and safely reduced the risk of death in bleeding trauma patients in our study. The option to use tranexamic acid should be available to doctors treating trauma patients in all countries, and this drug should be considered for inclusion on the WHO List of Essential Medicines. On the basis of these results, tranexamic acid should be considered for use in bleeding trauma patients."

TXA could also have other applications in addition to saving the lives of trauma victims that include hemorrhage that can occur after delivery and bleeding after brain surgery. A large clinical trial is underway to test the safety and effectiveness of tranexamic acid for post-partum hemorrhage.

the Lancet


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