Drug for Menstrual Bleeding Could Save Soldiers' Lives
A drug used to treat heavy menstrual bleeding could also control bleeding associated with severe injuries and save soldiers’ lives. Tranexamic acid (TXA) could reduce the risk of death of trauma victims by about 10 percent, equivalent to more than 70,000 lives saved around the world, according to a new Cochrane review.
Lives of soldiers and civilians could be saved
Tranexamic acid (Cyklokapron, Lysteda) belongs to a drug class called antifibrinolytics, and it works by stabilizing a protein which helps the blood clot normally to prevent and stop high-risk bleeding associated with surgery or a traumatic injury. In November 2009, the Food and Drug Administration (FDA) approved Lysteda specifically for the treatment of cyclic heavy menstrual bleeding.
Other antifibrinolytic drugs include aprotinin and epsilon-aminocaproic acid (EACA). In May 2008, aprotinin was withdrawn from the world market because of safety concerns.
In a new review of four studies by the Cochrane Database of Systematic Reviews, the investigators, led by Ian Roberts of the London School of Hygiene & Tropical Medicine, it was noted that TXA reduces the risk of death in injured individuals who experience severe bleeding by about 10 percent when compared with patients who receive no treatment.
The review included results from one trial that had 20,211 patients and another that included 240 patients. Two small trials of aprotinin did not provide any useful data.
According to the review, more than three million people die of injuries around the world each year, usually because of excessive blood loss. Injury is the second leading cause of death for people ages 5 to 45 years. Last year, Roberts was part of a consortium that recommended TXA be added to the list of essential drugs by the World Health Organization because of its ability to reduce deaths from all causes by ten percent compared to placebo in the CRASH 2 study.
Roberts explained that TXA appears to be effective in reducing the risk of bleeding to death after injury and has few side effects. “Given the high quality of evidence for the benefits of this drug, we recommend it be used more widely in injury victims with bleeding.” With the massive injuries frequently suffered by military personnel fighting in Iraq and Afghanistan and other combat zones, TXA could be used to save soldiers’ lives.
Roberts I et al. Cochrane Database of Systematic Reviews 2011; 1 (CD004896)