Simple injection of TXA could save the lives of thousands of accident victims

If recently injured patients with serious bleeding were to receive a cheap, widely available and easily administered drug to help their blood to clot, tens of thousands of lives could be saved every year.

Dr Ian Roberts, Professor of Epidemiology at the London School of Hygiene and Tropical Medicine (LSHTM), UK, revealed that results from a trial show that early administration of tranexamic acid (TXA) to patients with recent, severe bleeding injuries saves lives, with no evidence of adverse effects from unwanted clotting.

The trial, named CRASH-2, was a large, randomised trial involving over 20,000 adult patients in 274 hospitals across 40 countries, and was funded by England’s National Institute for Health Research (NIHR) Health Technology Assessment programme. This is the first trial of TXA in injured patients, although smaller trials have shown that it reduces bleeding in patients undergoing major surgery.

TXA is an off-patent drug, manufactured by a number of different companies. The cost per gram is about ?3 ($4.50).

The drug helps by reducing clot breakdown. Although this would be advantageous in patients with severe bleeding, doctors were worried that TXA might increase the risk of complications, such as heart attacks, strokes and clots in the lungs. The results of this large trial show that TXA reduces death from bleeding without any increase in these complications.

The researchers estimate that administering TXA soon after injury could prevent up to 100,000 deaths per year across the world. In India it could save about 13,000 lives each year, with about 12,000 lives saved in China. The drug would also save lives in developed countries, around 2,000 each year in the USA and more in Europe.

The paper is published on-line by The Lancet.

Source: London School of Hygiene & Tropical Medicine, UK



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