Anaphylaxis to tranexamic acid—a rare reaction to a common drug

Li, Philip H.; Trigg, C.J.; Rutkowski, Ryszard; Rutkowski, Krzysztof

doi:10.1016/j.jaip.2016.12.014

Cited by 23 publications

(15 citation statements)

References 8 publications

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“… 12–14 In addition, anaphylaxis to TXA during anaesthesia is extremely rare; only a few case reports on this issue have been published. 31–33 Therefore, we estimate that the probability of trial cessation due to SAEs is very low.…”

Section: Methods and Analysismentioning

confidence: 96%

Tranexamic ACid during PancereaticoDuodenectomy (TAC-PD): study protocol for a multicentre randomised, blind, placebo-controlled trial

2020

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IntroductionPancreaticoduodenectomy (PD) is a major gastroenterological surgery that results in a substantial amount of blood loss. Several studies have demonstrated that major blood loss during PD is associated with both short-term and long-term poor outcomes. Administration of perioperative tranexamic acid (TXA) has been reported to reduce intraoperative blood loss in various surgeries, including cardiovascular surgery and orthopaedic surgery. Nevertheless, the effect of perioperative TXA use in patients undergoing PD has not been investigated. This study aims to investigate the effect of TXA on blood loss during PD.Methods and analysisA multicentre (six hospitals), randomised, blind (patient-blinded, surgeon-blinded, anaesthesiologist-blinded, monitor-blinded), placebo-controlled trial of TXA during PD was started in September 2019. Patients undergoing PD for biliary, duodenal or pancreatic diseases are randomly assigned to the TXA or placebo group. The stratification factors are the institutions and preoperative clinical diagnosis. Before skin incision, the participants in TXA group are administrated 1 g TXA as a loading infusion followed by a maintenance infusion of 125 mg/hour TXA until the end of surgery or 8 hours from the incision. Participants in the placebo group are administrated the same volume of saline that is indistinguishable from the TXA. The primary outcome is blood loss during PD. The secondary outcomes are intraoperative and postoperative (up to day 2) blood transfusions, operation time, anaesthesia time, postoperative laboratory variables, length of hospital stay, in-hospital and 90-day mortality and postoperative complications occurring within 28 days of surgery or requiring readmission. To date, 115 patients of a planned 220 have been enrolled in the study.Ethics and disseminationThis protocol was approved by the Nagoya University Clinical Research Review Board and is registered with Japan Registry of Clinical Trials on 15 August 2019. The results of this trial will be disseminated through peer-reviewed journals.Trial registration numberjRCTs041190062.

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Section: Methods and Analysismentioning

confidence: 96%

Tranexamic ACid during PancereaticoDuodenectomy (TAC-PD): study protocol for a multicentre randomised, blind, placebo-controlled trial

2020

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“…Due to similar chemical structures and potential common epitopes, other lysine derivatives such as aminocaproic acid should be avoided [8]. Etamsylate seems to be a safe alternative [7][8][9].…”

Section: Txa Belongs To the World Health Organization (Who) Model Lismentioning

confidence: 99%

Two Cases of Anaphylaxis to Tranexamic Acid Confirmed by Drug Provocation Test: What About Skin Testsing?

Hanache¹,

Verdaguer²,

Collin³

et al. 2021

J Investig Allergol Clin Immunol

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“…To sum up, hypersensitivity reactions to TXA maybe IgE-mediated or cellular mediated and clinical symptoms and laboratory tests are crucial to address clinician suspects. For this purpose, Li et al [ 20 ] suggested a protocol for the investigation of a suspected anaphylactic reaction to TXA. Firstly, an accurate and complete medical history should be collected, thus focusing on previous suspected drug exposures.…”

Section: Introductionmentioning

confidence: 99%

Tranexamic acid adverse reactions: a brief summary for internists and emergency doctors

et al. 2020

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Tranexamic acid (TXA) is a synthetic lysine analogue that is well known as antifibrinolytic agent. It can reduce blood loss in clinical use, especially in conditions where fibrinolysis or hyperfibrinolysis are involved, such as trauma or surgery. Moreover, TXA has been approved as second-line prophylactic therapy for hereditary angioedema and further data have been published about a possible use of TXA as maintenance treatment for nonhistaminergic angioedema and treatment for episodes of bradykinin-mediated angioedema induced by ACE inhibitors. TXA can be administered through several routes: orally, topically, or intravenously. Although, it is a drug with a very high safety profile, in few cases hypersensitivity reactions have been described occurring with different clinical manifestations. Ethamsylate can be an alternative in TXA sensitized patients. In this brief article we describe TXA adverse reactions and current protocols which have been proposed to help clinicians to diagnose TXA hypersensitivity.

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Anaphylaxis to tranexamic acid—a rare reaction to a common drug

Cited by 23 publications

References 8 publications

Tranexamic ACid during PancereaticoDuodenectomy (TAC-PD): study protocol for a multicentre randomised, blind, placebo-controlled trial

Tranexamic ACid during PancereaticoDuodenectomy (TAC-PD): study protocol for a multicentre randomised, blind, placebo-controlled trial

Two Cases of Anaphylaxis to Tranexamic Acid Confirmed by Drug Provocation Test: What About Skin Testsing?

Tranexamic acid adverse reactions: a brief summary for internists and emergency doctors

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