Antifibrinolytic Treatment in Haemophilia: A Controlled Trial of Prophylaxis with Tranexamic Acid

Bennett, A. E.; Ingram, G. I. C.; Inglish, P J

doi:10.1111/j.1365-2141.1973.tb05729.x

Cited by 16 publications

(5 citation statements)

References 13 publications

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“…The double‐blind study by Bennett et al. did not show any benefit [43], whilst another double‐blind, crossover study found a minor reduction in spontaneous bleeding episodes [44]. In these studies, no coagulation factor concentrate substitution was provided, and as TXA does not improve clot initiation, TXA appeared not to be attractive as a stand‐alone prophylactic treatment drug in hemophilia.…”

Section: Discussionmentioning

confidence: 99%

Tranexamic acid combined with recombinant factor VIII increases clot resistance to accelerated fibrinolysis in severe hemophilia A

Hvas

Sørensen

Norengaard

et al. 2007

Journal of Thrombosis and Haemostasis

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Section: Discussionmentioning

confidence: 99%

Tranexamic acid combined with recombinant factor VIII increases clot resistance to accelerated fibrinolysis in severe hemophilia A

Hvas

Sørensen

Norengaard

et al. 2007

Journal of Thrombosis and Haemostasis

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“…In only one instance (Patient 2, mouth) was there improvement with the administration of tranexamic acid. In the remaining 17 comparisons there was either no difference (4) or actual worsening (13) under tranexamic acid. The number of bleeding episodes during tranexamic acid courses, classified according to site and averaged for all patients, showed significant worsening for skin (p < 0.02), borderline worsening for nose (p = 0.07), and no significant difference for mouth No adverse reactions necessitated stopping the trial.…”

Section: Resultsmentioning

confidence: 99%

Lack of efficacy of tranexamic acid in thrombocytopenic bleeding

et al. 1991

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A controlled, randomized, double-blind study was performed to assess the effect of the oral antifibrinolytic agent tranexamic acid in patients with amegakaryocytic thrombocytopenia as regards their need for platelet transfusions and the number of bleeding episodes experienced. Each patient served as his or her own control and received sequential, randomized courses of either tranexamic acid or an identical placebo. The need for platelet transfusions due to bleeding and the total number of bleeding episodes were compared for tranexamic acid and placebo courses. Patients received platelet transfusions at the discretion of their personal physician and kept detailed records of bleeding episodes. Of three patients who completed the full study, none had a reduction in the need for platelet transfusions. Moreover, in the eight patients who participated in the study, there was no reduction in number of bleeding episodes during tranexamic acid treatment as compared to the number with placebo. Our data indicate that the prophylactic administration of tranexamic acid does not decrease dependence on platelet transfusions or decrease bleeding episodes in patients with bleeding due to amegakaryocytic thrombocytopenia.

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“…Further trials in the 1960s concluded that antifibrinolytic agents as prophylaxis did not have a statistically significant effect, although further trials in larger cohorts were indicated [18][19][20]. Since prophylaxis with specific clotting factors has become the standard of care, this aspect has not been further investigated; however, a combination of clotting factor and TXA is the standard of care for bleeding and for treatment around surgery in many haemophilia centres in Europe [21].…”

Section: Discussionmentioning

confidence: 99%

Anti-fibrinolytic agents in bleeding disorders – A clinical perspective

Hart

Badle

2016

The Journal of Haemophilia Practice

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Tranexamic acid (TXA) is a synthetic antifibrinolytic drug used widely used to control bleeding complications in a wide variety of clinical situations. Soon after its development in the 1960s it found use in treatment of women with menorrhagia, and in inherited bleeding disorders. Subsequently it was used in surgery and with proven efficacy to reduce transfusion requirements and bleeding complications. Recent meta-analysis have provided further evidence of efficacy and safety. Tranexamic acid is now on the World Health Organization’s (WHO) list of essential drugs, and is the focus of ongoing worldwide trials. Similarly, there is increasing evidence base in both congenital and acquired bleeding disorders. We present a clinical narrative of the antifibrinolytic system and associated drugs to accompany the pharmacy review by Chaplin et al, with the aim of highlighting the evolution of TXA use in bleeding disorders over recent decades.

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Antifibrinolytic Treatment in Haemophilia: A Controlled Trial of Prophylaxis with Tranexamic Acid

Cited by 16 publications

References 13 publications

Tranexamic acid combined with recombinant factor VIII increases clot resistance to accelerated fibrinolysis in severe hemophilia A

Tranexamic acid combined with recombinant factor VIII increases clot resistance to accelerated fibrinolysis in severe hemophilia A

Lack of efficacy of tranexamic acid in thrombocytopenic bleeding

Anti-fibrinolytic agents in bleeding disorders – A clinical perspective

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