Bath, Philip M

Christensen, Hanna

Engelter, Stefan T

Glad, Solveig B

Law, Zha Kang

Liu, Liping

Meretoja, Atte

Muresan, Eugenia-Maria

Sprigg, Nikola

European Stroke Journal

English

Purpose \ud
Haematoma expansion is a devastating complication of intracerebral haemorrhage with no established treatment. Tranexamic acid had been an effective haemostatic agent in reducing post-operative and traumatic bleeding. We review current evidence examining the efficacy of tranexamic acid in improving clinical outcome after intracerebral haemorrhage. \ud
Method \ud
We searched MEDLINE, EMBASE, CENTRAL and clinical trial registers for studies using search strategies incorporating the terms “intracerebral haemorrhage”, “tranexamic acid” and “antifibrinolytic”. Authors of ongoing clinical trials were contacted for further details. \ud
Findings \ud
We screened 268 publications and retrieved 17 articles after screening. Unpublished information from three ongoing clinical trials was obtained. We found five completed studies. Of these, two randomised controlled trials comparing intravenous tranexamic acid to placebo (n=54) reported no significant difference in death or dependency. Three observational studies (n=281) suggested less haematoma growth with rapid tranexamic acid infusion. There are six ongoing randomised controlled trials (n=3089) with different clinical exclusions, imaging selection criteria (spot sign and haematoma volume), time window for recruitment and dosing of tranexamic acid. \ud
Discussion \ud
Despite their heterogeneity, the ongoing trials will provide key evidence on the effects of tranexamic acid on intracerebral haemorrhage. There are uncertainties of whether patients with negative spot sign, large haematoma, intraventricular haemorrhage, or poor Glasgow Coma Scale should be recruited. The time window for optimal effect of haemostatic therapy in intracerebral haemorrhage is yet to be established. \ud
Conclusion \ud
Tranexamic acid is a promising haemostatic agent for intracerebral haemorrhage. We await the results of the trials before definite conclusions can be drawn

Law, Zhe Kang

Engelter, Stefan T.

Christensen, Hanne

Glad, Solveig B.

Bath, Philip M.W.

Name not available

Treatment of intracerebral haemorrhage with tranexamic acid: a review of current evidence and ongoing trials

Purpose 

Haematoma expansion is a devastating complication of intracerebral haemorrhage with no established treatment. Tranexamic acid had been an effective haemostatic agent in reducing post-operative and traumatic bleeding. We review current evidence examining the efficacy of tranexamic acid in improving clinical outcome after intracerebral haemorrhage. 

Method 

We searched MEDLINE, EMBASE, CENTRAL and clinical trial registers for studies using search strategies incorporating the terms “intracerebral haemorrhage”, “tranexamic acid” and “antifibrinolytic”. Authors of ongoing clinical trials were contacted for further details. 

Findings 

We screened 268 publications and retrieved 17 articles after screening. Unpublished information from three ongoing clinical trials was obtained. We found five completed studies. Of these, two randomised controlled trials comparing intravenous tranexamic acid to placebo (n=54) reported no significant difference in death or dependency. Three observational studies (n=281) suggested less haematoma growth with rapid tranexamic acid infusion. There are six ongoing randomised controlled trials (n=3089) with different clinical exclusions, imaging selection criteria (spot sign and haematoma volume), time window for recruitment and dosing of tranexamic acid. 

Discussion 

Despite their heterogeneity, the ongoing trials will provide key evidence on the effects of tranexamic acid on intracerebral haemorrhage. There are uncertainties of whether patients with negative spot sign, large haematoma, intraventricular haemorrhage, or poor Glasgow Coma Scale should be recruited. The time window for optimal effect of haemostatic therapy in intracerebral haemorrhage is yet to be established. 

Conclusion 

Tranexamic acid is a promising haemostatic agent for intracerebral haemorrhage. We await the results of the trials before definite conclusions can be drawn

Nottingham eTheses

Purpose Haematoma expansion is a devastating complication of intracerebral haemorrhage (ICH) with no established treatment. Tranexamic acid had been an effective haemostatic agent in reducing post-operative and traumatic bleeding. We review current evidence examining the efficacy of tranexamic acid in improving clinical outcome after ICH. Method We searched MEDLINE, EMBASE, CENTRAL and clinical trial registers for studies using search strategies incorporating the terms ‘intracerebral haemorrhage’, ‘tranexamic acid’ and ‘antifibrinolytic’. Authors of ongoing clinical trials were contacted for further details. Findings We screened 268 publications and retrieved 17 articles after screening. Unpublished information from three ongoing clinical trials was obtained. We found five completed studies. Of these, two randomised controlled trials (RCTs) comparing intravenous tranexamic acid to placebo ( n = 54) reported no significant difference in death or dependency. Three observational studies ( n = 281) suggested less haematoma growth with rapid tranexamic acid infusion. There are six ongoing RCTs ( n = 3089) with different clinical exclusions, imaging selection criteria (spot sign and haematoma volume), time window for recruitment and dosing of tranexamic acid. Discussion Despite their heterogeneity, the ongoing trials will provide key evidence on the effects of tranexamic acid on ICH. There are uncertainties of whether patients with negative spot sign, large haematoma, intraventricular haemorrhage, or poor Glasgow Coma Scale should be recruited. The time window for optimal effect of haemostatic therapy in ICH is yet to be established. Conclusion Tranexamic acid is a promising haemostatic agent for ICH. We await the results of the trials before definite conclusions can be drawn. </jats:sec

Zhe Kang Law

Atte Meretoja

Stefan T Engelter

Hanne Christensen

Eugenia-Maria Muresan

Solveig B Glad

Liping Liu

Philip M Bath

Nikola Sprigg

Crossref

Treatment of intracerebral haemorrhage with tranexamic acid – A review of current evidence and ongoing trials

Helsingin yliopiston digitaalinen arkisto

Treatment of intracerebral haemorrhage with tranexamic acid : A review of current evidence and ongoing trials

Purpose Haematoma expansion is a devastating complication of intracerebral haemorrhage with no established treatment. Tranexamic acid had been an effective haemostatic agent in reducing post-operative and traumatic bleeding. We review current evidence examining the efficacy of tranexamic acid in improving clinical outcome after intracerebral haemorrhage. Method We searched MEDLINE, EMBASE, CENTRAL and clinical trial registers for studies using search strategies incorporating the terms “intracerebral haemorrhage”, “tranexamic acid” and “antifibrinolytic”. Authors of ongoing clinical trials were contacted for further details. Findings We screened 268 publications and retrieved 17 articles after screening. Unpublished information from three ongoing clinical trials was obtained. We found five completed studies. Of these, two randomised controlled trials comparing intravenous tranexamic acid to placebo (n=54) reported no significant difference in death or dependency. Three observational studies (n=281) suggested less haematoma growth with rapid tranexamic acid infusion. There are six ongoing randomised controlled trials (n=3089) with different clinical exclusions, imaging selection criteria (spot sign and haematoma volume), time window for recruitment and dosing of tranexamic acid. Discussion Despite their heterogeneity, the ongoing trials will provide key evidence on the effects of tranexamic acid on intracerebral haemorrhage. There are uncertainties of whether patients with negative spot sign, large haematoma, intraventricular haemorrhage, or poor Glasgow Coma Scale should be recruited. The time window for optimal effect of haemostatic therapy in intracerebral haemorrhage is yet to be established. Conclusion Tranexamic acid is a promising haemostatic agent for intracerebral haemorrhage. We await the results of the trials before definite conclusions can be drawn

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https://nottingham-repository.worktribe.com/821819/1/Main documents Revision-1.1 (002).pdf

Treatment of intracerebral haemorrhage with tranexamic acid : A review of current evidence and ongoing trials

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Nottingham eTheses

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Helsingin yliopiston digitaalinen arkisto

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