Tranexamic acid could save 100,000 lives a year

Tranexamic acid saves injury victims

Researchers have discovered that a new inexpensive drug, tranexamic acid (TXA), could save up to 100,000 injury victims across the world from bleeding to death.

The drug was developed to help women suffering from heavy periods, and is widely available and already used to treat patients undergoing non-emergency surgery and haemophiliacs, due to the fact that it can stop excessive bleeding, said Nursing Times.

Doctors at the London School of Hygiene and Tropical Medicine carried out further research into tranexamic acid and revealed that the drug has far wider-reaching potential than it is currently being used for.

The CRASH-2 study, which was funded by the UK's Department of Health, tested the off-patent treatment on 20,211 severely injured adults in 274 hospitals across 40 different countries. Participants were either injected with one gram of tranexamic acid, followed by another gram which was dispensed to the patient via a drip over an eight-hour period, or they were given an 'inactive' placebo treatment.

"Randomisation was balanced by centre, with an allocation sequence based on a block size of eight, generated with a computer random number generator," the CRASH-2 study stated.

The team of researchers discovered that the overall risk of death in the TXA-treatment group fell by 10 percent and the chance of death due to bleeding dropped by 15 percent. A total of 489 (4.9 percent) of TXA group patients bled to death compared to 574 (5.7 percent) in the placebo group.

Tranexamic acid's potential

Every year, over a million people die as a result of traffic injuries and a further 1.6 million die as a result of violent acts, and a huge number of these could be saved through instant action to stop haemorrhaging, the researchers said.

"Each year about 600,000 injured patients bleed to death worldwide," said the study's lead author, Ian Roberts, a professor of epidemiology. "Injuries may be accidental, for example, road crashes; or intentional, such as shootings, stabbings or land-mine injuries, and the majority of deaths occur soon after injury."

As well as car-crash, gun shot and stabbing victims, experts have also pointed out that tranexamic acid could improve the chances of survival for soldiers who have been wounded in battle.

The researchers have requested that the World Health Organization (WHO) place tranexamic acid on its list of recommended medicines and mark it as an essential drug.

"It's important to remember that deaths from injuries are increasing around the world and that they usually involve young adults," said the CRASH-2 researchers.

Initially the researchers were concerned that tranexamic acid may raise the risk of serious side effects, such as heart attacks, lung clots or strokes, but the study revealed that drug cut the chances of bleeding to death without increasing the chances of developing any life-threatening complications.

"The drug is inexpensive and could be given in hospitals worldwide," said Etienne Krug, director of violence and injury prevention and disability at the UN's WHO. "It is essential that doctors are aware of these results and take them into account in the emergency management of seriously injured patients."

Tranexamic acid treatment costs around GBP£3 per patient, and is manufactured by a number of different pharmaceutical companies.  

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