Tranexamic Acid May Benefit Patients With Stroke
Patients with intracerebral hemorrhage may benefit from receiving a drug currently used to treat blood loss from major trauma and bleeding after childbirth, according to an international trial.
The study, led by experts at the University of Nottingham in the United Kingdom and funded by the National Institute for Health Research (NIHR) Health Technology Assessment Program, found that giving tranexamic acid to people who had had intracerebral hemorrhage reduced the number of deaths in the early days following the stroke. It also found that the amount of bleeding in the brain and number of associated serious complications were lower in the patients who had received tranexamic acid treatment.
However, the investigators found no difference in the number of people who were left disabled or had died at three months after their stroke (ie, the study’s primary outcome). The researchers believe that further study is needed on larger groups of patients to enable them to fully understand the potential benefits.
Nikola Sprigg, MD, Professor of Stroke Medicine at the Stroke Trials Unit in the university’s Division of Clinical Neuroscience, led the trial. “Tranexamic acid is cheap, costing less than £15 per patient, and widely available, so it has the potential for reducing death and disability across the world,” she said.
“While we failed to show significant benefits three months after stroke, the reduction in early deaths, amount of bleeding on the brain, and serious complications are signs that this drug may be of benefit in the future. More trials are needed, particularly focusing on giving treatment as soon as possible after the start of bleeding in this emergency condition,” Dr. Sprigg added.
Approximately 15% of all strokes in the UK—affecting around 22,000 people every year—are hemorrhagic and lead to permanent damage. While all people with acute stroke benefit from treatment on a stroke unit, there is currently no specific treatment for hemorrhagic stroke. Many people with hemorrhagic stroke die within a few days. Those who do survive are often left with debilitating disabilities, including paralysis and an inability to speak.
A previous small pilot study by the University of Nottingham and funded by the university and the Stroke Association concluded that a larger study was needed to accurately assess the effectiveness of tranexamic acid. The drug was chosen for the study after previous research showed that it was successful in stopping bleeding in people involved in car accidents.