Role of TXA in GI bleed

As we discuss before. TXA is synthetic derivative of lysine.

What it do?

Bind to plasminogen. Prevent it conversion to plasmin. Plasmin break the clots. So no plasmin, more clots will stay. Prevent continuos bleeding. Plasmin also activate complement. So again, no plasmin, reduce inflammation.

Theoretically, it should be good to be given to any bleeding condition. But any drugs, for any indication must be pass clinical trial, about 4 phase. To look if it is cost effective and safe (no adverse effect).

So far, 8 clinical trials done on (Upper GIB only). Good outcome. Reduce mortality. BUT poor quality studies and DIDN’T report adverse outcome.

Good and large multi center RCT are being conducted. Sadly the study will finish around 2019-2020. HALT-IT.

For now, TXA was EXCLUDED from recents concencus of GIB management.

Ref:

http://www.emdocs.net/ed-crash-course-txa-matters/

http://haltit.lshtm.ac.uk/

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