Tranexamic acid (TXA) reduces the risk of death from bleeding without increasing the risk of vascular occlusive events or the need for surgical intervention in patients with acute traumatic injury, according to a review published in the 2011 Cochrane Database of Systematic Reviews.

Researchers at the London School of Hygiene & Tropical Medicine and the Leicester Royal Infirmary, Leicester, United Kingdom, reviewed 4 trials, 2 of which showed that TXA reduced the risk of death by 10% (RR=0.90, 95% CI, 0.85–0.97; P=.0035). Data from 1 trial of 20,211 patients found that TXA reduced the risk of death from bleeding by 15% (RR=0.85, 95% CI, 0.76–0.96; P=.0077). There was no substantial difference in the number of transfusions administered to trauma patients and those receiving placebo. Two small trials of aprotinin, which was withdrawn in May 2008 from world markets because of safety concerns, yielded no reliable data.

Further trials to determine the effects of TXA on patients with isolated traumatic brain injury are needed, the researchers concluded.