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By mouth: Treats heavy monthly periods (menstrual cycles) in women.

Injection: Given before tooth removal to prevent or control bleeding episodes in people who have hemophilia.

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Tranexamic acid for coronary artery bypass grafting with on-pump: a systematic review

Bibliographic details: Lian CW, Li H, Li Q, Liu B.  Tranexamic acid for coronary artery bypass grafting with on-pump: a systematic review. Chinese Journal of Evidence-Based Medicine 2011; 11(2): 150-160 Available from: http://www.cjebm.org.cn/oa/DArticle.aspx?type=view&id=201102008

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Systematic review and meta-analysis of the use of tranexamic acid in total hip replacement

We report a systematic review and meta-analysis of published randomised controlled trials evaluating the efficacy of tranexamic acid (TXA) in reducing blood loss and transfusion in total hip replacement (THR). The data were evaluated using the generic evaluation tool designed by the Cochrane Bone, Joint and Muscle Trauma Group. We identified 11 clinical trials which were suitable for detailed extraction of data. There were no trials that used TXA in revision THR. A total of seven studies (comprising 350 patients) were eligible for the blood loss outcome data. The use of TXA reduced intra-operative blood loss by a mean of 104 ml (95% confidence interval (CI) -164 to -44, p = 0.0006, heterogeneity I(2) 0%), postoperative blood loss by a mean of 172 ml (95% CI -263 to -81, p = 0.0002, heterogeneity I(2) 63%) and total blood loss by a mean of 289 ml (95% CI -440 to -138, p < 0.0002, heterogeneity I(2) 54%). TXA led to a significant reduction in the proportion of patients requiring allogeneic blood transfusion (risk difference -0.20, 95% CI -0.29 to -0.11, p < 0.00001, I(2) 15%). There were no significant differences in deep-vein thrombosis, pulmonary embolism, infection rates or other complications among the study groups.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Tranexamic acid in total knee replacement: a systematic review and meta-analysis

We conducted a systematic review and meta-analysis of randomised controlled trials evaluating the effect of tranexamic acid (TXA) upon blood loss and transfusion in primary total knee replacement. The review used the generic evaluation tool designed by the Cochrane Bone, Joint and Muscle Trauma Group. A total of 19 trials were eligible: 18 used intravenous administration, one also evaluated oral dosing and one trial evaluated topical use. TXA led to a significant reduction in the proportion of patients requiring blood transfusion (risk ratio (RR) 2.56, 95% confidence interval (CI) 2.1 to 3.1, p < 0.001; heterogeneity I(2) = 75%; 14 trials, 824 patients). Using TXA also reduced total blood loss by a mean of 591 ml (95% CI 536 to 647, p < 0.001; I(2) = 78%; nine trials, 763 patients). The clinical interpretation of these findings is limited by substantial heterogeneity. However, subgroup analysis of high-dose (> 4 g) TXA showed a plausible consistent reduction in blood transfusion requirements (RR 5.33; 95% CI 2.44 to 11.65, p < 0.001; I(2) = 0%), a finding that should be confirmed by a further well-designed trial. The current evidence from trials does not support an increased risk of deep-vein thrombosis (13 trials, 801 patients) or pulmonary embolism (18 trials, 971 patients) due to TXA administration.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

A meta-analysis of the effectiveness and safety of using tranexamic acid in spine surgery

OBJECTIVE: To assess the effectiveness and safety of using tranexamic acid (TXA) in reducing blood loss in spine surgery through a meta-analysis.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Tranexamic acid is associated with less blood transfusion in off-pump coronary artery bypass graft surgery: a systematic review and meta-analysis

OBJECTIVE: Tranexamic acid reduces blood loss and transfusion in on-pump coronary artery bypass graft (CABG) surgery. Compared with on-pump, off-pump surgery is associated with less blood loss and transfusion. Therefore, tranexamic acid may be less effective for off-pump surgery, and its safety profile may be different in this setting. The aim of this study was to determine the efficacy and safety of tranexamic acid for off-pump CABG surgery.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

A randomized trial of tranexamic acid in combination with cell salvage plus a meta-analysis of randomized trials evaluating tranexamic acid in off-pump coronary artery bypass grafting

The authors concluded that tranexamic acid alone reduces blood loss and the need for transfusion treatment in patients undergoing off-pump coronary artery bypass grafting surgery. The evidence appears to support the authors' conclusions, but the limited search, incomplete reporting of review methods and lack of a quality assessment weaken the robustness of these conclusions.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2006

Efficacy of tranexamic acid in the treatment of idiopathic and non-functional heavy menstrual bleeding: a systematic review

The review concluded that tranexamic acid was a safe and effective therapy for the treatment of idiopathic and non-functional heavy menstrual bleeding and could potentially improve quality of life. The review had some methodological issues and the quality of the evidence base was variable; hence, the reliability and generalisability of the authors' conclusions is uncertain.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Tranexamic acid reduces allogeneic red cell transfusions in patients undergoing total knee arthroplasty: results of a meta-analysis of randomized controlled trials

This review concluded that the use of tranexamic acid was effective in reducing the requirements of allogeneic blood transfusion for patients undergoing total knee arthroplasty. These conclusions needed to be interpreted in light of the fact that the included studies differed on key characteristics and other relevant studies might have been missed.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2005

Effectiveness and safety of tranexamic acid in reducing blood loss in total knee arthroplasty: a meta-analysis

The authors' conclusion that tranexamic acid was safe and effective in reducing blood loss for patients undergoing total knee arthoplasty should not be considered as reliable given the strong likelihood that relevant studies were excluded and because the analysis failed to take into account considerable variation between the trials.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Effect of tranexamic acid on surgical bleeding: systematic review and cumulative meta-analysis

The authors stated that there was reliable evidence spanning more than 10 years that tranexamic acid reduces blood transfusion in surgical patients. The effects on thromboembolic events and mortality remained uncertain and further research was needed. The authors' concluding statement reflected the evidence presented, but interpretation should take into account potential reviewer bias and uncertainties surrounding the trial synthesis.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

The effect of aprotinin, tranexamic acid, and aminocaproic acid on blood loss and use of blood products in major pediatric surgery: a meta-analysis

This review found no evidence to suggest that alternative fibrinolytics (like tranexamic acid) were less effective in reducing blood loss in major surgery in children than aprotinin. Although this appeared to be a generally well-conducted review, the possibility of publication and language bias and unclear reporting of some review processes mean the reliability of the authors' conclusion is unclear.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

Antifibrinolytic therapy with tranexamic acid in pregnancy and postpartum

This review concluded that tranexamic acid appeared to reduce blood loss and the need for blood transfusions after delivery during caesarean sections and vaginal deliveries and appeared safe and effective for prevention and management of bleeding during pregnancy. Methodological limitations of the included studies and discrepancies in the analyses mean that the findings of this review may not be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Lessons from aprotinin: is the routine use and inconsistent dosing of tranexamic acid prudent? Meta-analysis of randomised and large matched observational studies

This review concluded that tranexamic acid appeared to be an effective blood-conserving agent that significantly lowered risks of death in cardiac surgery patients, but it was less effective than aprotinin and both have a risk of complications. The reliability of these conclusions remains unclear given potential limitations in the literature search, included studies and review methods.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Use of intravenous tranexamic acid to reduce allogeneic blood transfusion in total hip and knee arthroplasty: a meta-analysis

This review compared intravenous tranexamic acid with placebo for reducing blood loss in total hip and knee arthroplasty. The authors concluded that intravenous tranexamic acid reduces blood loss and the need for transfusion without increasing the risk of complications. Differences between the included studies may mean that the results of the review are not reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2003

Practical issues for the use of tranexamic acid in total knee arthroplasty: a systematic review

PURPOSE: This systematic review was undertaken to answer three specific questions relating to the clinical values of tranexamic acid (TNA) in total knee arthroplasty (TKA): (1) Whether there are differences in blood-saving effects between the systemic and topical administrations; (2) Whether blood-saving effects of TNA differ by doses and timings of administration; and (3) Whether the use of TNA is safe at all reported doses, timings, and routes of administration with respect to the incidences of symptomatic deep-vein thrombosis (DVT) and pulmonary embolism (PE).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

The effect of tranexamic acid on blood loss in orthognathic surgery: a meta-analysis of randomized controlled trials

OBJECTIVE: The objective of this article was to evaluate the efficacy of tranexamic acid on blood loss in orthognathic surgery. A meta-analysis was performed.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Role of tranexamic acid in endoscopic sinus surgery – a systematic review and meta-analysis

BACKGROUND: The role of tranexamic acid in patients undergoing endoscopic sinus surgery (ESS) is not clearly defined. The aim of our study is to systematically review the existing evidence on the role of tranexamic acid in patients undergoing ESS.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Topical tranexamic acid in total knee replacement: a systematic review and meta-analysis

BACKGROUND: To examine the safety and efficacy of topical use of tranexamic acid (TA) in total knee arthroplasty (TKA).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Tranexamic acid reducing blood transfusion in children undergoing craniosynostosis surgery

BACKGROUND: Surgical correction of craniosynostosis in children is associated with substantial intraoperative bleeding. Intraoperatively administered tranexamic acid (TXA) can lessen blood loss during orthopedic and cardiovascular surgery, but its efficacy in craniosynostosis surgery is uncertain. Therefore, a meta-analysis performed with published comparative studies was to determine whether TXA could reduce packed red blood cells (or erythrocytes) (PRBCs) transfused and blood loss during pediatric craniosynostosis surgery.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

A meta-analysis of the effectiveness and safety of using tranexamic acid in primary unilateral total knee arthroplasty

BACKGROUND: To evaluate the effectiveness and safety of tranexamic acid (TEA) treatment in reducing perioperative blood loss and transfusion for patients receiving primary unilateral total knee arthroplasty (TKA) and to explore the most effective and safe protocol.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

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