Oral tranexamic acid at par with IV TXA for preventing blood loss after joint surgery: Study

Dr. Memtsoudis and colleagues randomized 199 patients between ages 18 and 80 undergoing total hip or total knee replacement to receive either oral TXA (1950 mg) two hours before surgery or IV TXA (1 g) at the start of the procedure. The primary outcomes observed were blood loss and transfusion rates.

In patients who underwent total hip replacement, the estimated blood loss calculated in the post anesthesia care unit (PACU) for oral TXA was 534 ± 285 mL, versus 676 ± 550 for IV TXA. On postoperative day one, estimated blood loss was 769 ± 257 mL for oral TXA and 798 ± 302 ml for IV TXA.

In patients who underwent total knee replacement, estimated blood loss in the PACU was 289 ± 219 mL for oral TXA, and was 486 ± 670 mL for IV TXA. On postoperative day one, estimated blood loss was 716 ± 288 mL for oral TXA versus 846 ± 659 mL for IV TXA.

No patients received transfusions during surgery. One patient who received IV TXA received a transfusion after surgery.

"Given our interim results, it seems that the oral version of TXA is equally as effective as intravenous administration. This translates to improvements in efficiency, cost and safety, all of which are important for patients, clinicians and policy makers," Dr. Memstoudis said. "The research seems rather clear at this point. However, a uniform translation into policy is what is needed, as there seems to be limited translation of best evidence into practice."

Complete results of this study will be analyzed later this year.