Topical Tranexamic acid may not help reduce nosebleeds or need for nasal packing: Study

UK: Topical tranexamic acid is not effective in controlling bleeding and reducing the need for anterior nasal packing in patients with atraumatic epistaxis that is uncontrolled with simple first aid measures, finds a recent study. The findings of the study are published in the journal Annals of Internal Emergency Medicine.

Epistaxis or nosebleed is common emergency department (ED) presentation. In most of the cases, it can be controlled by simple first aid measures but if those measures fail, anterior nasal packing is required. Tranexamic acid is an agent that contributes to blood clot stability. Adam Reuben, Royal Devon and Exeter NHS Foundation Trust, Exeter, England, and colleagues aimed to investigate the effectiveness of topical intranasal tranexamic acid in adult patients presenting to the ED with persistent epistaxis, and whether it reduces the need for anterior nasal packing.

For the purpose, the researchers performed a double-blind, placebo-controlled, multicenter 1:1, randomized controlled trial from May 5, 2017, to March 31, 2019 across 26 EDs in the United Kingdom. 

It included 496 participants with spontaneous epistaxis, persisting after simple first aid and application of a topical vasoconstrictor. They were randomly allocated to receive topical tranexamic acid or placebo.