Tranexamic acid may help control GI bleeding, prevent rebleeding in cirrhosis patients: Study

The primary outcome measure was the proportion of patients developing 5-day treatment failure. Failure to control bleeding by day 5 was seen in 19/300 (6.3%) patients in the tranexamic acid group and 40/300 (13.3%) patients in the placebo group (p=0.006). Esophageal endoscopic variceal ligation (EVL) site as a source of failure to control bleeding by day 5 among patients undergoing first-time esophageal EVL (excluding patients with a previous post-EVL ulcer as a source of bleed) was seen in 11/222 (4.9%) patients in the tranexamic acid group and 27/225 (1212.0%) patients in the placebo group (p=0.005). However, 5-day and 6-week mortality was similar in the tranexamic acid and placebo groups.

Tranexamic acid significantly reduces the failure to control bleeding by day 5 and failure to prevent rebleeding after day 5 to 6 weeks in patients with advanced liver cirrhosis (Child-Turcotte-Pugh class B or C) presenting with UGIB, by preventing bleeding from the EVL site.

Reference:

Kumar, Manoj1; Venishetty, Shantan1; Jindal, Ankur1; Bihari, Chhagan2; Maiwall, Rakhi1; Vijayaraghavan, Rajan1; Saggere Muralikrishna, Shasthry1; Arora, Vinod1; Kumar, Guresh3; Sarin, Shiv K.1. Tranexamic acid in upper gastrointestinal bleed in patients with cirrhosis: A randomized controlled trial. Hepatology 80(2):p 376-388, August 2024. | DOI: 10.1097/HEP.0000000000000817