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Published on: January 19, 2024
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Tranexamic acid in epistaxis: a systematic review.
Summary
Tranexamic acid shows promise for managing epistaxis, particularly topical formulations in acute cases and oral use for recurrent bleeding in hereditary hemorrhagic telangiectasia. Further research is needed to clarify its overall safety and efficacy.
Area of Science:
- Otorhinolaryngology
- Hematology
- Pharmacology
Background:
- The efficacy and safety of tranexamic acid (TXA) in epistaxis management are not well-established.
- Uncertainty exists regarding contraindications for TXA use in nosebleeds.
- A systematic review was conducted to evaluate TXA's role in epistaxis.
Purpose of the Study:
- To systematically review and summarize evidence on the efficacy and safety of tranexamic acid for epistaxis.
- To compare TXA's use in epistaxis with its application in other medical specialties.
Main Methods:
- Systematic review of randomized controlled trials (RCTs).
- Searches of MEDLINE, EMBASE, and the Cochrane library for relevant studies.
- Evaluation of RCTs using Cochrane Handbook recommendations.
Main Results:
- One RCT found no benefit of oral TXA for acute spontaneous epistaxis.
- One RCT showed no significant benefit of topical TXA, while another found significant benefit in acute epistaxis.
- Two RCTs demonstrated significant reduction in frequency and severity of recurrent epistaxis in hereditary hemorrhagic telangiectasia patients using oral TXA.
Conclusions:
- Tranexamic acid, a WHO essential medicine, has potential in epistaxis management.
- Evidence suggests topical TXA may benefit acute epistaxis, and oral TXA may help prevent recurrent bleeds in specific conditions.
- Further clarification on TXA's efficacy and safety profile in epistaxis is warranted.
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