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Topical tranexamic acid for spontaneous epistaxis.
María Jesús Santander1, Andrés Rosenbaum2, Matías Winter3
1Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Proyecto Epistemonikos, Santiago, Chile.
Medwave
|December 15, 2018
Summary
Topical tranexamic acid is a potential treatment for spontaneous epistaxis (nosebleeds). However, current evidence is very low certainty, making its effectiveness and impact on adverse events unclear.
Area of Science:
- Otorhinolaryngology
- Emergency Medicine
- Pharmacology
Background:
- Spontaneous epistaxis is a common emergency department presentation.
- Topical tranexamic acid is an emerging treatment option.
- The efficacy of topical tranexamic acid for epistaxis remains debated.
Purpose of the Study:
- To evaluate the efficacy of topical tranexamic acid in managing spontaneous epistaxis.
- To assess the risk of rebleeding and adverse effects associated with topical tranexamic acid.
- To synthesize evidence from systematic reviews on this treatment.
Main Methods:
- Systematic search of the Epistemonikos database, including MEDLINE, EMBASE, and Cochrane.
- Data extraction from systematic reviews.
- Meta-analysis of primary study data.
- Application of the GRADE approach for certainty of evidence assessment.
Main Results:
- Five systematic reviews were identified, each analyzing a single primary randomized trial.
- The certainty of evidence regarding the impact of topical tranexamic acid on hemostasis is very low.
- The effect on rebleeding risk and potential adverse effects is uncertain due to low-certainty evidence.
Conclusions:
- There is insufficient high-quality evidence to confirm the effectiveness of topical tranexamic acid for epistaxis.
- The potential for increased adverse effects with topical tranexamic acid warrants further investigation.
- More rigorous research is needed to clarify the role of topical tranexamic acid in epistaxis management.
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