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Widely Available Drug Could Reduce Death and Disability in Intracerebral Haemorrhage

USING a drug called tranexamic acid (TXA) to treat patients with stroke caused by bleeding on the brain, known as intracerebral haemorrhage, may reduce the risk of death in the early days following the stroke. The study from the University of Nottingham, Nottingham, UK, shows the potential for this cheap and widely available drug to reduce death and disability from this condition worldwide.

No Specific Treatment

Currently, there is no specific treatment for intracerebral haemorrhage, which forms around 15% of all stroke cases, and many people will die from it within a few days, while survivors are often left with debilitating disabilities such as paralysis.

5-Year Trial

In this study, the effectiveness of TXA, which is currently used to treat blood loss from bleeding and major trauma after childbirth, in treating intracerebral haemorrhage was assessed. The 5-year trial recruited 2,000 patients from 124 hospitals across 12 countries who had been diagnosed as having had bleeding on the brain. They were randomised into two groups to either receive TXA within 8 hours of the stroke or a saline placebo.

Results

CT scans were performed on the brain of each patient 24 hours after the stroke and progress was then monitored at Days 2 and 7, before a final follow-up at 90 days. In comparison to the placebo group, there were fewer deaths in patients treated with TXA by Day 7, and at Day 2 those receiving TXA had smaller amounts of blood in the brain. There were also fewer people in the TXA-treated arm who experienced a worsening of the bleed on their brain at Day 2. Additionally, there were a lower number of patients who experienced associated serious complications in those treated with TXA versus placebo. However, there were no significant differences in the number of deaths and disabilities between the two treatments at 90 days.

Future Benefit

Prof Nikola Sprigg, University of Nottingham, commented: “While we failed to show significant benefits 3 months after stroke, the reduction in early deaths, amount of bleeding on the brain, and serious complications are signs that this drug may be of benefit in the future. More trials are needed, particularly focussing on giving treatment as soon as possible after the start of bleeding in this emergency condition.”

The team also found evidence that TXA may be more effective in patients with a lower blood pressure.

 

James Coker, Reporter

For the source and further information about the study, click here.