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Rapid use of tranexamic acid after head injuries saves lives
An already available drug could significantly reduce deaths from head injuries. In a global study led by the London School of Hygiene & Tropical Medicine, the first clear evidence was found that tranexamic acid (TXA) reduces the number of deaths in patients with traumatic brain injuries by up to 20 percent.
The inexpensive drug inhibits the breakdown of blood clots and can thereby prevent bleeding in the brain. Just recently, another study made it clear that even with minor head injuries, there is a risk of microbleeding in the brain, which significantly increases the risk of disability. The current study now makes it clear that the administration of TXA can prevent bleeding in the brain and many deaths in patients with traumatic brain injuries. The study results were published in the specialist magazine "The Lancet".
Brain injuries are a common cause of death
Traumatic brain injuries are one of the most common causes of disability and premature death worldwide - with an estimated 69 million cases a year, reports the research group. In the CRASH-3 study (Clinical Randomization of an Antifbrinolytic in Significant Head Injury), the treatment options with TXA were examined in more than 12,000 people with head injuries from 175 hospitals in 29 countries. It is one of the largest clinical studies ever carried out on head injuries.
20 percent fewer deaths
The study participants were treated either intravenously with tranexamic acid or with a placebo due to their head injury. The researchers were able to show that the administration of TXA within three hours after the injury significantly reduced the number of deaths. This effect was most pronounced in those with mild and moderate traumatic brain injuries, in which the deaths were 20 percent lower, reports the London School of Hygiene & Tropical Medicine in a press release on the study results.
Benefits from treatment with TXA
"We already know that rapid administration of tranexamic acid can save lives in patients with life-threatening bleeding in the chest or abdomen, as we often see in victims of road accidents, shootings or knife stabs," explains study director Professor Ian Roberts of the London School of Hygiene & Tropical Medicine. The current study has now made it clear that early treatment with TXA can also prevent deaths from head injuries.
Early application recommended
Because TXA only prevents the bleeding from getting worse, but damage that has already occurred cannot be reversed, according to the researchers, early treatment is crucial. The study showed that there was a ten percent reduction in treatment effectiveness for every 20-minute delay. This shows that those affected should be treated with TXA as soon as possible after a head injury.
Save hundreds of thousands of lives worldwide
This is the first clinical trial to show that a drug can reduce mortality from traumatic brain injuries, said University of Birmingham Professor Antoni Belli, who was also involved in the study. "We believe that this could save hundreds of thousands of lives worldwide," continues the neurosurgeon. So far, the treatment of traumatic brain injuries has been a major challenge because there are very few treatment options available for those affected.
Broad clinical implementation required
Thanks to the new findings that can be applied to patients with head injuries of all causes and all population groups, a potentially powerful new treatment for traumatic head injuries is now available, according to the researchers. They were convinced that widespread clinical implementation could improve the survival of people with head injuries in high and low income countries around the world.
No side effects found
However, no clear benefit of the drug was discernible in the study in patients with very serious head injuries. However, there were no indications of side effects and there was no increase in disability among the survivors who received the drug. The researchers generally advocate using TXA as quickly as possible after traumatic head injuries. (fp)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Dipl. Geogr. Fabian Peters
- Ian Roberts, et al .: Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomized, placebo-controlled trial; in: The Lancet (published 10/14/2019), thelancet.com