Journal
THROMBOSIS RESEARCH
Volume 134, Issue 3, Pages 565-571Publisher
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.thromres.2014.06.012
Keywords
Antifibrinolytics; Epistaxis; Hereditary hemorrhagic telangiectasia; Osler-Rendu-Weber syndrome; Tranexamic acid
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Funding
- Pharmacia GmbH, Erlangen, Germany
- Baxter Deutschland GmbH, Unterschleissheim, Germany
- MEDA Pharma GmbH & Co. KG, Bad Homburg v. d. H., Germany
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Introduction: Epistaxis is the most frequent manifestation in hereditary hemorrhagic telangiectasia, in which no optimal treatment exists. It can lead to severe anemia and reduced quality of life. Positive effects of tranexamic acid, an antifibrinolytic drug, have been reported on epistaxis related to this disorder. We sought to evaluate the efficacy of treating nosebleeds in hereditary hemorrhagic telangiectasia with tranexamic acid. Materials and Methods: In a randomized, double-blind, placebo controlled, cross-over phase IIIB study, 1 gram of tranexamic acid or placebo was given orally 3 times daily for 3 months for a total of 6 months. Results: 22 patients were included in the intention-to-treat analysis. Hemoglobin levels, the primary outcome measure, did not change significantly (p = 0.33). The secondary outcome measure was epistaxis score and patients reported a statistically significant reduction in nosebleeds, equaling a clinically relevant 54% diminution (p = 0.0031), as compared to the placebo period. No severe side effects were observed. Conclusion: Tranexamic acid reduces epistaxis in patients with hereditary hemorrhagic telangiectasia. (C) 2014 Elsevier Ltd. All rights reserved.
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