Patients with stroke-related intracerebral hemorrhage (TICH-2), or “bleeding on the brain,” may benefit from receiving tranexamic acid (TXA), a drug used to treat blood loss from trauma and postpartum bleeding, according to research published May 16 in The Lancet and presented at the European Stroke Conference in Sweden.
The international trial, by Nikola Sprigg and colleagues at the University of Nottingham in the United Kingdom, aimed to assess whether TXA reduces hematoma expansion and improves health outcomes in adult patients with stroke due to intracerebral hemorrhage.
The researchers found a reduction in deaths after administering TXA. Additionally, they found less bleeding in the brain and fewer associated complications in the patients who received TXA.
TXA treatment may be more effective in patients who exhibit lower blood pressure. Those with blood pressure lower than 170 mmHg had more favorable outcomes with TXA treatment than individuals with blood pressure above 170 mmHg.
The trial was unable to find a difference in the number of people who were left disabled or had died three months after their stroke.
"While we failed to show significant benefits three 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,” Sprigg said in a press release. “More trials are needed, particularly focusing on giving treatment as soon as possible after the start of bleeding in this emergency condition.”
The study cohort included more than 2,000 patients who were diagnosed with bleeding in the brain, confirmed by a CT scan, from 124 hospitals in 12 countries over a four-year period. The researchers randomly sorted the patients into two groups—one received TXA within eight hours of stroke and the other was given a saline placebo.
The researchers monitored the patients after CT scans were performed 24 hours after stroke. Progress measurements were taken two and seven days after their stroke. The final follow-up was performed at 90 days.
At Day 2, fewer people in the TXA group exhibited a worsening of the bleed in the brain. They also had less blood in their brain compared to the control group. At Day 7, the TXA group had fewer deaths than the control group.
The researchers noted further research is needed on larger groups to fully understand the potential benefits of TXA administered on patients with stroke-related intracerebral hemorrhage.
As a senior news writer for TriMed, Subrata covers cardiology, clinical innovation and healthcare business. She has a master’s degree in communication management and 12 years of experience in journalism and public relations.