A cheap, commonly used drug that stops bleeding during elective surgeries could save the lives of tens of thousands worldwide if administered within eight hours of a bleeding injury.
The drug, tranexamic acid, or TXA, was given to more than 10,000 adult trauma patients in 40 countries who received the drug within eight hours of being injured. Researchers compared those patients’ outcomes to more than 10,000 accident victims who got a placebo treatment. Doctors initially worried that TXA might increase side effects such as blood clots or strokes in patients who received it, but the study showed no such effects.
The study found that patients who got TXA had a 15 percent lower chance of dying from a hemorrhage than those who didn’t get it. Dr. Ian Roberts, professor of epidemiology from the London School of Hygiene and Tropical Medicine and lead researcher for the study stated, “When people have serious injuries, whether from accidents or violence, and when they have severe hemorrhage, they can bleed to death. This treatment reduces the chances of bleeding to death by about a sixth.”
Patients who received the drug also had a 10 percent lower chance of dying from any other cause, including organ failure and head injuries, versus patients who didn’t receive TXA. The study was paid for by the British government and published online in the medical journal Lancet.
TXA is not patented and is manufactured generically by several companies. It costs approximately $4.50 a gram with a typical dose being 2 grams. Because it is generally given via an injection, it would be easy to introduce, even in developing countries, according to experts.
“The option to use tranexamic acid should be available to doctors treating trauma patients in all countries,” said Roberts and Haleema Shakur, also of the London School of Hygiene and Tropical Medicine, who are petitioning to have the drug listed as essential by the World Health Organization (WHO). Once a drug is on the WHO’s essential list, organizations such as UNICEF will often purchase it for use in developing countries. More than 90 percent of trauma deaths occur in countries where access to medicines is often restricted by poor infrastructure and few resources.
The drug also has major applications here in the United States where according to the Center for Disease Control (CDC) accidents are the fifth leading cause of death. Thousands of people needlessly bleed to death before they reach the hospital. Experts say that using TXA could save as many lives as mandatory seat belt laws or tougher drunk driving measures.
According to Roberts, roughly 600,000 people bleed to death each year. “It’s important to remember that deaths from injuries are increasing around the world and that they usually involve young adults, often the main breadwinner in the family. The impact on the family is devastating,” he added.
Study researchers estimate that 13,000 lives could be saved in India and 12,000 in China annually by increased use of TXA. In the U.S., they estimate that some 2,000 lives could be saved by using the drug.