The Trend of Tranexamic Use in Upper Gastrointestinal Bleeding Ulcers

Overview

Journal Gastroenterology Res

Specialty Gastroenterology

Date 2017 Jul 21

PMID 28725302

Citations 1

Authors

Stefan Redeen

Affiliations

Soon will be listed here.

Abstract

Background: Bleeding ulcer is a common condition, especially among the elderly population. Tranexamic acid (TXA) has been successfully used for many bleeding conditions. Its use in patients with bleeding ulcer is inclusive yet. The aim of this study was to provide an overview of the prescription of TXA.

Methods: This retrospective cohort study was performed as a review of medical records at the Surgery Department, University Hospital in Linkoping. Patients with complete esophagogastroduodenoscopy and ulcer disease were included and divided on the basis of treatment with TXA or not. Differences between the groups were statistically analyzed.

Results: The main part of the prescription of TXA, 65%, occurred during 2010 and 2011, and 35% between 2012 and 2013 (P < 0.05). In the group treated with TXA, 84% needed blood transfusion, compared to 64% in the control group (P = 0.039). Of the patients treated with TXA, 18% were re-bleeding compared to 14% of the controls (P = 0.594). Median value for days at hospital was 5 in the tranexamic group and 3 in the control group (P = 0.005).

Conclusion: The prescription of TXA has declined between 2010 and 2013. TXA was more often prescribed to patients with more severe gastrointestinal (GI) bleeding ulcer disease. Further investigation is needed to conclude the significance of tranexamic acid in patients with GI bleeding ulcer disease.

Citing Articles

Tranexamic acid as treatment for acute gastrointestinal bleeding: A comprehensive systematic review and meta-analysis.

Calderon Martinez E, Briceno Silva G, Sanchez Cruz C, Woldehana N, Shah Y, Dahiya D Indian J Gastroenterol. 2025; .

PMID: 40029534 DOI: 10.1007/s12664-025-01749-9.

Efficacy of Tranexamic Acid in the Treatment of Massive Upper Gastrointestinal Bleeding: A Randomized Clinical Trial.

Sedaghat M, Iranshahi M, Mardani M, Mesbah N Cureus. 2023; 15(1):e33503.

PMID: 36756018 PMC: 9904391. DOI: 10.7759/cureus.33503.

References

Hawkey G, Cole A, McIntyre A, Long R, Hawkey C . Drug treatments in upper gastrointestinal bleeding: value of endoscopic findings as surrogate end points. Gut. 2001; 49(3):372-9. PMC: 1728427. DOI: 10.1136/gut.49.3.372. View

Ahsberg K, Hoglund P, Stael von Holstein C . Mortality from peptic ulcer bleeding: the impact of comorbidity and the use of drugs that promote bleeding. Aliment Pharmacol Ther. 2010; 32(6):801-10. DOI: 10.1111/j.1365-2036.2010.04399.x. View

Wara P, Stodkilde H . Bleeding pattern before admission as guideline for emergency endoscopy. Scand J Gastroenterol. 1985; 20(1):72-8. DOI: 10.3109/00365528509089635. View

Hermansson M, Ekedahl A, Ranstam J, Zilling T . Decreasing incidence of peptic ulcer complications after the introduction of the proton pump inhibitors, a study of the Swedish population from 1974-2002. BMC Gastroenterol. 2009; 9:25. PMC: 2679757. DOI: 10.1186/1471-230X-9-25. View

Katschinski B, Logan R . Changes in birth-cohort pattern of peptic ulcer mortality in England and Wales. Postgrad Med J. 1991; 67(791):825-8. PMC: 2399114. DOI: 10.1136/pgmj.67.791.825. View

Zufferey P, Miquet M, Quenet S, MARTIN P, Adam P, Albaladejo P . Tranexamic acid in hip fracture surgery: a randomized controlled trial. Br J Anaesth. 2009; 104(1):23-30. DOI: 10.1093/bja/aep314. View

Lindell G, Celebioglu F, Von Holstein C, Graffner H . On the natural history of peptic ulcer. Scand J Gastroenterol. 1994; 29(11):979-82. DOI: 10.3109/00365529409094873. View

Ahsberg K, Ye W, Lu Y, Zheng Z, Stael von Holstein C . Hospitalisation of and mortality from bleeding peptic ulcer in Sweden: a nationwide time-trend analysis. Aliment Pharmacol Ther. 2011; 33(5):578-84. DOI: 10.1111/j.1365-2036.2010.04562.x. View

Gluud L, Klingenberg S, Langholz S . Systematic review: tranexamic acid for upper gastrointestinal bleeding. Aliment Pharmacol Ther. 2008; 27(9):752-8. DOI: 10.1111/j.1365-2036.2008.03638.x. View

10.

Bennett C, Klingenberg S, Langholz E, Gluud L . Tranexamic acid for upper gastrointestinal bleeding. Cochrane Database Syst Rev. 2014; (11):CD006640. PMC: 6599825. DOI: 10.1002/14651858.CD006640.pub3. View

11.

Patchett S, ODonoghue D . Pharmacological manipulation of gastric juice: thrombelastographic assessment and implications for treatment of gastrointestinal haemorrhage. Gut. 1995; 36(3):358-62. PMC: 1382445. DOI: 10.1136/gut.36.3.358. View

12.

Shakur H, Roberts I, Bautista R, Caballero J, Coats T, Dewan Y . Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. Lancet. 2010; 376(9734):23-32. DOI: 10.1016/S0140-6736(10)60835-5. View

13.

Staat M, McQuillan G, Kaslow R . A population-based serologic survey of Helicobacter pylori infection in children and adolescents in the United States. J Infect Dis. 1996; 174(5):1120-3. DOI: 10.1093/infdis/174.5.1120. View

14.

Hoylaerts M, Lijnen H, Collen D . Studies on the mechanism of the antifibrinolytic action of tranexamic acid. Biochim Biophys Acta. 1981; 673(1):75-85. View

15.

Lukes A, Moore K, Muse K, Gersten J, Hecht B, Edlund M . Tranexamic acid treatment for heavy menstrual bleeding: a randomized controlled trial. Obstet Gynecol. 2010; 116(4):865-875. DOI: 10.1097/AOG.0b013e3181f20177. View

16.

Sadic J, Borgstrom A, Manjer J, Toth E, Lindell G . Bleeding peptic ulcer - time trends in incidence, treatment and mortality in Sweden. Aliment Pharmacol Ther. 2009; 30(4):392-8. DOI: 10.1111/j.1365-2036.2009.04058.x. View

17.

Crescenti A, Borghi G, Bignami E, Bertarelli G, Landoni G, Casiraghi G . Intraoperative use of tranexamic acid to reduce transfusion rate in patients undergoing radical retropubic prostatectomy: double blind, randomised, placebo controlled trial. BMJ. 2011; 343:d5701. PMC: 3198510. DOI: 10.1136/bmj.d5701. View

18.

Rockall T, Logan R, Devlin H, Northfield T . Incidence of and mortality from acute upper gastrointestinal haemorrhage in the United Kingdom. Steering Committee and members of the National Audit of Acute Upper Gastrointestinal Haemorrhage. BMJ. 1995; 311(6999):222-6. PMC: 2550278. DOI: 10.1136/bmj.311.6999.222. View

19.

von Holstein C, Eriksson S, Kallen R . Tranexamic acid in gastric and duodenal bleeding. Scand J Gastroenterol Suppl. 1987; 137:71-4. DOI: 10.3109/00365528709089767. View

20.

Chung S, Lau J, Sung J, Chan A, Lai C, Ng E . Randomised comparison between adrenaline injection alone and adrenaline injection plus heat probe treatment for actively bleeding ulcers. BMJ. 1997; 314(7090):1307-11. PMC: 2126544. DOI: 10.1136/bmj.314.7090.1307. View