A single dose of a cheap, decades-old drug could save thousands of lives each year from catastrophic bleeding. The HAEM project will run large-scale clinical trials to find out whether tranexamic acid (TXA) — already proven to reduce deaths in trauma patients — also works for three other major causes of fatal bleeding: bleeding in the brain (intracranial haemorrhage), bleeding from the gut (gastrointestinal haemorrhage), and bleeding after childbirth (postpartum haemorrhage). Together, these conditions kill and disable huge numbers of people in the UK and worldwide. TXA costs pennies per dose and has no known serious side effects. If the trials confirm it works for these new indications, the public health benefit could be enormous — a safe, cheap treatment that could be deployed immediately in emergency departments and maternity units everywhere. The research team has already built an international network of emergency care trialists and has run successful proof-of-concept studies. The challenge now is to resolve the uncertainty with definitive evidence.
View original technical description
Acute severe haemorrhage is a major cause of mortality and morbidity in the UK and globally. Traumatic intracranial, gastrointestinal and postpartum haemorrhage, taken together, account for an enormous disease burden, causing many premature deaths, and in the case of intracranial bleeding, results in a large number of patients with long term disability. Recent results from the CRASH-2 trial show that tranexamic acid (TXA) significantly reduces mortality and morbidity in bleeding trauma patients, with no evidence of any increased risk of vascular occlusive events. TXA is not a new drug and is widely used in elective surgery to reduce bleeding. However, its repurposing for new indications has the potential to yield large public health benefits at low cost. If TXA also reduces mortality and morbidity in intracranial, gastrointestinal and postpartum bleeding this would be an important discovery. Systematic reviews of the existing evidence on TXA in these conditions and recent proof of concept studies conducted by the applicants provide firm grounds for optimism. The challenge is to conduct the clinical trials needed to resolve the uncertainty and confirm or refute such treatment effects. The applicants have established an extensive international network of emergency care trialists and have the experience and expertise needed to conduct these large trials.
Plain English summaries and category classifications on this site are generated by AI and may not perfectly reflect the original research.
Is something wrong? Let us know