Study: Drug to treat bleeding may reduce stroke deaths

By Allen Cone  |  May 16, 2018 at 11:37 AM
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May 16 (UPI) -- A drug used to treat blood loss from major trauma and bleeding after childbirth might benefit stroke victims who are bleeding on the brain, an international trial has revealed.

Researchers at the University of Nottingham in Britain found that tranexamic acid reduced the number of deaths in the early days after people had experienced intracerebral hemorrhage. They also found the amount of bleeding in the brain and number of associated serious complications were lower among those who used the drug, whose brand name is Cyklokapron.

The findings were published Tuesday in the medical journal The Lancet and presented at the fourth European Stroke Conference in Gothenburg, Sweden.

The two kinds of strokes are hemorrhagic and ischemia, which is generally caused by problems with blood vessels and disrupts tissues. In a hemorrhagic stroke, a brain aneurysm bursts or a weakened blood vessel leaks. Then blood spills into or around the brain, creating swelling and pressure, and damaging cells and tissue in the brain.

Only 15 percent of all strokes are hemorrhagic but they are responsible for about 40 percent of all stroke deaths, according to the National Stroke Association.

Ischemia strokes can be treated successfully with the use of clot-busting drugs -- called thrombolysis -- administered within 4.5 hours of the stroke but there is no specific treatment for hemorrhagic strokes.

"Tranexamic acid is cheap -- costing less than £15 per patient [$20] and widely available so has the potential for reducing death and disability across the world," trial leader Dr. Nikola Sprigg, professor of stroke medicine at the university's Division of Clinical Neuroscience, said in a press release.

The TICH-2 trial recruited 2,325 patients from 124 hospitals in 12 countries between 2013 and 2017. One group received TXA within eight hours of their stroke and another was given a saline placebo.

CT scans were performed 24 hours after their stroke and their progress was checked daily during the first week. A final followup was performed at 90 days.

"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 the TXA group, there were fewer deaths one week after the stroke and at the second day, fewer experienced a worsening of the bleed on their brain and had smaller amounts of blood in the brain compared to the control group.

Also, not as many patients experienced serious complications such as pneumonia and brain swelling.

In addition, researchers found TXA might be more effective in patients with lower blood pressure.

In this study, one-third of patients were given the drug within three hours of stroke onset.

"More trials are needed, particularly focusing on giving treatment as soon as possible after the start of bleeding in this emergency condition," Sprigg said.

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