TY - JOUR T1 - No role for tranexamic acid in the treatment of acute gastrointestinal bleeding JF - BMJ Evidence-Based Medicine JO - BMJ EBM DO - 10.1136/bmjebm-2020-111498 SP - bmjebm-2020-111498 AU - Vishakha Erasu AU - Alex Novak Y1 - 2020/10/21 UR - http://ebm.bmj.com/content/early/2020/10/21/bmjebm-2020-111498.abstract N2 - The HALT-IT Trial has shown that tranexamic acid does not improve outcome in acute gastrointestinal bleeding and may instead increase the risk of complications.Tranexamic acid (TXA) is an antifibrinolytic drug proven to reduce death due to bleeding in trauma,1 postpartum haemorrhage2 and head injury.3 A Cochrane meta-analysis of 1701 patients showed a large reduction in all-cause mortality with the use of TXA in upper gastrointestinal bleeding.4 The HALT-IT trial was planned as an international, multicentre, randomised, double-blind, placebo-controlled trial to evaluate the effect of TXA in acute upper and lower gastrointestinal bleeding.5The trial was done across 164 hospitals in 15 countries and randomised patients to either receive TXA (1 g loading dose over 10 min followed by 3 g infusion over 24 hours) or placebo (0.9% normal saline). Adults (16 years and older or 18 years and older, depending on national guidance) with clinically significant gastrointestinal bleeding were eligible for inclusion if the responsible clinician was substantially uncertain whether to use TXA for the gastrointestinal bleed. Significant bleeding was defined … ER -