REBEL Cast Ep85 - June 27, 2020 - By Salim Rezaie
"Paper: The HALT-IT Trial Collaborators. Effects of High-Dose 24-h Infusion of Tranexamic Acid on Death and Thromboembolic Events in Patients with Acute Gastrointestinal Bleeding (HALT-IT): An International Randomised, Double-Blind, Placebo-Controlled Trial. Lancet 2020. [Epub Ahead of Print]
Clinical Question: Does IV tranexamic acid reduce 5-day death due to bleeding in adult patients with acute gastrointestinal hemorrhage compared to placebo?
Author Conclusion: “We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomized trial.”
Clinical Take Home Point: This is a very well done, large, multicenter randomized controlled trial of TXA vs placebo for acute GIB. The results demonstrate no benefit of giving TXA on 5d mortality in patients with acute GIB and a small signal of harm with increased VTE and seizures. TXA should not be recommended at this time for patients with acute GIB."