Cheap drug that prevents bleeding may save 100,000 lives each year: Study

By Dr. Ananya Mandal, MDJun 14 2010

Dr Ananya Mandal, MD

Researchers have shown that a cheap and easy to use drug that stops bleeding may save up to 100,000 lives each year from injuries associated with road accidents and violence. The study was published this Tuesday in the acclaimed international journal The Lancet and was conducted by doctors at the London School of Hygiene and Tropical Medicine.

The researchers tested an off-patent treatment called tranexamic acid (TXA) among 20,000 severely-injured adults in 274 hospitals in 40 countries. This drug is widely available in its generic form and commonly given to women who experience heavy periods.

The study researchers found that more than a million died as a result of accidental or intentional injuries each year and any drug that can rapidly stop bleeding may be the answer. Lead author of the CRASH-2 international trial, Ian Roberts, a professor of epidemiology said, “Each year about 600,000 injured patients bleed to death worldwide… Injuries may be accidental, for example, road crashes, or intentional, such as shootings, stabbings or land-mine injuries, and the majority of deaths occur soon after injury.”

TXA aids in reducing the breakdown of clots and stops bleeding. One gram of this drug costs $4.50 and £3 in respective countries. It does not need to be refrigerated and is manufactured by many pharmaceutical companies.

The study involved administration of either one gram of TXA by injection followed by another one gram in a drip over the following eight hours, or a placebo with no medicinal properties. The analysis of results showed that TXA successfully reduced the risk of death due to any cause by 10 percent compared to placebo. TXA reduced risk of death by bleeding by 15 percent.

They found that this drug if widely available and used appropriately would save as many as 100,000 lives a year, 13,000 of them in India and 12,000 in China. The best feature of this drug was its versatility the authors said. This means that TXA could be used in any type of facility. Professor Roberts said, “TXA is one of the cheapest ways to save a life there is.”

The drug was also not associated with complications like increase in heart attacks, strokes and lung clots or pulmonary embolism, the study found. These complications are life threatening and are feared while using agents like TXA. This trial showed that such fears are unfounded.

Etienne Krug, director of violence and injury prevention and disability at the UN's World Health Organization (WHO) said, “The drug is inexpensive and could be given in hospitals worldwide…It is essential that doctors are aware of these results and take them into account in the emergency management of seriously injured patients.” The authors say that after this trial TXA merits a place in the WHO List of Essential Medicines. UK health minister Earl Howe applauded the effort and said that this was a “great example of how important research can help the NHS save more lives and spread best practice around the world.”

This trial was jointly funded by the National Institute for Health Research, part of the Department of Health, the drug company Pfizer, the BUPA Foundation and the JP Moulton Charitable Foundation.