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Tranexamic acid for hyperacute primary intracerebral haemorrhage (TICH-2)

Tranexamic acid (TXA) is a drug that is commonly used to treat blood loss from major trauma and bleeding after childbirth.

Led by the University of Nottingham, a new international study investigated whether patients with a spontaneous bleed in the brain (or intracerebral haemorrhage, which is a type of stroke) could benefit from this drug, when delivered as an emergency treatment. 

The results were presented on Thursday 16 May at the European Stroke Organisation Conference in Gothenburg, Sweden, and also published in The Lancet, journal.

The study

The main outcome of the study was to discover if patients who received tranexamic acid had a better outcome with less disability at 90 days after their stroke, than those who received the dummy drug. The study recruited 2,325 participants. 1161 were randomly assigned to receive tranexamic acid, and 1164 a dummy (placebo) drug.  

The study did not find any significant differences between the outcomes in the tranexamic acid and dummy drug groups at 90 days after stroke. However, the study did find that there were fewer deaths and serious adverse events in the tranexamic acid group, in the first seven days after their stroke, than the dummy drug group.

Juliet Bouverie, Chief Executive at the Stroke Association, which co-funded the initial, pilot phase of the research, said:

“There are over 15,000 strokes in the UK caused by brain haemorrhage each year. Though these account for only 15% of all strokes, they are more likely to be fatal or cause serious disability.

“Currently, treatment for haemorrhagic stroke is very limited so we are excited by the findings of this study into haemorrhage (bleeding) that happens within the brain.  We hope there will now be further research into how this relatively cheap and widely available drug could be used to potentially save lives and improve long-term recovery from this type of stroke. Haemorrhagic stroke continues to be seriously underfunded and under researched and that’s why it has been and continues to be a research priority for the charity.”

The TICH-2 study was funded by the National Institute of Health Research (NIHR) in the UK.

Professor Nikki Sprigg, University of Nottingham, interviewed on TICH-2 trial results