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Effects of Tranexamic Acid on Hemoptysis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

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Abstract

Background

Hemoptysis, a common symptom of different lung diseases, engenders shortness of breath and increased mortality. Tranexamic acid (TXA), a commonly used antifibrinolytic agent, can control bleeding. However, the effects of its use on pulmonary hemorrhage have rarely been discussed.

Objective

We conducted this systematic review and meta-analysis of randomized controlled trials (RCTs) of TXA for hemoptysis to investigate its effectiveness in reducing hemoptysis volume and duration.

Methods

We searched the Cochrane Library, Embase, PubMed (including MEDLINE), and Scopus databases for relevant RCTs. Two of the authors individually assessed study quality by using the Cochrane risk-of-bias (RoB) 2.0 tool, and the pooled results were evaluated using RevMan 5.3.

Results

We obtained 617 articles, of which four RCTs met eligibility criteria. The pooled results demonstrated no significant differences in bleeding duration or hemoptysis resolution between the TXA and control groups. Nevertheless, TXA use reduced bleeding volume (mean difference [MD] =  − 56.21 mL; 95% CI − 94.70 to − 17.72 mL), further intervention risk (Peto odds ratio = 0.24; 95% CI 0.08–0.67; I2 = 0%), and length of hospital stay (MD =  − 1.62 days; 95% CI − 2.93 to − 0.31; I2 = 0%).

Conclusion

TXA use was observed to reduce bleeding volume, further intervention risk, and length of hospital stay in patients with hemoptysis; however, our results may have low statistical power because of limited sample size. Additional large-scale RCTs are thus warranted to confirm the effectiveness and safety of TXA use.

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Acknowledgements

We thank Winstun W. Shen for the constructive editing comments on a previous version of this manuscript.

Author information

Author notes

  1. Yi-San Tsai and Li-Wen Hsu contributed equally to this manuscript.

Authors and Affiliations

  1. Department of Nursing, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan

    Yi-San Tsai, Li-Wen Hsu & Kee-Hsin Chen

  2. Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan

    Yi-San Tsai

  3. Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan

    Yi-San Tsai

  4. Division of Gastroenterology, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan

    Ming-Shun Wu

  5. Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan

    Kee-Hsin Chen

  6. Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan

    Kee-Hsin Chen & Yi-No Kang

  7. Evidence-Based Knowledge Translation Center, Wan Fang Hospital, Taipei, Taiwan

    Kee-Hsin Chen

  8. Evidence-Based Medicine Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan

    Kee-Hsin Chen & Yi-No Kang

  9. Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan

    Yi-No Kang

  10. Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan

    Yi-No Kang

Authors
  1. Yi-San Tsai
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  2. Li-Wen Hsu
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  4. Kee-Hsin Chen
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Contributions

Conceptualization: LiWH, M-SW. Data curation: L-WH, Y-ST. Formal analysis: Y-NK. Investigation: Y-ST, L-WH, K-HC. Methodology: K-HC, Y-NK. Supervision: M-SW, K-HC. Visualization: Y-NK. Writing – original draft: Y-ST, L-WH. Writing – review and editing: K-HC, M-SW, Y-NK.

Corresponding authors

Correspondence to Kee-Hsin Chen or Yi-No Kang.

Ethics declarations

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Availability of data and material

All data generated or analyzed during this study are included in this published article.

Competing interests

Yi-San Tsai, RN, Li-Wen Hsu, RN, Ming-Shun Wu, PhD, Kee-Hsin Chen, PhD, and Yi-No Kang declare that they have no competing interest.

Funding

This study did not receive any funding.

Financial/nonfinancial disclosures

All authors declare that they have no financial or nonfinancial conflicts of interest to disclose.

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Cite this article

Tsai, YS., Hsu, LW., Wu, MS. et al. Effects of Tranexamic Acid on Hemoptysis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Clin Drug Investig 40, 789–797 (2020). https://doi.org/10.1007/s40261-020-00946-y

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  • DOI: https://doi.org/10.1007/s40261-020-00946-y

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