Effects of a 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

HALT-IT Trial Collaborators. Lancet 2020; 395; 1927-36. doi:10.1016/S0140-6736(20)30848-5

Clinical Question

• In patients with gastrointestinal (GI) bleeding does high dose tranexamic acid (TXA) when compared to a placebo reduce mortality from GI bleeding?
  N = 12009, 164 hospitals in 15 countries

Authors’ Conclusions

• TXA does not reduce death from GI bleeding and should not be used as part of a uniform approach to treat GI bleeding

The Bottom Line

• Despite the weaknesses above this is a very well designed, large trial. A “negative” trial of this magnitude is clinically important and following this I won’t be using TXA in my management of GI bleeding.
• Future trials (PATCH) will provide further information on TXA and it’s side effect profile