Ultra-early tranexamic acid after subarachnoid haemorrhage (ULTRA): a randomised controlled trial

Post, R. et al. Lancet 2021; 397:112-18. doi:10.1016/S0140-6736(20)32518-6]

Clinical Question

• In adults presenting with subarachnoid haemorrhage (SAH), does ultra early short term treatment with tranexamic acid improve clinical outcome at 6 months?

N = 950, 24 sites in Netherlands

Authors’ Conclusions

• The use of tranexamic acid after CT confirmation of SAH does not improve clinical outcome at 6months as measured by mRS

The Bottom Line

-  This study does not show any clear clinical benefit from tranexamic acid use in SAH.

• There may be some potential use of tranexamic acid in SAH in the future, when the patient group and timings are clearer. However, given the potential increased risk of delayed cerebral ischaemia I would not be routinely be using this in my practice