Clinical Trial: Topical Intranasal Tranexamic Acid for Epistaxis in the Emergency Department

Study Status: Recruiting
Recruit Status: Recruiting
Study Type: Interventional

Official Title: Topical Intranasal Tranexamic Acid for Epistaxis in the Emergency Department

Brief Summary: It is estimated that epistaxis results in 4.5 million emergency department visits per year throughout the United States. Due to the adverse effects of standard treatment options for epistaxis, tranexamic acid (TXA) may be considered an attractive option. In previous studies, when used with nasal packing, TXA showed faster time to control of bleeding. The goal of this study is to determine the efficacy and safety of topical intranasal TXA applied via atomizer for patients with epistaxis who present to the emergency department.

Detailed Summary:

This is a prospective, randomized, single-center, double-blinded, placebo controlled study comparing efficacy and safety of topical intranasal tranexamic acid for epistaxis. The primary outcome was time to control of bleeding and secondary outcomes were length of stay in the emergency department, re-bleeding within the first 24 hours, and re-bleeding at one week. Safety outcomes were the incidence of thromboembolic events and other drug-related adverse events.

Patients aged 18 years of age or older and diagnosed with anterior epistaxis were included. Patients were excluded if they were unable to consent, do not have a valid telephone number, pregnant women, prisoners, cognitively impaired individuals, diagnosis of posterior epistaxis, major trauma, bleeding disorder (such as thrombocytopenia or hemophilia), hemodynamically unstable, or had a known hypersensitivity to study medication.

Patients were randomly assigned to tranexamic acid treatment group or placebo group. After consenting, patients received TXA (100 mg/1mL) or 0.9% sodium chloride (1 mL) in to the affected nostril(s) via intranasal atomization device. If bleeding did not cease, two repeat doses were allowed and after twenty minutes of continued bleeding the study physician could treat with any additional treatment options. Patients were contacted via telephone within one week to inquire about incidences of re-bleeding or any complications.


Sponsor: University of California, Davis

Current Primary Outcome: Time to control of bleeding [ Time Frame: 7 days ]

Original Primary Outcome: Same as current

Current Secondary Outcome:

  • Length of stay in the Emergency Department [ Time Frame: 1 day ]
  • Re-bleeding within the first 24 hours [ Time Frame: 24 hours ]
  • Re-bleeding within the first week [ Time Frame: 7 days ]
  • Incidence of thromboembolic events [ Time Frame: 7 days ]
  • Incidence of drug-related events [ Time Frame: 7 days ]


Original Secondary Outcome: Same as current

Information By: University of California, Davis

Dates:
Date Received: October 10, 2016
Date Started: February 2016
Date Completion: January 2019
Last Updated: February 13, 2017
Last Verified: February 2017