The effectiveness of oral tranexamic acid (TXA) for the treatment of recurrent epistaxis in HHT patients

Introduction:

Hereditary hemorrhagic telangiectasia is an autosomal dominant hereditary disease of the vascular connective tissue. Tranexamic acid is a synthetic derivate of the amino acid lysine. The antifibrinolytic effect is based on the reversible blockage of the lysine binding site on the plasminogen molecule.

Method:

We have been treating 58 patients with Osler's disease over a period of eight years. Excluded from the study were minors, pregnant women, patients with thrombosis or varicosity, renal insufficiency or massive hematuria, patients with malignant processes and patients who did not wish to receive therapy. All patients received the same tranexamic acid scheme: 3 tablets 3 times daily for one week followed by 2 tablets 3 times daily for another week and then 1 tablet 3 times a day ongoing. It is a retrospective study based on a telephone survey. The effect of the tranexamic acid on the duration, intensity and frequency of recurrent epistaxis was investigated.

Results:

Out of the total of 58 patients, the treatment attempt was performed in 35 of the cases.8 patients did not wish the therapy and 15 had contraindications. Out of a total of 35 patients receiving treatment,63% reported efficacy in terms of recurrent epistaxis, reduction in the need for inpatient treatment, and a reduction of blood transfusions. In 30% of the patients a reduction in epistaxis duration was reported, in 25% a decrease in epistaxis intensity and in 10% of patients a decrease in epistaxis frequency.

Conclusion:

The oral application of tranexamic acid in patients with HHT showed a positive effect in terms of reducing the duration and intensity of the nosebleeds. All treated patients reported a significant increase in quality of life.

Publication History

Publication Date:
18 April 2018 (online)