Tranexamic acid may be a useful pharmacotherapy for endoscopically resistant small bowel angiodysplasia

Table 1 Mechanisms of drugs used to treat gastrointestinal angiodysplasia and the main studies

Drug/therapy	Mechanism	Leading clinical trial	No. of cases	Result	Ref.
Hormone therapy	Enhanced coagulability
		Double-blind, placebo-controlled, crossover trial for GIAD	10	Effective	[20]
		Prospective observational study for OGIB	43	Effective	[21]
		Double-blind RCT for GIAD	72	Not effective	[22]
		Systematic review for GIAD	63	Not effective	[27]
		Comparing before and after therapy for GIAD	12	Effective	[23]
Somatostatin analogs	Inhibition of angiogenic promoters
	Relaxation of intestinal smooth muscle	RCT for gastrointestinal bleeding due to GIAD	70	Effective	[25]
		Systematic review for GIAD	72	Effective	[27]
		Systematic review for GIAD	212	Effective	[26]
Thalidomide	Anti-angiogenic agent
		RCT for GIAD	55	Effective	[30]
VEGF-neutralizing antibodies	Angiogenesis inhibition
		Only case reports
Tranexamic acid	Antifibrinolytic effects
		Observational study for GAVE	8	Effective	[51]
		Retrospective study for HHT	42	Effective	[12]

OGIB: Obscure gastrointestinal bleeding; GAVE: Gastric antral vascular ectasia; HHT: Hereditary hemorrhagic telangiectasia; GIAD: Gastrointestinal angiodysplasia; RCT: Randomized control trial; VEGF: Vascular endothelial growth factor.