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World J Clin Cases. Dec 16, 2014; 2(12): 893-898
Published online Dec 16, 2014. doi: 10.12998/wjcc.v2.i12.893
Published online Dec 16, 2014. doi: 10.12998/wjcc.v2.i12.893
Table 1 Summary of the selected studies
Ref. | Country | Type of study | Meanage | Symptom-atology | Participants | Aim of thestudy | Regimenadministration | Results | Adverse effects | Comment |
Lakhani et al[10] | United Kingdom | Longitudinal Prospective | 42.8 | Menorrhagia Pelvic pain | n = 12 | Ultrasound assesment of PI and RI of UA in women with TA administration | Tranexamic acid P.O. 1 g x 3 for 2 cycles | No significant changes in blood loss or PI and RI | Not reported | No changes in UA-PI resistance in women with fibroids |
Caglar et al[11] | Turkey | Prospective randomized double-blind placebo | 34.2 | Menorrhagia Pelvic pain | n = 50 (TA) n = 50 (Placebo) | To compare the perioperative blood loss in patients undergoing myomectomy and taking TA with patients not taking TA | Tranexamic acid 10 mg/kg iv (max 1 g) 15 min before incision | Significant statistical differences in two groups postoperative, total blood loss and duration of surgery (P < 0.01) in favor of TA | Not reported | TA does not reduce perioperative blood loss nor Hb levels. It reduces postoperative and total blood loss and surgery time in correlation with myoma size. However further investigations required |
Ip et al[12] | Hong Kong | Observational | 43.8 ± 25 | Menorrhagia Pelvic pain | n = 22 | Pathology assesment of fibroid specimen in women receiving TA | Tranexamic acid Per os dosage not reported | Necrosis and infarcts in resected fibroids. Larger daimeter fibroids more prone to necrosis changes. Size is an independent factor | Not reported | Authors emphasize the necrosis and thrombosis in fibroids but suggest precaution for complications |
Lukes et al[14] | United States | Randomized double-blind placebo | 36.5 | Menorrhagia Pelvic pain | n = 42 (TA) n = 26 (Placebo) | To assess the efficacy and safety of TA for heavy menstrual bleeding | Tranexamic acid Per os 1.3 g daily for 5 d up to 6 cycles | Reduction in menstrual blood loss in women receiving TA compared to placebo. No statistically significant changes in blood loss in patients with fibroids | Mild adverse effects Menstrual cramps Gastrointestinal allergies | TA was effective in the treatment of heavy menstrual bleeding regardless of the presence or absence of fibroids |
Eder et al[13] | United States | Randomized double-blind placebo | 38 | Menorrhagia Pelvic pain | n = 96 (TA) n = 51 (Placebo) | To compare the menstrual blood loss in women with fibroids and TA and women with fibroids not taking TA. consisting placebo group | Tranexamic acid Per os 3.9 g/d for 5 d up to 6 menstrual cycles | Menstrual blood loss reduced in women receiving TA (P < 0.001) | 3 patients in TA group and 3 in placebo group reported headache | TA was well tolerated and reduced menstrual blood loss |
Table 2 Quality assessment of the studies according to Scottish Intercollegiate Guidelines Network guidelines
Ref. | Setting | Sign grade | Interpretation |
Lakhani et al[10] 1998 | University teaching hospital | 2+ | Well conducted study |
Caglar et al[11] 2007 | University teaching hospital | 2++ | High quality study |
Ip et al[12] 2007 | University teaching hospital | 2+ | Well conducted study |
Lukes et al[14] 2010 | University teaching hospital | 2++ | High quality study |
Eder et al[13] 2013 | Private research institution and University teaching hospital | 2++ | High quality study |
- Citation: Peitsidis P, Koukoulomati A. Tranexamic acid for the management of uterine fibroid tumors: A systematic review of the current evidence. World J Clin Cases 2014; 2(12): 893-898
- URL: https://www.wjgnet.com/2307-8960/full/v2/i12/893.htm
- DOI: https://dx.doi.org/10.12998/wjcc.v2.i12.893