The quality of evidence is downgraded by imprecise results (few patients and outcome events) and by indirectness (differences between the population of interest and those studied).
A Cochrane review [Abstract] 1 included 2 studies with a total of 70 subjects to evaluate the effectiveness and safety of antifibrinolytic agents in reducing the volume and duration of haemoptysis in adult and paediatric patients.
One trial evaluated the effectiveness of tranexamic acid (TXA) administered orally in 46 hospital in- and outpatients with haemoptysis of various etiologies. Another RCT performed in Peru evaluated the effectiveness of intravenous TXA in 24 hospitalised patients presenting with haemoptysis secondary to tuberculosis.
Pooled together, results demonstrated a significant reduction in bleeding time between patients receiving TXA and patients receiving placebo with a weighted mean difference (WMD) of -19.47 (95% CI -26.90 to -12.03 hours), but with high heterogeneity (I² = 52%). No differences in remission rates at seven days were found between the patients receiving antifibrinolytics and the patients receiving placebo (OR 1.56, 95% CI 0.44 to 5.46). Adverse effects caused by the drug's mechanism of action were not reported. There was no significant difference in the incidence of mild side effects between active and placebo groups (OR 3.13, 95% CI 0.80 to 12.24).
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