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Comment & Response
September 1, 2021

Importance of the Assessment Time Window for Intravenous Tranexamic Acid and Thromboembolic Events

Author Affiliations
  • 1Department of Obstetrics and Gynecology, Bordeaux University Hospital, Bordeaux, France
  • 2EPOPé Team, INSERM, Paris University, Paris, France
JAMA Surg. 2022;157(1):79-80. doi:10.1001/jamasurg.2021.4138

To the Editor We congratulate Taeuber and colleagues1 for their systematic review and meta-analysis of 216 studies suggesting that intravenous tranexamic acid (TXA), irrespective of dosing, is not associated with an increased risk of any thromboembolic events. However, as emphasized by the authors, the assessment period of the thrombotic complications widely varied between trials from 24 hours to several months.1 For example, in the obstetrical context, although women have an excess risk of thromboembolic events up to 12 weeks after delivery compared with individuals who are not pregnant,2 almost all trials testing the effect of TXA at delivery assessed thromboembolic events only, at best, until hospital discharge.3 Taeuber and colleagues speculated that intravenous TXA-related adverse events would be detected within a short period of follow-up because its half-life is only a few hours.1 We would like to warn against this assertion.

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