[Skip to Navigation]
Sign In
Views 542
Citations 0
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.

Add or change institution
Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words