Oral Tranexamic Acid vs. Oral Aminocaproic Acid to Reduce Blood Loss and Transfusion After Total Knee Replacement.

Summary

This study compares two oral medications (tranexamic acid and aminocaproic acid) as hemostatic agent administered in patients undergoing total knee replacement.

Timeline

Start

2017-10-15

Primary completion

2019-07-01

Completion

2019-07-01

Outcome

Mixed primary results

paper Primary outcome measures included transfusions, estimated blood loss, and the drop in the hemoglobin (Hgb) level. PMID 28976426 ↗

paper Although the patients who received TXA averaged less estimated blood loss than the patients who received EACA (t185 = 2.18, p = 0.031; PMID 28976426 ↗

paper no transfusions were required in either group. PMID 28976426 ↗

paper We observed no statistically significant or clinically relevant between-group differences in the change in Hgb PMID 28976426 ↗

Publications

• Results Boese CK, Centeno L, Walters RW. Blood Conservation Using Tranexamic Acid Is Not Superior to Epsilon-Aminocaproic Acid After Total Knee Arthroplasty. J Bone Joint Surg Am. 2017 Oct 4;99(19):1621-1628. doi: 10.2106/JBJS.16.00738.
• Results Harper RA, Sucher MG, Giordani M, Nedopil AJ. Topically Applied Epsilon-Aminocaproic Acid Reduces Blood Loss and Length of Hospital Stay After Total Knee Arthroplasty. Orthopedics. 2017 Nov 1;40(6):e1044-e1049. doi: 10.3928/01477447-20170925-07. Epub 2017 Oct 3.
• Results Hobbs JC, Welsby IJ, Green CL, Dhakal IB, Wellman SS. Epsilon Aminocaproic Acid to Reduce Blood Loss and Transfusion After Total Hip and Total Knee Arthroplasty. J Arthroplasty. 2018 Jan;33(1):55-60. doi: 10.1016/j.arth.2017.08.020. Epub 2017 Aug 24.
• Results Churchill JL, Puca KE, Meyer E, Carleton M, Anderson MJ. Comparing epsilon-Aminocaproic Acid and Tranexamic Acid in Reducing Postoperative Transfusions in Total Knee Arthroplasty. J Knee Surg. 2017 Jun;30(5):460-466. doi: 10.1055/s-0036-1593362. Epub 2016 Oct 3.
• Results Banerjee S, Issa K, Pivec R, McElroy MJ, Khanuja HS, Harwin SF, Mont MA. Intraoperative pharmacotherapeutic blood management strategies in total knee arthroplasty. J Knee Surg. 2013 Dec;26(6):379-85. doi: 10.1055/s-0033-1353992. Epub 2013 Aug 16.
• Results Sepah YJ, Umer M, Ahmad T, Nasim F, Chaudhry MU, Umar M. Use of tranexamic acid is a cost effective method in preventing blood loss during and after total knee replacement. J Orthop Surg Res. 2011 May 21;6:22. doi: 10.1186/1749-799X-6-22.
• Results Camarasa MA, Olle G, Serra-Prat M, Martin A, Sanchez M, Ricos P, Perez A, Opisso L. Efficacy of aminocaproic, tranexamic acids in the control of bleeding during total knee replacement: a randomized clinical trial. Br J Anaesth. 2006 May;96(5):576-82. doi: 10.1093/bja/ael057. Epub 2006 Mar 10.
• Results Ahlberg A. Diffusion of epsilon aminocaproic acid to the joints. Proc Soc Exp Biol Med. 1970 Sep;134(4):988-9. doi: 10.3181/00379727-134-34927. No abstract available.

Drugs

Evaluation	Drug	Modality	Dose	Route
Subject	Aminocaproic Acid	Small molecule	1 g	Oral
Comparator	Tranexamic Acid	Small molecule	1.3 g	Oral

Indications