{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T11:56:10Z","timestamp":1769946970425,"version":"3.49.0"},"reference-count":32,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2016,3,18]],"date-time":"2016-03-18T00:00:00Z","timestamp":1458259200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2016,12]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The role of tranexamic acid in the management of epistaxis remains unclear. There is uncertainty about its safety and about the contraindications for its use. We performed a systematic review of the use of systemic and topical tranexamic acid in epistaxis and a comparative review of its use in other specialties.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective of review<\/jats:title><jats:p>This review assesses and summarises the existing evidence for the efficacy and safety of tranexamic acid in the management of epistaxis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Type of review<\/jats:title><jats:p>Systematic review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Search strategy<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">MEDLINE<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">EMBASE<\/jats:styled-content> were searched for \u2018epistaxis\u2019 and equivalent <jats:styled-content style=\"fixed-case\">MESH<\/jats:styled-content> terms, combined with the Boolean operator \u2018<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u2019 and \u2018tranexamic acid\u2019. The Cochrane library and society guidelines were reviewed for evidence regarding the use of tranexamic acid in other specialties.<\/jats:p><\/jats:sec><jats:sec><jats:title>Evaluation method<\/jats:title><jats:p>All five relevant <jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s were included in the review and were evaluated according to the recommendations of the Cochrane Handbook for Systematic Reviews.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Three <jats:styled-content style=\"fixed-case\">RCTS<\/jats:styled-content> pertained to spontaneous epistaxis; of these, one trial found no benefit of oral tranexamic acid in acute epistaxis, one trial found no significant benefit of topical tranexamic acid, but the largest of the trials showed significant benefit of topical tranexamic acid in acute epistaxis management. Two <jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s examined oral tranexamic acid for prophylaxis of recurrent epistaxes in patients with hereditary haemorrhagic telangiectasia; both showed significant reduction in severity and frequency.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Tranexamic acid, as a <jats:styled-content style=\"fixed-case\">WHO<\/jats:styled-content> \u2018essential medicine\u2019, is a powerful, readily available tool, the use of which in epistaxis has been limited by uncertainty over its efficacy and its safety profile. This systematic review summarises the existing evidence and extrapolates from the wealth of data for other specialties to address the clinical question \u2013 does <jats:styled-content style=\"fixed-case\">TXA<\/jats:styled-content> have a role in epistaxis management?<\/jats:p><\/jats:sec>","DOI":"10.1111\/coa.12645","type":"journal-article","created":{"date-parts":[[2016,3,6]],"date-time":"2016-03-06T07:52:30Z","timestamp":1457250750000},"page":"771-776","source":"Crossref","is-referenced-by-count":34,"title":["Tranexamic acid in epistaxis: a systematic review"],"prefix":"10.1111","volume":"41","author":[{"given":"Y.","family":"Kamhieh","sequence":"first","affiliation":[{"name":"ENT Department Royal Glamorgan Hospital Llantrisant Wales UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Fox","sequence":"additional","affiliation":[{"name":"ENT Department Royal Glamorgan Hospital Llantrisant Wales UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,3,18]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"129","article-title":"The frequency of epistaxis in a male population sample","volume":"13","author":"Petruson B.","year":"1975","journal-title":"Rhinology"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-199957060-00017"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00554669"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.I.01518"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(00)70139-5"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1552-4604.1987.tb05605.x"},{"key":"e_1_2_9_8_1","unstructured":"World Health Organisation 18th Expert Committee on the Selection and Use of Essential Medicines. 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