Hemoglobin reduction, total blood loss similar between oral and intravenous TXA use in primary TKA

DALLAS — Data presented here at the American Association of Hip and Knee Surgeons Annual Meeting indicated both hemoglobin reduction and total blood loss were comparable between patients who were administered tranexamic acid either orally or intravenously during primary total knee arthroplasty.

A switch “from [intravenous administration] to oral would provide us a cost savings of $23 million to $67 million per year to the health care system, and we as surgeons are the ones who are ordering the medications [that] can drive this reduction in cost,” Yale A. Fillingham, MD, said in his presentation of the James R. Rand Award-winning study.

Fillingham and colleagues evaluated 73 patients of similar demographics who underwent primary total knee arthroplasty (TKA). Patients were separated by whether they were given either 1 g of tranexamic acid (TXA) intravenously (36 patients) or 1.95 g orally (32 patients) before wound closure. Reduction of hemoglobin was the primary metric of the study.

Yale A. Fillingham

No significant difference in reduction of hemoglobin or total blood loss was observed between the oral and intravenous (IV) cohorts. Transfusions were performed in one patient from each cohort, and no thromboembolic occurrences were observed.

There were five patients excluded from the study due to protocol deviation.

“Given that current practice trends are requiring treatments to both be clinically and cost-effective, the lower price of oral TXA and the ease of dosing make it a superior alternative to the more expensive IV formulations,” Fillingham said. — by Christian Ingram

Reference:

Fillingham YA, et al. A randomized controlled trial of oral and IV tranexamic acid: The same efficacy at lower cost? Presented at: American Association of Hip and Knee Surgeons Annual Meeting. Nov. 6-8, 2015; Dallas.

Disclosure: Fillingham reports no relevant financial disclosures.