Anti-inflammatory effect of multi-dose tranexamic acid in hip and knee arthroplasty: a systematic review and meta-analysis of randomized controlled trials.

IF 4.6 2区医学 Q2 IMMUNOLOGY

Inflammopharmacology Pub Date : 2025-03-01 Epub Date: 2025-02-24 DOI:10.1007/s10787-025-01679-0

Chen Rui, Guangchun Dai, Chuwei Tian, Shaoyang Zhou, Yucheng Gao, Mumin Cao, Wei Wu, Shengbo Qin, Yunfeng Rui

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引用次数: 0

Abstract

Background: Tranexamic acid (TXA) is considered a potential therapeutic approach to mitigate postoperative inflammatory responses; however, its anti-inflammatory effects remain controversial. This study conducts a systematic review and meta-analysis of randomized controlled trials aiming to investigate the efficacy of multi-dose TXA in exerting anti-inflammatory effects in hip and knee arthroplasty.

Methods: We identified potential relevant literature evaluating the anti-inflammatory effects of TXA in patients undergoing hip and knee arthroplasty from PubMed, Embase, and the Cochrane Library. Meta-analysis was performed using RevMan 5.3.

Results: Nine randomized controlled studies met the inclusion criteria. Meta-analysis results indicated that, compared with lower doses of TXA, multi-dose TXA significantly reduced the inflammatory markers IL-6 and CRP in patients undergoing hip and knee arthroplasty and shortened the length of hospital stay, with statistically significant results. Nonsignificant differences were found in the incidence of thromboembolic events.

Conclusion: Based on the current evidence, our results indicate that multi-dose TXA effectively reduces postoperative inflammatory responses in patients undergoing hip and knee arthroplasty. This anti-inflammatory effect is dose-dependent and is accompanied by a reduction in the length of hospital stay. Nonetheless, further high-quality, multicenter, large-sample-size randomized controlled trials are needed to confirm the anti-inflammatory effects of TXA.

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多剂量氨甲环酸在髋关节和膝关节置换术中的抗炎作用：随机对照试验的系统回顾和荟萃分析。

背景：氨甲环酸（TXA）被认为是缓解术后炎症反应的潜在治疗方法；然而，它的抗炎作用仍然存在争议。本研究对随机对照试验进行系统回顾和荟萃分析，旨在探讨多剂量TXA在髋关节和膝关节置换术中发挥抗炎作用的疗效。方法：我们从PubMed、Embase和Cochrane图书馆中寻找评估TXA对髋关节和膝关节置换术患者抗炎作用的潜在相关文献。采用RevMan 5.3进行meta分析。结果：9项随机对照研究符合纳入标准。meta分析结果显示，与低剂量的TXA相比，多剂量TXA可显著降低髋关节置换术患者的炎症标志物IL-6和CRP，缩短住院时间，结果具有统计学意义。血栓栓塞事件的发生率无显著差异。结论：基于目前的证据，我们的研究结果表明，多剂量的TXA可以有效地减轻髋关节和膝关节置换术患者的术后炎症反应。这种抗炎作用是剂量依赖性的，并伴随着住院时间的缩短。然而，还需要进一步的高质量、多中心、大样本的随机对照试验来证实TXA的抗炎作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Inflammopharmacology IMMUNOLOGYTOXICOLOGY-TOXICOLOGY

CiteScore

8.00

自引率

3.40%

发文量

200

期刊介绍： Inflammopharmacology is the official publication of the Gastrointestinal Section of the International Union of Basic and Clinical Pharmacology (IUPHAR) and the Hungarian Experimental and Clinical Pharmacology Society (HECPS). Inflammopharmacology publishes papers on all aspects of inflammation and its pharmacological control emphasizing comparisons of (a) different inflammatory states, and (b) the actions, therapeutic efficacy and safety of drugs employed in the treatment of inflammatory conditions. The comparative aspects of the types of inflammatory conditions include gastrointestinal disease (e.g. ulcerative colitis, Crohn''s disease), parasitic diseases, toxicological manifestations of the effects of drugs and environmental agents, arthritic conditions, and inflammatory effects of injury or aging on skeletal muscle. The journal has seven main interest areas: -Drug-Disease Interactions - Conditional Pharmacology - i.e. where the condition (disease or stress state) influences the therapeutic response and side (adverse) effects from anti-inflammatory drugs. Mechanisms of drug-disease and drug disease interactions and the role of different stress states -Rheumatology - particular emphasis on methods of measurement of clinical response effects of new agents, adverse effects from anti-rheumatic drugs -Gastroenterology - with particular emphasis on animal and human models, mechanisms of mucosal inflammation and ulceration and effects of novel and established anti-ulcer, anti-inflammatory agents, or antiparasitic agents -Neuro-Inflammation and Pain - model systems, pharmacology of new analgesic agents and mechanisms of neuro-inflammation and pain -Novel drugs, natural products and nutraceuticals - and their effects on inflammatory processes, especially where there are indications of novel modes action compared with conventional drugs e.g. NSAIDs -Muscle-immune interactions during inflammation [...]