Tranexamic acid-induced anaphylaxis: a systematic review.

IF 2.4 3区医学 Q3 PHARMACOLOGY & PHARMACY

European Journal of Clinical Pharmacology Pub Date : 2025-08-01 Epub Date: 2025-06-02 DOI:10.1007/s00228-025-03857-z

Pei-Shuang Lin, Yun-Tai Yao, Alparslan Turan, Daniel I Sessler

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引用次数: 0

Abstract

Purpose: Tranexamic acid (TXA) is a synthetic antifibrinolytic agent widely used in a diverse range of hemorrhagic scenarios. Despite documented superior safety profile, increasing reports have emerged describing anaphylactic reactions to TXA. We reviewed reported cases of anaphylactic reactions to TXA and summarize their clinical characteristics, diagnosis and treatment protocols.

Methods: PubMed, Embase, Web of Science were searched with the terms "tranexamic acid", "antifibrinoly*", "anaphylaxis", "anaphylactic", "anaphylactoid", "allergy" and "hypersensitivity" to identify relevant case reports. Data were extracted and analyzed.

Results: Our review identified 15 cases of TXA-induced anaphylaxis. Patients were 2 to 80 years old, with 60.0% adults. The most common symptoms were hypotension, hypoxia and rash in an equal 66.7%, followed by tachycardia in 60.0%. TXA was confirmed as the culprit allergen in 73.3% of cases through allergological workup. Major treatments consisted of corticosteroids (80.0%), epinephrine (73.3%) and antihistamine (60.0%). While most patients recovered, 1 patient experienced recurrent anaphylaxis and 1 patient died.

Conclusions: Anaphylaxis to TXA is a rare drug adverse reaction with varying manifestations. Prompt recognition and appropriate treatment are critical in facilitating optimal outcomes.

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氨甲环酸致过敏反应：系统回顾。

目的：氨甲环酸（TXA）是一种合成抗纤溶药物，广泛用于各种出血情况。尽管有文献记载的优越的安全性，越来越多的报告出现了对TXA的过敏反应。我们回顾报道的TXA过敏反应病例，总结其临床特点、诊断和治疗方案。方法：检索PubMed、Embase、Web of Science，检索词为“氨甲环酸”、“抗纤溶酶*”、“过敏反应”、“过敏性”、“类过敏”、“变态反应”和“超敏反应”，查找相关病例报告。提取数据并进行分析。结果：我们的回顾确定了15例txa诱发的过敏反应。患者年龄2 ~ 80岁，成人占60.0%。最常见的症状是低血压、缺氧和皮疹（66.7%），其次是心动过速（60.0%）。通过过敏检查，73.3%的病例确认TXA为罪魁祸首过敏原。主要治疗方法为皮质激素（80.0%）、肾上腺素（73.3%）和抗组胺药（60.0%）。虽然大多数患者康复，但有1例患者出现复发性过敏反应，1例患者死亡。结论：TXA过敏反应是一种少见且表现多样的药物不良反应。及时识别和适当治疗是促进最佳结果的关键。

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

European Journal of Clinical Pharmacology 医学-药学

CiteScore

5.40

自引率

3.40%

发文量

170

审稿时长

3-8 weeks

期刊介绍： The European Journal of Clinical Pharmacology publishes original papers on all aspects of clinical pharmacology and drug therapy in humans. Manuscripts are welcomed on the following topics: therapeutic trials, pharmacokinetics/pharmacodynamics, pharmacogenetics, drug metabolism, adverse drug reactions, drug interactions, all aspects of drug development, development relating to teaching in clinical pharmacology, pharmacoepidemiology, and matters relating to the rational prescribing and safe use of drugs. Methodological contributions relevant to these topics are also welcomed. Data from animal experiments are accepted only in the context of original data in man reported in the same paper. EJCP will only consider manuscripts describing the frequency of allelic variants in different populations if this information is linked to functional data or new interesting variants. Highly relevant differences in frequency with a major impact in drug therapy for the respective population may be submitted as a letter to the editor. Straightforward phase I pharmacokinetic or pharmacodynamic studies as parts of new drug development will only be considered for publication if the paper involves -a compound that is interesting and new in some basic or fundamental way, or -methods that are original in some basic sense, or -a highly unexpected outcome, or -conclusions that are scientifically novel in some basic or fundamental sense.