Methodology: 4/5
Usefulness: 4/5

HALT-IT Trial Collaborators. Lancet. 2020 Jun 20;395(10241):1927-1936

Questions and Methods: This was an international, randomized, double-blind, placebo-controlled trial with the objective to quantify the effect of TXA on death due to bleeding in acute GI bleeds.

Findings: Death due to bleeding at 5 days was similar between both groups (3.7% vs. 3.8% for TXA vs. placebo, respectively, RR 0.99) with a small increased risk of VTE in the TXA group (0.8% for TXA versus 0.4% in placebo).

Limitations: Although the biggest flaw in this study was the change in the primary outcome from all cause-mortality to death due to bleeding, this did not significantly change the study results.

Interpretation: Overall this is a well-designed RCT. Based on this trial’s results, we should not be routinely using TXA for patients with acute GI bleeding.

By: Dr. Renee Bradley

Hans Rosenberg
Dr. Rosenberg is an emergency physician at the Ottawa Hospital, assistant professor at the University of Ottawa, and Director of the Digital Scholarship and Knowledge Dissemination Program.