Tranexamic acid and trauma

To the Editor: Gruen and colleagues’ editorial1 contained a number of claims that are unsubstantiated.

Clinical Trials Unit, London School of Hygiene and Tropical Medicine, London, United Kingdom.

Correspondence: ian.roberts@lshtm.ac.uk

Competing interests:

I was the clinical coordinator and principal investigator of the CRASH-2 trial.

1. Gruen RL, Jacobs IG, Reade MC; PATCH-Trauma study investigators. Trauma and tranexamic acid. Med J Aust 2013; 199: 310-311. <eMJA full text> <MJA full text>
2. Ker K, Edwards P, Perel P, et al. Effect of tranexamic acid on surgical bleeding: systematic review and cumulative meta-analysis. BMJ 2012; 344: e3054.
3. Roberts I, Shakur H, Ker K, Coats T; CRASH-2 Trial collaborators. Antifibrinolytic drugs for acute traumatic injury. Cochrane Database Syst Rev 2011; (1): CD004896.
4. British Forces News. Injured soldiers in Afghanistan saved by clotting drug [video]. 19 Jan 2011. http://www.youtube.com/watch?v=oj6P2cwwRYw (accessed Feb 2014).
5. Committee on Tactical Combat Casualty Care. Tranexamic acid (TXA) in tactical combat casualty care [guideline revision recommendation]. 11 Aug 2011. http://emcrit.org/wp-content/uploads/2012/02/TXA-in-tac-combat-casualty-care.pdf (accessed Feb 2014).
6. Roberts I, Shakur H, Coats T, et al. The CRASH-2 trial: a randomised controlled trial and economic evaluation of the effects of tranexamic acid on death, vascular occlusive events and transfusion requirement in bleeding trauma patients. Health Technol Assess 2013; 17: 1-79.
7. Prieto-Merino D, Smeeth L, Staa TPV, Roberts I. Dangers of non-specific composite outcome measures in clinical trials. BMJ 2013; 347: f6782.

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