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To study the effectiveness of tranexamic acid (TXA) 10% mouthwash for bleeding after tooth extraction in patients with non-vitamin K oral anticoagulants (NOACs) therapy.
Patients with non-vitamin K oral anticoagulants usually
suffer from bleeding following tooth extraction. Although the tranexamic acid
10% mouthwash was no good for bleeding during the procedure or untimely
bleeding after the extraction as observed from this randomised study, but in
case of multiple teeth extractions, it lessened
delayed and post-operative bleeding.
To study the effectiveness of tranexamic acid (TXA) 10% mouthwash for
bleeding after tooth extraction in patients with non-vitamin K oral
anticoagulants (NOACs) therapy.
The patients were allocated to either TXA 10% (106 patients)
or placebo (112 patients) group mouthwash
and were directed to use the mouthwash before the tooth extraction and 3 times
daily for 3 days after the extraction. The number of patients with any oral
bleeding after the tooth extraction for a week was the primary outcome.
Bleeding during the procedure, untimely, and delayed bleeding, and the safety
outcomes comprising of all thrombotic events were the secondary outcomes.
Out of total 218 patients under consideration, bleeding
after the extraction was noticed in 28 (26.4%) patients in TXA and 32 (28.6%)
patients in placebo group. Patients in TXA group had 46 bleeds compared to 85
placebo.
TXA did not decrease the rate of bleeding during the
procedure and untimely bleeding.
However, the TXA group had delayed bleeding and reduced
bleeding following more than one dental extractions.
A patient in the placebo group had a brief ischemic attack
(mini stroke) while interfering the NOAC treatment in planning for the
extraction.
Compared to placebo, the use of TXA did not seem to lessen
bleeding during the procedure or untimely postoperative bleeding in patients on
NOACs undergoing tooth extraction. But, in case of multiple teeth extractions,
TXA did lessen delayed bleeds and post-operative bleeding.
PloS Medicine
Tranexamic acid and bleeding in patients treated with non-vitamin K oral anticoagulants undergoing dental extraction: The EXTRACT-NOAC randomized clinical trial
Anna Ockerman et al.
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