SynthesisNaunyn-Schmiedeberg's archives of pharmacology2026
Tranexamic acid for spontaneous intracerebral hemorrhage: hematoma control without clinical benefits? A meta-analysis of RCTs.
Synthesis in Naunyn-Schmiedeberg's archives of pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- Effect of tranexamic acid for acute spontaneous intracerebral haemorrhage: a systematic review and individual patient data meta-analysis.Journal of neurology, neurosurgery, and psychiatry · 2026Pooled it
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Spontaneous intracerebral hemorrhage (sICH) is a serious form of stroke associated with high mortality and poor functional outcomes. Hematoma expansion critically affects prognosis, necessitating early intervention. Tranexamic acid (TXA), an antifibrinolytic, has an uncertain role in sICH. This meta-analysis synthesizes evidence from randomized controlled trials (RCTs) to evaluate the efficacy and safety of TXA in sICH. Comprehensive searches of PubMed, Scopus, Web of Science, and Cochrane Library identified RCTs comparing intravenous TXA to placebo in sICH, focusing on hematoma expansion. Data on functional outcomes, mortality, thromboembolic events, and quality of life were extracted. Cochrane RoB2 assessed the quality of studies. RevMan 5.4 was used for data analysis, employing fixed-effects models. Subgroup analyses were conducted based on time windows and patient subgroups. Eight RCTs (2974 patients) were included. TXA significantly reduced 24-h hematoma volume (MD = - 1.17 mL, 95% CI = - 1.97 to - 0.36), particularly when administered within 8 h (MD = - 1.71 mL, 95% CI = - 2.68 to - 0.74). However, odds of expansion, functional outcomes, 90-day mortality, thromboembolic events, and quality of life were similar between groups. Another subgroup analysis based on study populations revealed a significant effect of TXA on hematoma volume in studies involving sICH without a specific subgroup classification. However, no significant effect was observed in other subgroups, including sICH with spot sign, hypertensive ICH, and NOAC-associated ICH. TXA has been shown to reduce hematoma expansion in sICH, particularly when administered within 8 h of symptom onset, without a corresponding increase in thromboembolic events. However, this benefit has not translated into significant improvements in functional outcomes, mortality, or quality of life. As such, current evidence does not support the routine use of TXA in sICH, and further high-quality research is warranted.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.