How is Transamin used for treatment of gastric bleeding?

Upper Gastrointestinal Bleeding has been observed that gastric mucosa is rich in plasminogen activator and fibrinolytic activity is high in gastric venous blood. Therefore, it seems to be rationale to use fibrinolytic drugs in the management of bleeding from gastrointestinal lesion.

Henry et al. performed a meta-analysis fo six randomized double-blind placebo controlled trials from UK, Sweden and Australia which investigated the effect of fibrinolytic inhibitors in 1,267 patients in total with upper gastrointestinal bleeding. Most patients were bleeding from peptic ulcers in the stomach and duodenum (43 – 88%) or gastric erosions (4 – 23 %). Transamin 3 – 6 g/day given intravenously for 2 or 3 days followed by 3 – 6 g/day orally for a further 3 to 5 days (four trials) or 4.5 – 12 g/day orally for 2 to 7 days (two trials). Treatment with Transamin was associated with a 20 – 30% reduction in the rate of rebleeding, and a 40% reduction (95% confidence interval 10 – 60 %) in mortality. From the meta-analysis, it was concluded that Transamin might be of value to patients considered to be at risk of dying after an upper gastrointestinal hemorrhage.

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