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CompletedNCT01940419PeTraHUpdated Oct 22, 2015

Testing of the Drug Tranexamic Acids as Prophylaxis of Bleeding in Benign Surgical Removal of the Uterus

A Phase 4 interventional study of Tranexamic Acid and Placebo in Gynecologic Surgical Procedures, Hysterectomy and Tranexamic Acid, sponsored by Hillerod Hospital, Denmark. Completed at 1 site in Denmark. Open to female participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2015-10-22.

Sponsored by Hillerod Hospital, Denmark · Phase 4, Interventional, and Prevention

Phase
Phase 4
Study type
Interventional
Enrollment
332
Allocation
Randomized
Ages
18 Years and older
Sex
Female
01

Study summary

In Denmark, 4400 women annually undergo hysterectomy on benign background (surgical removal of the uterus). 10% of these women experience bleeding complications. The drug Tranexamic Acid (Cyklokapron) has showed significant reduction of bleeding in relation to other types of surgery. The hypothesis of this study is that Tranexamic Acid could also reduce the operative bleeding associated with benign hysterectomy. The study will be carried out as a randomized, placebo-controlled national multicenter trial

Read the detailed description

In Denmark, there are approximately 4400 elective benign hysterectomies annually. In about 10% of these there will occur a per- or postoperative bleeding complications with increased hospital stay, reoperations and prolonged sick leave as a result. The pharmaceutical product 'Tranexamic acid' has proved to be effective in reducing blood loss in other forms of surgery, in trauma patients, and in relation to certain medical conditions. The hypothesis of the proposed study is that Tranexamic acid could also reduce the operative bleeding associated with hysterectomy on benign indications. Based on the literature and previous studies, the objective of the trial is an average bleeding reduction of 25%.

The clinical trial will be conducted as a randomized, placebo-controlled, double blind multicenter trial in gynecological departments several places in Denmark: Nordsjællands Hospital, Rigshospitalet, Odense University Hospital and Aarhus University Hospital - Skejby. The subjects will be recruited in outpatient clinics of the gynecological departments. During the study there will be an ongoing monitoring by external partner. The experiment is approved by all relevant bodies. The total period of time in which the trial is planned to last is one year commencing 01.02.3013 and ending 28.02.2014. All together the trial will include 314 participants determined by presumed bleeding reduction, the average bleeding on hysterectomy and type 1 error of 0.05 and type 2 error of 0.20. Randomization will be conducted electronically and both clinician, patient and data collector we will be blinded. Data for the study will partly be collected through registrations to the already well established and well functioning Danish Hysterectomy and Hysteroscopy Database. Data used in relation to the study will be validated by examining the manual records in conjunction with data extraction. The results will be analyzed by univariate and multivariate analyzes and static regression analyzes. All final results from the study will be sought published in recognized international journals.

Regarding ethical aspects it is noted that the study is carried out with the highest standard of design, and with a proven drug without unexpected side effects or disadvantages. In the literature, there seems no evidence to suspect an increased risk of blood clot formation using the drug. However, it seems clear that the incidence of complications associated with hysterectomy is quite high. It is therefore ethically fully responsible and appropriate to carry out the planned study with the desire to ensure the quality and improve hysterectomy, surgery.

The project is supported by funds and receives no commercial support.

02

Conditions studied

  • Gynecologic Surgical Procedures
  • Hysterectomy
  • Tranexamic Acid

Keywords

  • Reduction of blood loss
  • Surgical complication
  • Hysterectomy
  • Antifibrinolytic Agents
  • Randomized Controlled Trials
03

In context

Lead sponsor

Hillerod Hospital, Denmark is the lead sponsor of 27 studies on the registry; 1 is open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
Female
Accepts healthy volunteers
Yes

Inclusion criteria

  • Women over 18 who is to undergo elective benign hysterectomy

Exclusion criteria

Exclusion Criteria:

  • Known thrombophilia
  • Active / previous thromboembolic disease
  • Family history of thromboembolic disease (thrombophilia in the family)
  • Hypersensitivity to any ingredient in Tranexamic acid
  • Renal impairment
  • Ongoing hematuria
  • Subarachnoid hemorrhage
  • Daily use of any type of blood thinners (Clopidogrel / Marevan / Warfarin / Nonsteroidal Antiinflammatory Drugs (not when pain is the indication))
  • Preoperative use of Tranexamic acid within 24 hours of the operation
  • Known malignancy or hysterectomy as part of the investigation for suspected malignancy
  • Insufficient understanding of the information concerning the project: language disabilities, intellectual limitations, or the like.
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Study design

Phase
Phase 4
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Care provider, Investigator)
Enrollment
332 participants (actual)

Study arms

  • Active comparator
    Tranexamic Acid

    1g Tranexamic acid iv just before surgery

    Drug: Tranexamic Acid

  • Placebo comparator
    Placebo

    sterile sodium chloride 9mg/ml iv

    Drug: Placebo

Interventions

  • DrugTranexamic Acid

    1g Tranexamic acid iv administered over 10 minutes just before surgery

    Also known as: Cyklokapron

  • DrugPlacebo

    10 ml sodium chloride iv administered over 10 minutes just before surgery

06

What researchers measure

Primary outcomes

  1. Intraoperative bleeding

    In relation to the trial there is at set of standards to objectify blood loss during surgery. Output and input will be weighed and will form the basis of the calculated operative blood loss

    Time frame: 1 day (Bleeding is measured immediately after surgery)

07

Study locations

1 site
  • Department of gynecology and obstetrics, Nordsjællands Hospital
    Hillerød, 3400, Denmark
08

References and documents

Publications

  • Henry DA, Carless PA, Moxey AJ, O'Connell D, Stokes BJ, Fergusson DA, Ker K. Anti-fibrinolytic use for minimising perioperative allogeneic blood transfusion. Cochrane Database Syst Rev. 2011 Mar 16;2011(3):CD001886. doi: 10.1002/14651858.CD001886.pub4. PubMed 21412876 ↗
  • CRASH-2 trial collaborators; Shakur H, Roberts I, Bautista R, Caballero J, Coats T, Dewan Y, El-Sayed H, Gogichaishvili T, Gupta S, Herrera J, Hunt B, Iribhogbe P, Izurieta M, Khamis H, Komolafe E, Marrero MA, Mejia-Mantilla J, Miranda J, Morales C, Olaomi O, Olldashi F, Perel P, Peto R, Ramana PV, Ravi RR, Yutthakasemsunt S. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. Lancet. 2010 Jul 3;376(9734):23-32. doi: 10.1016/S0140-6736(10)60835-5. Epub 2010 Jun 14. PubMed 20554319 ↗
  • Lethaby A, Farquhar C, Cooke I. Antifibrinolytics for heavy menstrual bleeding. Cochrane Database Syst Rev. 2000;(4):CD000249. doi: 10.1002/14651858.CD000249. PubMed 11034679 ↗
  • Dunn CJ, Goa KL. Tranexamic acid: a review of its use in surgery and other indications. Drugs. 1999 Jun;57(6):1005-32. doi: 10.2165/00003495-199957060-00017. PubMed 10400410 ↗
  • Sukeik M, Alshryda S, Haddad FS, Mason JM. Systematic review and meta-analysis of the use of tranexamic acid in total hip replacement. J Bone Joint Surg Br. 2011 Jan;93(1):39-46. doi: 10.1302/0301-620X.93B1.24984. PubMed 21196541 ↗
  • Astedt B, Liedholm P, Wingerup L. The effect of tranexamic acid on the fibrinolytic activity of vein walls. Ann Chir Gynaecol. 1978;67(6):203-5. PubMed 742821 ↗
  • Lukes AS, Moore KA, Muse KN, Gersten JK, Hecht BR, Edlund M, Richter HE, Eder SE, Attia GR, Patrick DL, Rubin A, Shangold GA. Tranexamic acid treatment for heavy menstrual bleeding: a randomized controlled trial. Obstet Gynecol. 2010 Oct;116(4):865-875. doi: 10.1097/AOG.0b013e3181f20177. PubMed 20859150 ↗
  • Bonnar J, Sheppard BL. Treatment of menorrhagia during menstruation: randomised controlled trial of ethamsylate, mefenamic acid, and tranexamic acid. BMJ. 1996 Sep 7;313(7057):579-82. doi: 10.1136/bmj.313.7057.579. PubMed 8806245 ↗
  • Coulter A, Kelland J, Peto V, Rees MC. Treating menorrhagia in primary care. An overview of drug trials and a survey of prescribing practice. Int J Technol Assess Health Care. 1995 Summer;11(3):456-71. doi: 10.1017/s0266462300008679. PubMed 7591547 ↗
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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Oct 22, 2015, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT01940419
Lead sponsor
Hillerod Hospital, Denmark
Collaborators
Rigshospitalet, Denmark, Odense University Hospital, Central Denmark Region, Research grant from Nordsjællands Hospital, The fund of Olga Bryde, The Danish hysterectomy and hysteroscopy database
Responsible party
Märta Fink Topsøe (DM, PhD-student, Hillerod Hospital, Denmark) — Principal investigator
First posted
Sep 12, 2013
Start date
Apr 2013
Primary completion
Nov 2014
Completion
Oct 2015
Last update
Oct 22, 2015

Study contacts

Märta F Topsøe, DM
principal investigator · Department of gynecology and obstetrics, Nordsjællands Hospital, 3400 Hillerød

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Oct 2015. You cannot join it, but the record below documents what was studied.

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