A Phase 3 interventional study of TXA Nebulization and 0.9% NS Nebulization in Hemoptysis, sponsored by Post Graduate Institute of Medical Education and Research, Chandigarh. Status unknown at 1 site in India. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2022-12-13.
Sponsored by Post Graduate Institute of Medical Education and Research, Chandigarh · Phase 3, Interventional, and Treatment
Hemoptysis is a common presentation in medical emergency. Prompt medical therapy, bronchoscopic and endovascular procedures remains the cornerstone of management for both diagnostic as well as therapeutic purpose in hemoptysis. Priority is given for medical management to achieve hemostasis and prevent aspiration as well as treatment of underlying etiology, before undertaking any definitive bronchoscopic or endovascular intervention. While majority of the patients are managed successfully by prompt medical therapy, only the refractory cases and life-threatening hemoptysis need more definitive procedures like DSA guided bronchial artery embolization and bronchoscopic procedures like endobronchial biocompatible glue, endobronchial embolization using silicone spigots, endobronchial stents, laser photocoagulation. Tranexamic acid is an anti-fibrinolytic agent which prevent breakdown of fibrin clots, thus helping in clot stabilization and controlling bleeding. As a medical therapy Tranexamic Acid is used for bleeding control in hemoptysis as well as other surgical or traumatic bleeding. Previously conducted institutional study comparing IV infusion of TXA to placebo in patients with sub massive hemoptysis showed results favoring TXA over placebo in terms of decreasing frequency \& quantity of hemoptysis, duration of hospital stay and need for DSA/ broncoscopic/ surgical intervention and blood transfusion (1). While the oral and IV routes have been most commonly studied, use of novel approaches like aerosolized TXA and endobronchial instillation of TXA during bronchoscopy have showed positive results in achieving hemostasis in hemoptysis (2). A recently conducted RCT, to assess the effectiveness of TXA nebulization in sub-massive hemoptysis concluded that nebulized TXA is effective in reducing the frequency and quantity of hemoptysis. Nebulized TXA was also found to be safe as no severe ADR was noted during its use as per previous RCT as well as multiple case reports.
However, because of limited number of research with small sample size and barring some case reports evidence for the use of nebulized TXA is limited in hemoptysis. In hemoptysis nebulized form of TXA is supposed to reach local site of bleeding (lung/ airway) promptly at a higher concentration leading to rapid control of hemoptysis. So, this study has been planned to evaluate further this novel approach of TXA nebulization for the management of hemoptysis. Similarly, data regarding adverse drug reaction related to TXA nebulization is also limited. This study will produce additional information regarding efficacy, safety and ADR related to TXA nebulization.
37 studies on the registry are indexed under Hemoptysis; 6 are open to participants now.
This study's planned enrollment of 60 is below the median of 73 across 20 interventional studies indexed under Hemoptysis.
Browse Hemoptysis studies →Post Graduate Institute of Medical Education and Research, Chandigarh is the lead sponsor of 298 studies on the registry; 45 are open to participants now.
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Exclusion Criteria:
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Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.
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Contraception
Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.
Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Nebulization with TXA 500mg/ 5mL 8 hourly for 2 days.
Drug: TXA Nebulization
Nebulization with 0.9%normal saline 5mL 8 hourly for 2 days
Other: 0.9% NS Nebulization
Nebulization with TXA 500mg/ 5mL 8 hourly for 2 days plus standard care of therapy
Nebulization with 0.9% normal saline (NS) 5mL 8 hourly for 2 days plus standard care of therapy
Frequency of hemoptysis
Number of episode of hemoptysis per day will be compared at baseline and day 2 (48 hours)
Time frame: 48 hours
Quantity of hemoptysis
Through collection of expectorated blood, quantityofhemoptysis per day will be compared at baseline and day2 (48hours) .
Time frame: 48 hours
Visual analogue scale (VAS)
Visual subjective assessment by the patient will be used to compare the amount of hemoptysis at baseline and day 2 (48 hours). VAS will be presented to the patients as a 100 mm line anchored by description with 'no-hemoptysis' at one end and 'worst imaginable hemoptysis' on the other end. Patients will be asked to mark a point on the 100 mm line to indicate the severity. A millimeter scale will be used to measure the score and this will provide 0-100 levels of hemoptysis and the score increases with increasing severity.
Time frame: 48 hours
Adverse drug events
Frequency/number of adverse drug events will be compared between the groups.
Time frame: 48 hours
Resolution of hemoptysis
Resolution of hemoptysis is defined as no episode of hemoptysis containing fresh blood sustained for at least 48 hours following cessation of hemoptysis. The rate of resolution of hemoptysis will be compared between the groups.
Time frame: 48 Hours
Need for intervention
The overall the rate of the need for therapeutic interventional procedures (BAE, bronchoscopic procedures), to achieve hemostasis, will be compared between the study and control group.
Time frame: 48 Hours
Need for blood transfusion
The percentage of patients requiring blood transfusion as well as the mean number of PRBCs transfused will be compared between the groups.
Time frame: 48 Hours
Duration of hospital stay
The total duration of hospital stay (from the day of admission to the day of discharge or death) will be compared between both the groups.
Time frame: 4 weeks
Mortality
All patients will be followed up at day 28, physically or telephonically to assess the mortality as well as their well-being. The rate of mortality will be compared between the groups.
Time frame: 4 weeks
Recurrence of hemoptysis
Recurrence will be defined as fresh episode of hemoptysis after resolution during 28 days follow-up. The rate of recurrence of hemoptysis will be compared between the groups.
Time frame: 4 weeks
Plan to share: No
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Started Feb 2022 (actual). Primary completion is estimated for Jan 2023, 11 months after the start.
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This study is status unknown, as verified in Dec 2022. You cannot join it, but the record below documents what was studied.
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Post Graduate Institute of Medical Education and Research, Chandigarh →