{
    "abstract": "\u0395-Aminocaproic acid oral solution (EACA OS) is the only commercially available antifibrinolytic for patients who cannot swallow tablets. Insurance denials and high costs remain barriers to its use.\nTo determine the safety and efficacy of crushed tranexamic acid tablets in water (cTXAw) for children with bleeding disorders.\nWe retrospectively reviewed records of children (<10 years) with bleeding disorders who received cTXAw or EACA OS from 1 December 2018, through 31 July 2022, at Mayo Clinic (Rochester, Minnesota). Bleeding outcomes were defined according to ISTH criteria.\nThirty-two patients were included (median age, 3 years; male, n\u00a0=\u00a023). Diagnoses were VWD (n\u00a0=\u00a017), haemophilia (n\u00a0=\u00a05), FVII deficiency (n\u00a0=\u00a03), inherited platelet disorder (n\u00a0=\u00a04), ITP (n\u00a0=\u00a02), and combined FV and FVII deficiencies (n\u00a0=\u00a01). Thirty-two courses of cTXAw (monotherapy 24/32; mean duration 6 days) and fifteen courses of EACA (monotherapy 12/15; mean duration 5 days) were administered. No surgical procedures (n\u00a0=\u00a028) were complicated by bleeding. Of the 19 bleeding events, 16 had effective haemostasis, two had no reported outcome, and one had no response. cTXAw and EACA were equally effective in preventing and treating bleeding (p value\u00a0>\u00a0.1). No patients had adverse effects. Eight of 19 patients (42%) who were initially prescribed EACA OS did not receive it because of cost or insurance denial. The estimated average wholesale price of one treatment was $94 for cTXAw and $905 for EACA OS.\nCTXAw appears to be an effective, safe, and low-cost alternative option to EACA OS for young children with bleeding disorders.",
    "authors": [
        {
            "affiliation": "Division of Pediatric Hematology/Oncology, Mayo Clinic, Rochester, Minnesota, USA.",
            "firstname": "Ahmad",
            "initials": "A",
            "lastname": "Al-Huniti"
        },
        {
            "affiliation": "Department of Pharmacy, Mayo Clinic, Rochester, Minnesota, USA.",
            "firstname": "Linda",
            "initials": "L",
            "lastname": "Marshall"
        },
        {
            "affiliation": "Department of Nursing, Mayo Clinic, Rochester, Minnesota, USA.",
            "firstname": "Dawn",
            "initials": "D",
            "lastname": "Rusk"
        },
        {
            "affiliation": "Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA.",
            "firstname": "Rajiv K",
            "initials": "RK",
            "lastname": "Pruthi"
        },
        {
            "affiliation": "Division of Hematology/Oncology and BMT, Nationwide Children's Hospital, Columbus, Ohio, USA.",
            "firstname": "Vilmarie",
            "initials": "V",
            "lastname": "Rodriguez"
        },
        {
            "affiliation": "Division of Pediatric Hematology/Oncology, Mayo Clinic, Rochester, Minnesota, USA.",
            "firstname": "Asmaa",
            "initials": "A",
            "lastname": "Ferdjallah"
        },
        {
            "affiliation": "Department of Pharmacy, Mayo Clinic, Rochester, Minnesota, USA.",
            "firstname": "Alexis",
            "initials": "A",
            "lastname": "Kuhn"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2024 John Wiley & Sons Ltd.",
    "doi": "10.1111/hae.14996",
    "journal": "Haemophilia : the official journal of the World Federation of Hemophilia",
    "keywords": [
        "antifibrinolytic agents",
        "blood coagulation disorders",
        "blood platelet disorders",
        "haemophilia A",
        "haemophilia B",
        "paediatrics",
        "thrombocytopenia",
        "tranexamic acid",
        "von Willebrand diseases"
    ],
    "methods": null,
    "publication_date": "2024-03-20",
    "pubmed_id": "38507239",
    "results": "Thirty-two patients were included (median age, 3 years; male, n\u00a0=\u00a023). Diagnoses were VWD (n\u00a0=\u00a017), haemophilia (n\u00a0=\u00a05), FVII deficiency (n\u00a0=\u00a03), inherited platelet disorder (n\u00a0=\u00a04), ITP (n\u00a0=\u00a02), and combined FV and FVII deficiencies (n\u00a0=\u00a01). Thirty-two courses of cTXAw (monotherapy 24/32; mean duration 6 days) and fifteen courses of EACA (monotherapy 12/15; mean duration 5 days) were administered. No surgical procedures (n\u00a0=\u00a028) were complicated by bleeding. Of the 19 bleeding events, 16 had effective haemostasis, two had no reported outcome, and one had no response. cTXAw and EACA were equally effective in preventing and treating bleeding (p value\u00a0>\u00a0.1). No patients had adverse effects. Eight of 19 patients (42%) who were initially prescribed EACA OS did not receive it because of cost or insurance denial. The estimated average wholesale price of one treatment was $94 for cTXAw and $905 for EACA OS.",
    "title": "Use of crushed tranexamic acid tablets in water for paediatric patients with bleeding disorders.",
    "xml": "<Element 'PubmedArticle' at 0x78850573dee0>"
}