Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

123 questions · 129 findings · 13 reviews

No studies found 28 · 21.7%GRADE not reported 25 · 19.4%Very low 20 · 15.5%Low 26 · 20.2%Moderate 28 · 21.7%High 2 · 1.6%

Interventions (ibuprofen, tolfenamic acid, aspirin, tranexamic acid) vs placebo or active comparators (paracetamol, tranexamic acid)

Menstrual blood loss: mean loss

Interventions (ibuprofen, tolfenamic acid, aspirin, tranexamic acid) showed no clear difference in menstrual blood loss (alkaline hematin method) compared with placebo or active comparators (paracetamol, tranexamic acid); GRADE not reported.

2 findings from 1 review

Interventions (ibuprofen, tolfenamic acid, aspirin, tranexamic acid) vs placebo or active comparators (paracetamol, tranexamic acid)

Duration of bleeding (menstrual diary)

Interventions (ibuprofen, tolfenamic acid, aspirin, tranexamic acid) showed no clear difference in duration of bleeding (menstrual diary) compared with placebo or active comparators (paracetamol, tranexamic acid); GRADE not reported.

1 finding from 1 review

Interventions (ibuprofen, tolfenamic acid, aspirin, tranexamic acid) vs placebo or active comparators (paracetamol, tranexamic acid)

Menstrual blood loss % occurrence of heavy menstrual bleeding (alkaline hematin method)

The review found no eligible studies for this question.

1 finding from 1 review

Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs placebo

Re‐operation due to bleeding (7 days post‐surgery) ‐ not reported · people undergoing definitive fixation of hip, pelvic and long bone fractures

The review found no eligible studies for this question.

1 finding from 1 review

Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs placebo

Myocardial infarction (0 to 30 days) · people undergoing definitive fixation of hip, pelvic and long bone fractures

It is very uncertain whether topical tranexamic acid changes risk of myocardial infarction (30 days post‐surgery) compared with placebo (very low certainty).

1 finding from 1 review

Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs placebo

Stroke · people undergoing definitive fixation of hip, pelvic and long bone fractures

It is very uncertain whether topical tranexamic acid changes risk of cerebrovascular accident/stroke (30 days post‐surgery) compared with placebo (very low certainty).

1 finding from 1 review

Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs placebo

Deep vein thrombosis · people undergoing definitive fixation of hip, pelvic and long bone fractures

It is very uncertain whether topical tranexamic acid changes risk of deep vein thrombosis (30 days post‐surgery) compared with placebo (very low certainty).

1 finding from 1 review

Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs placebo

Risk of suspected serious drug reactions (30 days post‐surgery) · people undergoing definitive fixation of hip, pelvic and long bone fractures

The review found no eligible studies for this question.

1 finding from 1 review

Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs placebo

Risk of requiring allogeneic blood transfusion (30 days post‐surgery) · people undergoing definitive fixation of hip, pelvic and long bone fractures

It is very uncertain whether topical tranexamic acid changes risk of requiring allogeneic blood transfusion (30 days post‐surgery) compared with placebo (very low certainty).

1 finding from 1 review

Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs placebo

All‐cause mortality (30 days post‐surgery) · people undergoing definitive fixation of hip, pelvic and long bone fractures

It is very uncertain whether topical tranexamic acid changes all‐cause mortality (30 days post‐surgery) compared with placebo (very low certainty).

1 finding from 1 review