6/30/23, 2:16 AM TICH-2 Pathway Feedback Search Clinical Topics Home Studies TICH 2 TICH 2 Disease Intracerebral hemorrhage Trial question What is the effect of tranexamic acid in patients with stroke due to intracerebral hemorrhage? Study design Multi-center Double blinded RCT Population Characteristics of study participants 44.0% female N = 2325 56.0% male 2325 patients (1024 female, 1301 male) Inclusion criteria: adults with intracerebral hemorrhage from acute stroke Key exclusion criteria: intracerebral hemorrhage secondary to anticoagulation, thrombolysis, trauma, or a known underlying structural abnormality; contraindication to tranexamic acid; prestroke dependence; life expectancy < 3 months; and Glasgow Coma Scale score < 5 Interventions N=1161 tranexamic acid (1 g intravenous bolus followed by another 1 g infused over 8 hours, within 8 hours of symptom onset) N=1164 placebo (normal saline 0.9% administered with an identical regimen) Primary outcome https://web.pathway.md/studies/recxZPGKPAFJM2hOK 1/2 6/30/23, 2:16 AM TICH-2 Pathway Death at 90 days 22.0 % 22 21 16.5 % 11.0 % 5.5 % No significant difference 0.0 % Tranexamic acid Placebo No significant difference in death at 90 days (22% vs. 21%; aHR 0.92, 95% CI 0.77 to 1.1) Secondary outcomes Significant decrease in change in volume of hematoma from baseline to 24 hours (3.72 mL vs. 4.9 mL; AD -1.37 mL, 95% CI -2.71 to -0.04) Significant increase in length of stay in hospital (63.12 days vs. 63.73 days; AD 1.09 days, 95% CI 0.97 to 1.24) Safety outcomes No significant differences in venous thromboembolic events, arterial occlusions, seizure, nervous system disorders, infections. Significant differences in serious adverse events by day 2 (33% vs. 36%), day 7 (39% vs. 43%), 90 days (45% vs. 48%). Conclusion In adults with intracerebral hemorrhage from acute stroke, tranexamic acid was not superior to placebo with respect to death at 90 days. Reference Nikola Sprigg, Katie Flaherty, Jason P Appleton et al. Tranexamic acid for hyperacute primary IntraCerebral Haemorrhage (TICH-2): an international randomised, placebo-controlled, phase 3 superiority trial. Lancet. 2018 May 26;391(10135):2107-2115. Open reference URL https://web.pathway.md/studies/recxZPGKPAFJM2hOK 2/2