Crash-3 MS

Full title: Mechanism of action of tranexamic acid in isolated head injury: a mechanistic sub-study of the CRASH-3 trial

Aim: the main CRASH-3 study has been designed to tell us whether tranexamic acid is helpful or not, this mechanistic study is an extra part to help us work out why it is or isn’t helpful.

Background:When somebody has a serious head injury, this may cause bleeding inside the head, which could in turn cause more damage to the brain. We already know that the medication tranexamic acid is good at helping the blood’s natural clotting process. Therefore, we want to find out whether adding tranexamic acid to the usual treatments can improve patients’ outcomes after they have had a serious head injury with bleeding inside the head.

As well as helping the blood to clot better, there is some scientific evidence that tranexamic acid has some other effects on the brain. For example, in the lab, we know it can reduce inflammation and directly stop brain cells from dying. However, we don’t yet know whether these things meaningfully help patients.

An injured brain produces many chemicals which can tell us about the levels of inflammation and brain cell damage. In this study, CRASH-3-MS, we are measuring some of these chemicals in the brain to see whether treatment with tranexamic acid changes them and whether this is related to a patient’s eventual outcome after their injury.