Conclusions on the clinical efficiency of general haemostatic drugs

Abstract

Medical journals are littered with promises of successful general haemostatic drugs and every year a new drug is offered which is better than the last and free from side effects. Most of the enthusiastic proponents have ignored the occurrence of spontaneous arrest of bleeding in individuals without a major bleeding disorder. The advent of an effective‘general’ haemostatic drug for systemic use would, however, be greatly welcomed for the treatment of excessive bleeding in patients for whom specific treatment is not available. Indeed, in patients with a known bleeding disorder specific treatment is usually provided by substitution of the missing or defective coagulation component or correction of the haemostatic defect. There is, however, no point in overdosage with e.g. vitamin K or heparin antagonists in a vain attempt to correct the original disorder. Valuable drugs such as vitamin K are also often misused in patients with a normal prothrombin time, since no pharmacological effect can be expected.