Twelve RCTs were included in the analysis (the number of participants was not explicit, but the highest number included in the analyses shown was 619).
Patients treated with IV tranexamic acid were less likely to require allogenic blood transfusion than those treated with placebo (11 RCTs; pooled OR 0.16, 95% confidence interval, CI: 0.09, 0.26).
The number of units of blood transfused (11 RCTS) and the amount of blood loss peri-operatively (12 RCTs) was lower in the IV tranexamic group than the placebo group (WMD -0.85 units, 95% CI: -1.33, -0.36 and WMD -460.12 mL, 95% CI: -626.19, -274.06, respectively), but significant heterogeneity was seen in these results.
The occurrence of deep vein thrombosis was not significantly different in the IV tranexamic acid group than in the placebo group (12 RCTs; pooled OR 0.98, 95% CI: 0.45, 2.12).
Sensitivity analyses did not make a substantial difference to the results.
The funnel plot for the transfusion outcome suggested a small publication bias in favour of studies with positive results.
Seven of the 12 included RCTs had adequate allocation concealment.