2023 Oct 23

New citation required and conclusions have changed

Our new conclusion is, "In this updated Cochrane Review including 20 RCTs involving 4652 participants, rFVIIa likely results in little to no difference in reducing death or dependence after spontaneous ICH with or without surgery; antifibrinolytic drugs result in little to no difference in reducing death or dependence after spontaneous ICH, but result in a slight reduction in ICH expansion within 24 hours; platelet transfusion likely increases death or dependence after antiplatelet‐associated ICH; and the evidence is very uncertain about the effect of PCC compared to FFP on death or dependence after anticoagulant‐associated ICH. Thirteen RCTs are ongoing and are likely to increase the certainty of the estimates of treatment effect."

2023 Oct 23

New search has been performed

• Literature and trial register search strategies updated to September 2022.

• The search was updated to also include reversal agents for DOACs.

• We added eight new RCTs and data from a further 2922 participants, for a total of 20 RCTs and 4652 participants.

• We included RCTs that investigated haemostatic therapies for people taking DOACs prior to ICH.

• We have graded the evidence using GRADE, and downgraded some of the previously included studies due to risk of bias, imprecision, indirectness, or inconsistency.

• Title modified.

• Co‐authors added: Helle Eilertsen, Chaamanti Sivakumar Menon, Chen Chen, Michael JR Desborough, and Else Charlotte Sandset.

2017 Dec 10

New search has been performed

• Title modified.

• Inclusion criteria clarified to include participants with stroke due to intracerebral haemorrhage accompanied by any sort of antithrombotic drug use.

• Inclusion criteria clarified to allow placebo, open control, or active comparators.

• Literature and trial register search strategies updated to November 2017.

• Stratification of analyses by antithrombotic use.

• We added six new trials and data from a further 334 participants, for a total of 12 trials and 1732 participants.

2017 Dec 10

New citation required and conclusions have changed

• Our new conclusion is that platelet transfusion seems hazardous in comparison to standard care for adults with antiplatelet‐associated acute spontaneous intracerebral haemorrhage.

• We remain unable to draw firm conclusions about the efficacy and safety of blood clotting factors and antifibrinolytic drugs for acute spontaneous intracerebral haemorrhage.

2009 Jun 29

New citation required and conclusions have changed

In comparison to the previous version of this review, I no longer find that haemostatic drugs significantly reduce death or dependence after acute spontaneous intracerebral haemorrhage.

2009 Jun 29

New search has been performed

Updated with the addition of 841 people randomised in the rFVIIa phase III FAST trial.

2008 Jul 08

Amended

Converted to new review format.

2017 May 10

Amended

Converted to new review format.