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AnaemiaPhase 3WOMAN-3NCT06519422

Tranexamic Acid for Anaemia Trial

A Phase 3 study testing Tranexamic Acid 500 MG in people with Anaemia, run by London School of Hygiene and Tropical Medicine at 3 sites in 3 countries.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Anaemia is when the body does not have enough healthy red blood cells to carry oxygen. It is common in women because they lose blood every month during their periods. Anaemia can womwn make feel tired, weak, dizzy and out of breath. It can also make it harder to study, work or look after their family. Read more about this study

Who is it for?
Ages 18 years and older, women only
Conditions the study is for
Anaemia
What is being tested?
Tranexamic Acid 500 MG
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
4,000 participants
Where
3 sitesin 3 countries
Study dates
10 Aug 2026to Sep 2028
Phase
Phase 3
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Adult women aged 18 years and older.
  • Currently menstruating, with menstrual periods occurring at least every 38 days and lasting ≥2 days.
  • Anaemia at screening, defined as hemoglobin (Hb) <120 g/L by point-of-care finger prick test.
  • Willing and able to provide informed consent.
  • Able to attend in-person follow-up visits during the trial period.
  • Individuals with known thalassaemia and sickle cell disease are eligible to participate and take the trial treatment but will not be given standard of care iron supplementation unless it is prescribed by their own treating clinician. They will continue to receive their usual standard care.

Who cannot join

  • Planning to get pregnant during the trial period
  • Already taking TXA
  • Known to have possible contraindications to TXA treatment (including allergy to TXA or its excipients, renal impairment, active thromboembolic disease, history of venous or arterial thrombosis, history of convulsion.)

Trial locations and contacts

3 sites in 3 countries. Contact the study team or a site near you to ask about taking part.

Professor Ian Roberts contact

020 7958 8128

woman3@lshtm.ac.uk

3 sites in 3 countries

Nigeria1 site, 1 recruiting
  • University College Hospital

    Ibadan, Oyo State

    Folasade A Bello, +2347067427993, nigeria.woman3@lshtm-ctu.org

    Folasade A Bello

    Recruiting

Other trials in Nigeria

Pakistan1 site, 1 recruiting
  • Shifa Tameer e Millat University

    Islamabad

    Rizwana Chaudhri, +923205514960, pakistan.woman3@lshtm-ctu.org

    Rizwana Chaudhri

    Not yet recruiting

Other trials in Pakistan

Tanzania1 site, 1 recruiting
  • Mbeya College of Health and Allied Sciences, University of Dar es Salaam

    Mbeya

    Projestine Muganyizi, +255688267218, tanzania.woman3@lshtm-ctu.org

    Projestine Muganyizi

    Not yet recruiting

Other trials in Tanzania

About this study

Official title: The Effects of Tranexamic Acid on Anaemia, Menstrual Health and the Wellbeing of Women: an International Randomised, Placebo-controlled Trial Among Menstruating Women With Anaemia

Anaemia is when the body does not have enough healthy red blood cells to carry oxygen. It is common in women because they lose blood every month during their periods. Anaemia can womwn make feel tired, weak, dizzy and out of breath. It can also make it harder to study, work or look after their family. If woman become pregnant with anaemia, it can cause problems for both mother and baby, such as early birth or heavy bleeding when giving birth. It is best to treat anaemia in young women well before they get pregnant. Doctors treat anaemia with iron and vitamins. But some people get side effects when taking iron tablets and so they stop taking them. Tranexamic acid (TXA) is a medicine used to treat heavy periods. The investigators of this study would like to find out if taking TXA with the usual iron and vitamin supplements is better at treating anaemia than taking iron and vitamin supplements alone. (Lay Summary)

Read the detailed description

World-wide, half a billion women of reproductive age are anaemic. Anaemia has major health consequences for pregnant women and their babies. Anaemia increases the risk of ante-partum haemorrhage, prematurity, stillbirth, neonatal death, post-partum haemorrhage and maternal death. Early intervention to reduce the risk of anaemia before pregnancy offers the potential to reduce adverse maternal and birth outcomes and improve well-being across the reproductive life course.

The global target, set in 2000, to halve the prevalence of anaemia in women of reproductive age by 2025 was not met. Anaemia worsens bleeding through multiple biological mechanisms. Anaemia increases blood flow from bleeding vessels due to reduced blood viscosity and anaemic blood clots are more susceptible to fibrinolysis. Although iron and multivitamin replacement is the mainstay of anaemia treatment, iron stores in young women depend more on menstrual iron loss than on dietary intake. Because anaemia worsens bleeding, women with anaemia have heavier menstrual periods than if they were not anaemic. For this reason, offering iron replacement without reducing menstrual iron loss may be inefficient.

The antifibrinolytic tranexamic acid (TXA) reduces menstrual bleeding by preventing blood clot breakdown. The investigators propose that giving TXA with iron and vitamin replacement will be more effective in treating anaemia than iron and vitamin replacement alone.

Conditions
Anaemia
Being tested
Tranexamic Acid 500 MG, Placebo
Keywords
Tranexamic acid, Antifibrinolytic, Anaemia, Menstrual health, Menstruation, Bleeding, Iron Deficiency
Medical subject headings
Anemia, Hemorrhage, Iron Deficiencies

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Tranexamic Acid 500 MGDrug

    Also called TXA, Tranexamic Acid

    Tablets

  • PlaceboDrug

    Also called Matched Placebo

    Tablets

Study groups in NCT06519422
Study groupRoleWhat they receive
Tranexamic acid (TXA)ExperimentalTranexamic acid (TXA) 2 x 500 mg oral tablets, taken three times daily from the first to the last day of the menstrual period (maximum 5 days), for six consecutive menstrual cycles (up to a maximum of 9 months). Participants also receive standard of care oral iron and folic acid supplementation for three months from randomisation.
Receives: Drug: Tranexamic Acid 500 MG
PlaceboPlacebo comparatorMatching placebo 2 x 500 mg oral tablets, taken three times daily from the first to the last day of the menstrual period (maximum 5 days), for six consecutive menstrual cycles (up to a maximum of 9 months). Participants also receive standard of care oral iron and folic acid supplementation for three months from randomisation.
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Proportion of Participants with Anaemia

    Proportion of participants with hemoglobin (Hb) <120 g/L, measured via venous blood samples at baseline and at the end of the intervention period.

    Measured: From enrollment until after the 6th menstrual period but before the 7th, or within 9 months from randomization (±1 week), whichever occurs first.

Secondary outcomes (15)
  1. Haemoglobin (Hb) concentration

    Hb measured on venous blood at baseline and end of treatment/ early withdrawal

    Measured: From enrollment until after the 6th menstrual period but before the 7th, or within 9 months from randomization (±1 week), whichever occurs first.

  2. Severity of anaemia

    Mild Anaemia (Hb=110-119 g/L); Moderate Anaemia (Hb=80-109 g/L); Severe Anaemia (Hb < 80 g/L); Hb measured on venous blood

    Measured: From enrollment until after the 6th menstrual period but before the 7th, or within 9 months from randomization (±1 week), whichever occurs first.

  3. Ferritin

    Serum ferritin (from venous blood sample) and CRP-adjusted ferritin (see below, under C-reactive protein) measured at baseline and end of the intervention period; we will report change in iron status from baseline

    Measured: From enrollment until after the 6th menstrual period but before the 7th, or within 9 months from randomization (±1 week), whichever occurs first.

  4. Iron deficiency

    Iron deficiency defined as ferritin <15 ug/L (WHO definition) and defined as ferritin <30 ug/L, (new clinical consensus); Serum ferritin from venous blood sample; CRP-adjusted ferritin (see below, under C-reactive protein); we will report change in iron status from baseline

    Note: CRP-adjusted ferritin (see below);

    Measured: From enrollment until after the 6th menstrual period but before the 7th, or within 9 months from randomization (±1 week), whichever occurs first.

  5. C-reactive protein (CRP)

    Measured to adjust ferritin values. The Statistical Analysis Plan (SAP) will include details on how ferritin values will be corrected by taking into account CRP levels (inflammation marker), because normal ferritin concentrations may mask an iron deficient state if inflammation is present

    Measured: From enrollment until after the 6th menstrual period but before the 7th, or within 9 months from randomization (±1 week), whichever occurs first.

  6. Iron-deficiency anaemia

    The proportion of participants with iron-deficiency anaemia, defined as presence of both anaemia (Hb<120 g/L) plus iron deficiency (ferritin <15 ug/L AND/OR <30 ug/L)

    Measured: From enrollment until after the 6th menstrual period but before the 7th, or within 9 months from randomization (±1 week), whichever occurs first.

  7. Menstrual blood loss

    Self-reported number of menstrual products used

    Measured: Throughout the trial from enrollment through the final visit (after 6th menstrual period or within 9 months from randomization).

  8. Perceived change in menstrual blood loss

    Participant's subjective assessment of intensity and impact of menstrual bleeding, using visual analogue scales (HMB-VAS), assessed at baseline and final visit

    Measured: Throughout the trial from enrollment through the final visit (after 6th menstrual period or within 9 months from randomization).

  9. Degree of effect of menstrual bleeding on health-related Quality of Life

    SAMANTA scale (ref: Calaf, 2020, DOI: 10.1089/jwh.2018.7446 and Sinharoy 2023, DOI: 10.1016/S2214-109X(23)00416-3; Affirmative answers to two questions ('experiencing menstrual bleeding for >7 days per month' and 'being bothered by menstruation due to its Abundance') each receive 3 points, while affirmative answers to all other questions each receive 1 point ('≥3 days of heavier bleeding', 'blood spotting on clothes at night', 'worried about staining furniture', 'avoid some activities because of the need to change menstrual materials'). These values are summed, resulting in a potential range of values for the heavy menstrual bleeding score from 0 to 10.)

    Measured: Throughout the trial from enrollment through the final visit (after 6th menstrual period or within 9 months from randomization).

  10. Mean Menstrual Period Duration

    Evaluated longitudinally via participant daily diary logs to assess changes in bleeding length across treatment cycles.

    Measured: Throughout the trial from enrollment through the final visit (after 6th menstrual period or within 9 months from randomization).

  11. Change From Baseline in Menstrual Pain Severity Score

    Measured on a standard 0 to 10 numerical rating scale inside the participant diary, where 0 represents no pain and 10 represents the worst imaginable period pain.

    Measured: Throughout the trial from enrollment through the final visit (after 6th menstrual period or within 9 months from randomization).

  12. Mean Hemoglobin (Hb) Concentration at Final Visit

    Analysed via laboratory venous blood collection to document efficacy on maternal anemia resolution.

    Measured: Throughout the trial from enrollment through the final visit (after 6th menstrual period or within 9 months from randomization).

  13. Mean Serum Ferritin Concentration at Final Visit

    Evaluated via venous blood sample to track maternal iron storage status. Ferritin values will be adjusted against C-reactive protein levels within the final Statistical Analysis Plan (SAP) to prevent acute inflammation from masking underlying iron depletion.

    Measured: Throughout the trial from enrollment through the final visit (after 6th menstrual period or within 9 months from randomisation).

  14. Mean Systolic and Diastolic Blood Pressure at Study Completion

    Monitored via a standard automated digital sphygmomanometer during in-person clinical visits.

    Measured: Throughout the trial from enrollment through the final visit (after 6th menstrual period or within 9 months from randomization).

  15. Mean Heart Rate at Study Completion

    Pulse rates monitored on-site alongside vital sign collections.

    Measured: Throughout the trial from enrollment through the final visit (after 6th menstrual period or within 9 months from randomisation)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted25 Jul 2024
  2. Study start10 Aug 2026
  3. Primary completionAug 2028 (estimated)
  4. Study completionSep 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Two-arm parallel design comparing tranexamic acid (TXA) versus placebo, with participants randomized in a 1:1 ratio.
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
4,000 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06519422
Sponsor's protocol ID
WOMAN-3
Other IDs
ISRCTN, PACTR
Acronym
WOMAN-3
Status last verified
Aug 2026
First submitted
11 Jul 2024
Last updated
17 Aug 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: We are committed to sharing data for ethical research with justified scientific objectives. Until all planned analyses are completed by the LSHTM CTU Global Health Trials Group, data will be shared through a controlled access approach; thereby researchers can make formal applications for data sharing. Afterwards, we will share the anonymised dataset via the LSHTM CTU Global Health Trials Group data sharing platform at freebird.lshtm.ac.uk or a similar platform. We will make all relevant trial materials available on the trial website.

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Tranexamic Acid 500 MG in people with Anaemia, run by London School of Hygiene and Tropical Medicine at 3 sites in 3 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 17 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in Nigeria, Pakistan, Tanzania. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Eni Balogun (020 7958 8117, woman3@lshtm.ac.uk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Proportion of Participants with Anaemia (time frame: From enrollment until after the 6th menstrual period but before the 7th, or within 9 months from randomization (±1 week), whichever occurs first.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Aug 2026.

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