Treatment Of Stroke reCurrence in Cerebral Amyloid Angiopathy with TraneXamic Acid (TOSCCAA- TXA)

This study aims to assess the safety and feasibility of using tranexamic acid (TXA) in patients with cerebral amyloid angiopathy (CAA) and symptomatic brain bleeding to determine if TXA can reduce risk of recurrent intracranial haemorrhage without harmful side effects. We hypothesise TXA to be a safe and well tolerated treatment option for patients with CAA in reducing their risk of recurrent brain bleeding. Participants will be recruited from Alfred Health and Royal Melbourne Hospital, diagnosed with probable CAA, who have had previous brain bleeding within the last 6 months. They will be randomly assigned to take either 1 gram of TXA orally three times per day or an identical placebo for 6 months. All participants will have MRI scans with contrast and blood tests at the start and end of the study to measure biomarkers. Researchers will track participants' compliance with the treatment and any adverse events over the 6-month period. Primary outcomes will include feasibility measures (participation and adherence rates) and safety (monitoring for serious adverse events like clotting conditions, heart attacks, strokes, or death). Secondary outcomes will track the recurrence of various brain haemorrhages, progression of white matter changes, changes in cognitive function, and brain volume loss, as well as the development of new strokes.