Randomised Placebo Controlled Trial of Celecoxib for Acute Burn Inflammation and Fever

Background The tissue trauma of burn injury incites a unique cascade of inflammatory cytokines that leads to acute local and systemic complications. Chronic inflammation contributes to increased morbidity and mortality that persists for more than 20 years after injury. Scar quality is a global indicator of acute recovery and predictor of long term complications. Despite receiving optimal surgical management, almost half of injuries result in hypertrophic scarring. Adjunctive therapies to complement contemporary surgical burns management are urgently needed and non-steroidal anti-inflammatory drugs (NSAIDs) are prime candidates. Despite extensive and promising pre-clinical data, there have been no clinical trials. Aims By conducting a randomised controlled trial, we aim to answer the important, original research questions: (1) Does early and sustained use of the non-steroidal anti-inflammatory drug, celecoxib, following acute burn injury improve recovery as measured by scar quality at six weeks? (2) Does the use of celecoxib attenuate the persistent aberrant inflammatory response? Significance Scar quality is an important, patient centred outcome that reflects every intervention from the time of injury and is associated with long term quality of life. Annual costs of burn injury to WA Health are $11m with individual costs correlated with time to healing. Improving quality of recovery will facilitate return of physical and psychological wellness for the patients and reduce their need for ongoing healthcare.