Dr Edward Raby1, A/Prof Laurens Manning1, Prof Fiona Wood1
1Fiona Stanley Hospital, , Australia
There is conflicting evidence from animal models on the effects of NSAIDs on healing and scar quality. Celecoxib has the potential to reduce acute inflammation and modulate scar formation after burn injury but has not previously been studied in humans.
Adults with non-major acute burn injury were eligible for recruitment and randomisation. Participants received either six weeks of celecoxib 200 mg twice daily or identically packaged placebo capsules. The primary outcome was participant reported Patient Observer Scar Assessment Scale at the day 42 visit.
Thirty-one participants were allocated to celecoxib and thirty to placebo, one participant in each arm was later deemed ineligible and removed from analysis. The trial was terminated before achieving the target sample size due to slow recruitment. The primary outcome was available for 21/30 participants in the celecoxib arm and for 23/29 who received placebo. There was no significant difference in the primary outcome between treatment groups with a mean difference of -3.49 (95% CI [-11.57, 4.59], p = .39). There was no increase in graft loss or delayed healing attributed to the intervention.
As the current study was underpowered, the effect of celecoxib on burn specific outcomes including scar quality remains to be determined. Celecoxib was relatively well tolerated. Future trials should consider a broader cohort including major burn injury and an older population. Timing, dosage and duration should all be explored, aiming initially to commence as soon as is practicable after injury to modulate the acute inflammatory response.
Dr Raby is a clinical microbiologist and infectious diseases consultant working at Royal Perth and Fiona Stanley Hospitals where his main clinical interest is skin and soft tissue infection in the setting of burns and diabetes-related foot disease.