Results of a Pilot Multicenter Genotype-based Randomized Placebo-controlled Trial of Propranolol to Reduce Pain After Major Thermal Burn Injury. Issue 1 (January 2015)

• Record Type: Journal Article
• Authors: Orrey, Danielle C.; Halawa, Omar I.; Bortsov, Andrey V.; Shupp, Jeffrey W.; Jones, Samuel W.; Haith, Linwood R.; Hoskins, Janelle M.; Jordan, Marion H.; Bangdiwala, Shrikant I.; Roane, Brandon R.; Platts-Mills, Timothy F.; Holmes, James H.; Hwang, James; Cairns, Bruce A.; McLean, Samuel A.
• Is Part Of: Clinical journal of pain. Volume 31:Issue 1(2015)
• Publication Date: 2015-01
• Subjects: propranolol -- burn -- randomized control trial -- catechol-O-methyltransferase; Pain -- Periodicals; Pain -- Treatment -- Periodicals; Analgesia -- Periodicals; 616.047205
• DOI: 10.1097/AJP.0000000000000086
• Languages: English
• ISSNs: 0749-8047

Abstract

Abstract : Background: Results of previous studies suggest that β-adrenoreceptor activation may augment pain, and that β-adrenoreceptor antagonists may be effective in reducing pain, particularly in individuals not homozygous for the catechol- O -methyltransferase ( COMT ) high-activity haplotype. Materials and Methods: Consenting patients admitted for thermal burn injury at participating burn centers were genotyped; those who were not high-activity COMT homozygotes were randomized to propranolol 240 mg/d or placebo. Primary outcomes were study feasibility (consent rate, protocol completion rate) and pain scores on study days 5 to 19. Secondary outcomes assessed pain and posttraumatic stress disorder symptoms 6 weeks postinjury. Results: Seventy-seven percent (61/79) of eligible patients were consented and genotyped, and 77% (47/61) were genotype eligible and randomized. Ninety-one percent (43/47) tolerated study drug and completed primary outcome assessments. In intention-to-treat and per-protocol analyses, patients randomized to propranolol had worse pain scores on study days 5 to 19. Conclusions: Genotype-specific pain medication interventions are feasible in hospitalized burn patients. Propranolol is unlikely to be a useful analgesic during the first few weeks after burn injury.