Leukotriene Receptor Antagonists for the Prevention and Treatment of Capsular Contracture: A Systematic Review and Meta-analysis

TL;DR

This study finds that leukotriene receptor antagonists, especially zafirlukast, may help prevent and treat capsular contracture after breast implant surgery.

Contribution

The study provides a meta-analysis showing that zafirlukast significantly reduces capsular contracture severity.

Findings

LRAs showed a statistically significant pooled risk difference of -0.29 in reducing CC.

Zafirlukast specifically had a significant effect with a risk difference of -0.40.

The findings suggest LRAs are effective in early-stage CC prevention and treatment.

Abstract

Capsular contracture (CC) is a common complication following breast implant surgery, characterized by excessive fibrous tissue formation around the implant. Leukotriene receptor antagonists (LRAs), such as montelukast and zafirlukast, have been investigated for their anti-inflammatory and anti-fibrotic properties as potential preventive and therapeutic agents for CC. However, findings remain inconclusive.

A systematic literature search was conducted, and studies involving human subjects that utilized the Baker scale for CC assessment and were published in English were included. Relevant studies were reviewed, and a meta-analysis was performed.

The pooled risk difference (RD) was -0.29, with a standard error (SE) of 0.10 and a corresponding 95% CI of -0.48 to -0.09. This finding was statistically significant (Z-value = -2.81), suggesting that LRAs are effective in the prevention and treatment of CC. Subgroup analysis demonstrated that zafirlukast had a significant effect in reducing CC (RD = -0.40, SE = 0.10, 95% CI -0.60 to -0.20, Z-value = -3.96, p = 0.00).

This systematic review and meta-analysis indicate that LRAs, particularly zafirlukast, are effective in reducing the severity and recurrence of CC, especially in its early stages. Further high-quality clinical trials are warranted to establish standardized guidelines for the use of LRAs in the management of CC.

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