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

• Published in: Curēus (Palo Alto, CA) Vol. 17; no. 6; p. e86566
• Main Authors: Bin Abdul Aziz, Omer, Jalil, Meezan, Ahmad, Bilal, Hussain, Aamir, Mughal, Muhammad Awais
• Format: Journal Article
• Language: English
• Published: United States Springer Nature B.V 22.06.2025; Cureus
• Subjects: Breast implants; Breast surgery; Clinical trials; General Surgery; Human subjects; Intervention; Mastectomy; Meta-analysis; Observational studies; Other; Patients; Plastic Surgery; Prevention; Prostheses; Systematic review; management; zafirlukast; montelukast; capsular contracture; leukotriene receptor antagonist
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.86566

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.