Commentary on: Treatment and Prevention of Periprosthetic Capsular Contracture in Breast Surgery with Prosthesis using Leukotriene Receptor Antagonists: A Meta-Analysis

2021 ◽  
Author(s):  
Dennis C Hammond
Keyword(s):  
Breast Surgery ◽  
Meta Analysis ◽  
Capsular Contracture ◽  
Receptor Antagonists ◽  
Leukotriene Receptor Antagonists ◽  
Treatment And Prevention ◽  
Leukotriene Receptor

Treatment and Prevention of Periprosthetic Capsular Contracture in Breast Surgery With Prosthesis Using Leukotriene Receptor Antagonists: A Meta-Analysis

2021 ◽  
Author(s):  
Andrei Pașca ◽  
Eduard-Alexandru Bonci ◽  
Codruța Chiuzan ◽  
Nicoleta Monica Jiboc ◽  
Vlad Alexandru Gâta ◽  
...  
Keyword(s):  
Subgroup Analysis ◽  
Breast Surgery ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Capsular Contracture ◽  
Risk Difference ◽  
Receptor Antagonists ◽  
Leukotriene Receptor Antagonists ◽  
Treatment And Prevention ◽  
Leukotriene Receptor

Abstract Background Capsular Contracture (CC) is the most common long-term complication of breast surgery with prosthesis. Leukotriene Receptor Antagonists (LRAs) have been tested as a potential treatment; however, mixed results have been observed. Objectives This study presents a meta-analysis to clarify the treatment and prophylactic capabilities of LRAs in the management of CC. Methods A systematic literature search in the most popular English databases was performed to identify relevant primary publications. We included all studies that evaluated the treatment and preventive capabilities of LRAs using the Baker scale assessment. Results Six eligible studies were included based on predefined inclusion and exclusion criteria, totalling 2276 breasts, out of which 775 did not receive LRAs and 1501 did. Final pooled results showed that LRAs could help manage CC with a Risk Difference (RD) of -0.38 with the corresponding 95% Confidence Interval (CI) between -0.69 and -0.08, showing statistical significance at a Z value of 2.48, p=0.01. Subgroup analysis based on the type of drug used showed that only montelukast yielded statistical significance (RD=-0.27, 95% CI between -0.51 and -0.03, Z=2.20, p=0.03). Zafirlukast did not seem to influence CC. Further subgroup analysis based on treatment timing showed that prophylaxis was ineffective and only treatment for ongoing CC yielded statistical significance. Conclusions The current meta-analysis proved that LRAs could be used in the management of CC. Only treatment for the ongoing CC showed statistical significance. Montelukast seemed to be more efficient with a safer profile for adverse effects, while zafirlukast yielded no statistical significance.

scholarly journals Management of allergic rhinitis with leukotriene receptor antagonists versus selective H1-antihistamines: a meta-analysis of current evidence

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Yan Feng ◽  
Ya-Ping Meng ◽  
Ying-Ying Dong ◽  
Chang-Yu Qiu ◽  
Lei Cheng
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Meta Analysis ◽  
Current Evidence ◽  
Receptor Antagonists ◽  
Leukotriene Receptor Antagonists ◽  
Nasal Symptoms ◽  
H1 Antihistamines ◽  
Leukotriene Receptor

Abstract Background Inconsistencies remain regarding the effectiveness and safety of leukotriene receptor antagonists (LTRAs) and selective H1-antihistamines (SAHs) for allergic rhinitis (AR). A meta-analysis of randomized controlled trials (RCTs) was conducted to compare the medications. Methods Relevant head-to-head comparative RCTs were retrieved by searching the PubMed, Embase, and Cochrane’s Library databases from inception to April 20, 2020. A random-effects model was applied to pool the results. Subgroup analyses were performed for seasonal and perennial AR. Results Fourteen RCTs comprising 4458 patients were included. LTRAs were inferior to SAHs in terms of the daytime nasal symptoms score (mean difference [MD]: 0.05, 95% confidence interval [CI] 0.02 to 0.08, p = 0.003, I2 = 89%) and daytime eye symptoms score (MD: 0.05, 95% CI 0.01 to 0.08, p = 0.009, I2 = 89%), but were superior in terms of the nighttime symptoms score (MD: − 0.04, 95% CI − 0.06 to − 0.02, p < 0.001, I2 = 85%). The effects of the two treatments on the composite symptom score (MD: 0.02, 95% CI − 0.02 to 0.05, p = 0.30, I2 = 91%) and rhinoconjunctivitis quality-of-life questionnaire (RQLQ) (MD: 0.01, 95% CI − 0.05 to 0.07, p = 0.71, I2 = 99%) were similar. Incidences of adverse events were comparable (odds ratio [OR]: 0.97, 95% CI 0.75 to 1.25, p = 0.98, I2 = 0%). These results were mainly obtained from studies on seasonal AR. No significant publication bias was detected. Conclusions Although both treatments are safe and effective in improving the quality of life (QoL) in AR patients, LTRAs are more effective in improving nighttime symptoms but less effective in improving daytime nasal symptoms compared to SAHs.

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