Suture for a Living recently published a blog entry that looks at the effectiveness of zafirlukast — often used in treating asthma — for treating capsular contracture. The author cites a half-dozen studies. The primary message is that while noting the positive response in many patients, the studies and even the Suture for a Living writer Ramona Bates, MD, notes that further studies need to be done. However, Bates' anecdotal information on a few of her own patients that have tried the drug does suggest its use may be beneficial. Use of Zafirlukast for Capsular Contracture:
I first read of the off-labeled use of zafirlukast back in 2002. I had one patient with a unilateral Baker’s Grade IV capsular contracture who wanted to avoid surgery (open capsulectomy). I told her it wasn’t proven (only 30 patients) but that half experienced softening of their capsules. I went over the possible side-effects of the drug with her. She wanted to give it a try. So I prescribed zafirlukast 20 mg twice daily for 3 months. She responded with softening of her capsule. After 3 months she asked for a refill to try to achieve more softening. She now had a Grade II-III capsular contracture. I agreed. It softened to a Grade II and she was happy.
I now have another patient who is in the same state. I have decided to try to review the literature and see if the early study has been confirmed. The first six articles referenced below are the ones I found. All were small in number, ranging from 20-120 human patients or 40 rats.