2025/07/01 by Eva Visser, Thomas Pinkney, Lianne Heuthorst +3 · 1 voice · 2 citations
Biochemistry, Genetics and Molecular Biology · Medicine · #Appendicitis Diagnosis and Management #Colitis #Disease #Diverticular Disease and Complications #Gastroenterology #Inflammatory Bowel Disease #Internal medicine #Medicine #Post hoc #Post-hoc analysis #Ulcerative colitis
paper · open access · doi:10.1093/bjs/znaf137
published in British journal of surgery 112(7) (Oxford University Press)
openalex publication_date 2025/07/01 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/01
Dear Editor, Epidemiological studies have suggested that appendicectomy, particularly when performed during childhood, may reduce the risk of developing ulcerative colitis (UC)1. This observation has led to a growing interest in its potential therapeutic role in modifying the course of UC. The ACCURE trial, the first randomized controlled superiority trial of this intervention, demonstrated that appendicectomy significantly reduces clinical relapses within one year in patients with UC compared to standard medical therapy2. As 36% of patients still relapse following appendicectomy, the identification of upfront patient and disease characteristics associated with the optimal benefit might result in a more targeted treatment approach. As such, this analysis aimed to explore patient-level predictors of maintained disease remission up to one year after appendicectomy in the ACCURE trial cohort. A post-hoc analysis of 156 patients from the ACCURE trial (NTR2883 and ISRCTN60945764; Fig. S1) was undertaken. Remission was defined as the absence of relapse according to predefined study criteria within 12 months, confirmed by an endoscopic Mayo score (subscore 0 or 1). Time-dependent Cox regression was used to identify baseline characteristics associated with maintained remission at one year, and interaction terms between treatment group and baseline factors were calculated to assess the effect of appendicectomy on efficacy outcome (supplementary methods).