Appendectomy Boosts Remission Rates in Ulcerative Colitis Patients, Landmark Study Finds
amsterdam, Netherlands – A major international trial has revealed that laparoscopic appendectomy, combined with standard medical therapy, significantly improves the rate of sustained remission in patients with ulcerative colitis (UC). The ACCURE study, involving 201 patients across the Netherlands, Ireland, and the United Kingdom, demonstrated a 35% reduction in relapse rates within one year for those who underwent appendectomy compared to those who continued medical therapy alone.
Researchers hypothesized that the appendix may have an immunomodulating role in UC. Between 2012 and 2022,they randomized UC patients in clinical remission-but with a history of relapse in the prior 12 months-to either an appendectomy plus continued maintenance therapy (101 patients) or continued maintenance therapy alone (100 patients). Following exclusions, the final analysis included 99 patients in the intervention group and 98 in the control group.
The primary endpoint, relapse defined as a total Mayo score of ≥ 5 with an endoscopic subscore of 2 or 3, occurred in 36% of the appendectomy group versus 56% of the control group (RR 0.65; 95% CI 0.47-0.89; P = 0.005, and p = 0.002 after correction). Side effects were reported in 11% of the appendectomy group and 10% of the control group,with the most common being temporary postoperative abdominal pain (3% in the intervention group) and skin rash (3% in the control group). Two patients in the intervention group experienced more severe side effects, while none were reported in the control group. Notably, low-grade appendiceal Mucinous Neoplasms (Lamn) were incidentally discovered in two removed appendixes.
The findings, published in Lancet Gastroenterology & Hepatology (2025;10:550-61), offer a potential new avenue for managing UC, a chronic inflammatory bowel disease affecting millions worldwide.The study was conducted by Acherman YIZ, arebid N, Arthurs E, and the ACCURE Study Group.
