{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T15:41:57Z","timestamp":1788363717563,"version":"build-2803163510"},"reference-count":27,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Appendectomy has been proposed to influence ulcerative colitis (UC) outcomes, but its effect based on timing before or after diagnosis and long-term UC outcomes remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Using TriNetX U.S. Collaborative Network, we identified adults with UC (2010-2024) who underwent appendectomy before or after diagnosis. Two 1:1 propensity score-matched comparisons were performed: appendectomy-before-UC and appendectomy-after-UC versus controls. The primary outcome was a 5-year composite of oral\/intravenous (IV) corticosteroid use or colectomy. Secondary outcomes included individual composite outcomes and advanced therapy initiation in biologic-naive patients. Subgroup analyses stratified by age and biologic exposure were also performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After matching, appendectomy after UC diagnosis showed no association with the composite outcome (aHR 0.98, 95% CI, 0.83-1.16), oral steroids (aHR 0.90, 95% CI, 0.75-1.09), IV steroids (aHR 1.11, 95% CI, 0.87-1.43), colectomy (aHR 1.24, 95% CI, 0.77-1.99), or advanced therapy initiation (aHR 0.97, 95% CI, 0.63-1.48). Appendectomy before UC diagnosis also showed no difference in the composite outcome (aHR 0.91, 95% CI, 0.76-1.09), oral steroids (aHR 0.88, 95% CI, 0.72-1.08), colectomy (aHR 0.99, 95% CI, 0.60-1.63), or advanced therapy initiation (aHR 0.77, 95% CI, 0.53-1.13). However, IV steroid use was reduced (aHR 0.68, 95% CI, 0.51-0.90, P\u2009=\u2009.006). In subgroup analyses, advanced therapy initiation was lower in patients aged 18-40\u2009years following appendectomy after UC diagnosis (aHR 0.56, 95% CI, 0.33-0.96, P\u2009=\u2009.03).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Appendectomy was not associated with improved long-term UC outcomes of oral\/IV steroid use, colectomy or initiation of advanced therapy regardless of timing.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ibd\/izag159","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T12:04:15Z","timestamp":1784721855000},"source":"Crossref","is-referenced-by-count":1,"title":["Appendectomy before or after ulcerative colitis diagnosis is not associated with improved long-term outcomes: a multicenter real-world study"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6604-7712","authenticated-orcid":false,"given":"Aakash","family":"Desai","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Hepatology & Nutrition, Allegheny Health Network , Pittsburgh, PA,","place":["United States"]},{"name":"Drexel University College of Medicine Department of Medicine, , Philadelphia, PA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4571-3453","authenticated-orcid":false,"given":"Kartik","family":"Dapke","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Saint Vincent Hospital , Worcester, MA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4994-2093","authenticated-orcid":false,"given":"Hany","family":"Habib","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Allegheny General Hospital , Pittsburgh, PA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jana G","family":"Hashash","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Inflammatory Bowel Disease Center, Mayo Clinic , Jacksonville, FL,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis A","family":"Farraye","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Inflammatory Bowel Disease Center, Mayo Clinic , Jacksonville, FL,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"2026080611585622900_izag159-B1","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1016\/S0140-6736(23)00966-2","article-title":"Ulcerative colitis","volume":"402","author":"Le Berre","year":"2023","journal-title":"Lancet"},{"key":"2026080611585622900_izag159-B2","doi-asserted-by":"publisher","first-page":"2068","DOI":"10.3748\/wjg.v30.i15.2068","article-title":"Combination treatment of inflammatory bowel disease: present status and future perspectives","volume":"30","author":"Triantafillidis","year":"2024","journal-title":"World J Gastroenterol"},{"key":"2026080611585622900_izag159-B3","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1093\/ibd\/izac106","article-title":"Appendix and ulcerative colitis: a key to explaining the pathogenesis and directing novel therapies?","volume":"29","author":"Arjomand Fard","year":"2023","journal-title":"Inflamm Bowel Dis"},{"key":"2026080611585622900_izag159-B4","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1186\/s13099-025-00696-2","article-title":"The functional landscape of the appendix microbiome under conditions of health and 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and application to use the real-world data and analytics platform TriNetX","volume":"16","author":"Ludwig","year":"2025","journal-title":"Front Pharmacol"},{"key":"2026080611585622900_izag159-B13","doi-asserted-by":"publisher","first-page":"803","DOI":"10.1136\/gut.51.6.803","article-title":"Effects of appendicectomy on the course of ulcerative colitis","volume":"51","author":"Cosnes","year":"2002","journal-title":"Gut"},{"key":"2026080611585622900_izag159-B14","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1093\/ecco-jcc\/jjy127","article-title":"Appendectomy for therapy-refractory ulcerative colitis results in pathological improvement of colonic inflammation: short-term results of the PASSION Study","volume":"13","author":"Sahami","year":"2019","journal-title":"J Crohns Colitis"},{"key":"2026080611585622900_izag159-B15","doi-asserted-by":"publisher","first-page":"b716","DOI":"10.1136\/bmj.b716","article-title":"Appendicitis, mesenteric lymphadenitis, and subsequent risk 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