Clinical significance of isolated periappendiceal red patch in ulcerative colitis: A systematic review, meta-analysis, and meta-regression.
Khawaja Abdul Rehman, Noor Us Sehar, Umar Akram et al.
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In 30 seconds
This systematic review and meta-analysis examined whether an isolated periappendiceal red patch (PARP) is associated with disease extent or outcomes in ulcerative colitis. It included 13 nonrandomized studies with 2289 patients (725 with PARP and 1564 without). PARP was associated with higher odds of proctitis (OR, 1.54; 95% CI, 1.09-2.18; P = .02), but not with left-sided or extensive colitis. The analysis found no association with disease progression, pharmacotherapeutic escalation, or colectomy, although heterogeneity was moderate to high for most outcomes.
Key findings
- PARP was associated with higher odds of proctitis (OR, 1.54; 95% CI, 1.09-2.18; P = .02).
- No significant association was found with left-sided colitis (OR, 0.88; 95% CI, 0.57-1.35; P = .51) or extensive colitis (OR, 0.84; 95% CI, 0.50-1.41; P = .45).
- PARP was not associated with disease progression, pharmacotherapeutic escalation, or colectomy.
Why it matters
A periappendiceal red patch may accompany ulcerative proctitis, but these pooled findings do not indicate that it marks more extensive disease or worse long-term clinical outcomes. This distinction can help clinicians interpret the endoscopic finding without assuming it signals a need for treatment escalation or predicts colectomy.
What to keep in mind
The evidence came from nonrandomized studies, and moderate-to-high heterogeneity was observed across most outcomes.