With novel CD therapies now available, there is a critical need for the development of a companion diagnostic for all biologics (including anti-TNF) to provide guidance to clinicians for the initial treatment selection as long-term efficacy may be affected by the first biologic exposure.27 Respectively, West et al and Wojtal et al found increased intestinal expression of OSM12 and FCGRIA16 were associated with anti-TNF nonresponse. The gene discussed is TNF; the disease is Cowden disease.