Thus, Ungaro et al. observed a higher mortality and a prolonged disease course in IBD patients with thiopurines in the SECURE-IBD cohort particularly in comparison to TNF-blockers (aOR 4.08, 95% CI 1.73–9.61), warranting considerations to not newly begin or discontinue thiopurine therapy in IBD patients unless vaccines are broadly available.58 This evidence concerns the gene TNF and inflammatory bowel disease.