TNF and inflammatory bowel disease: Alternatively, swapping TNF inhibitor therapy for another class of drug has been recommended following treatment failure.58 Yet, current data demonstrate that patients who fail TNF inhibitor therapy do not respond well to alternative treatments.29 This may also be dependent on the therapy29 and reason for discontinuation of TNF inhibitors.122 A recent meta-analysis of eight IBD studies found that patients with primary non-response to TNF inhibitors were less likely to respond to non-TNF biologic therapies than those who discontinued due to secondary loss of response or intolerance.123