Furthermore, although prolonged corticosteroid therapy leads to a higher mortality rate than anti-tumor necrosis factor (TNF) therapy18, the cumulative use of corticosteroids, risk of IBD-related surgery, and mortality are similar between EO-IBD and NEO-IBD16, and those with EO-IBD are less likely to receive treatment with immunomodulators and anti-TNF agents compared to those with NEO-IBD5,11,14–16,19. This evidence concerns the gene TNF and inflammatory bowel disease.