Adalimumab, a fully human anti-tumor necrosis factor (TNF) monoclonal antibody, and vedolizumab, a humanized anti-α4β7 integrin monoclonal antibody, are both US Food and Drug Administration (FDA)-approved biologic treatments for moderate-to-severe CD.17,18 In separate placebo-controlled trials, adalimumab (CHARM19) and vedolizumab (GEMINI 220) have been shown to improve clinical outcomes and maintain remission in biologic-naive patients with moderate-to-severe CD. This evidence concerns the gene TNF and Cowden disease.