During the past 2 decades, the therapeutic armamentarium for the medical management of patients with moderate-to-severe IBD has substantially expanded.5 Although tumor necrosis factor (TNF) antagonists have been the mainstay of treatment for patients with IBD refractory to conventional therapies, newer therapies such as vedolizumab, an anti-integrin monoclonal antibody, potentially offers a safety advantage because of its gut selectivity, which may be attractive for older patients. The gene discussed is TNF; the disease is inflammatory bowel disease.