TNF and inflammatory bowel disease: In theory, vedolizumab, by inhibiting the adhesion and migration of leukocytes into the gastrointestinal tract7 may be an attractive option for PSC, as it blocks gut-homing lymphocyte trafficking to bile ducts which have been linked with the pathophysiology of PSC.8 Although it is acknowledged that several biologics other than anti-TNF and anti-integrins have been approved for use in IBD,9 data regarding their use in PSC-IBD are sparse (often reported in case reports or case series or only one cohort study) hence were excluded from this meta-analysis.