TNF and Cowden disease: Consequently, researchers have developed several new biologic agents based on different immune mechanisms to address the non-response to TNFα antagonists in CD patients: interleukin antagonists like Ustekinumab and Risankizumab (Benson et al., 2011; Singh et al., 2015), anti-integrin monoclonal antibody like Vedolizumab (Soler et al., 2009).