What is the role of vedolizumab in the era of anti-TNF agents?

Current treatment options for Crohn’s disease (CD) include 5-aminosalicylates, steroids, immune suppressants, or biologics depending on the severity of a patient’s symptoms. Biologics, initially limited to anti-TNF agents such as infliximab, adalimumab, and certolizumab pegol, have typically been reserved for patients with disease refractory to immune suppressants or with disease characteristics placing the patient at high risk for disability. Although highly effective, 20-40% of CD patients do not respond to induction therapy (1).