Clinicians often face uncertainty in deciding when and how to position biologics versus Janus kinase (JAK) inhibitors in anti-tumor necrosis factor (TNF) therapy-refractory patients with ulcerative colitis (UC). To shed light on this dilemma, Marjolijn Duijvestein, MD, of Amsterdam University Medical Center in the Netherlands, and colleagues compared the relative effectiveness and safety of vedolizumab (Entyvio) and the JAK inhibitor tofacitinib (Xeljanz) in anti-TNF-exposed UC patients in the Dutch Initiative on Crohn and Colitis (ICC) Registry.