Six years ago, the Gemini pharma trial reported no significant difference in response rate between Ulcerative Colitis (UC) patients randomized to q8week vedolizumab dosing vs q4weeks.1 In Gemini, patients were randomized based on response after 6 week induction, but post-hoc analysis and real world data report an average response time of 19 weeks.2 Patients in Gemini may have been dose escalated too early, which minimized potential difference between groups. Previous studies indicate dose intensification benefits patients who initially achieved remission on standard dosing but lost response.