The need for the SERENE studies of high-dose adalimumab induction therapy was clear. From the first randomized controlled trial evaluating the efficacy and safety of adalimumab for the management Crohn’s disease, CLASSIC-I trial, we were confident about the valuable role this biologic would have in the management of patients with Crohn’s disease (CD).1 Subsequently, the ULTRA trials gave us optimism about the utility of adalimumab for the management of ulcerative colitis (UC).2 However, from the beginning, we had legitimate concerns that, due to the lack of an obvious shouldering of the results at the highest dose studied, better results were possible.