{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T21:18:11Z","timestamp":1783459091674,"version":"3.55.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and aims<\/jats:title>\n                    <jats:p>In patients with inflammatory bowel diseases (IBD), tumor necrosis factor antagonists (anti-TNFs) are frequently used alongside immunomodulators to improve treatment efficacy. While an increased risk of cancers with thiopurines is well established, there is sparse data on cancer risk with methotrexate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study of patients with Crohn\u2019s disease (CD) or ulcerative colitis (UC) at a large, integrated healthcare system. Eligible patients received either anti-TNF monotherapy or combination (anti-TNF\u2009+ methotrexate) between 1999 and 2025. The primary outcome was incident cancer confirmed by chart review. Cox-proportional hazards models were used to identify the independent effect of combination therapy on cancer risk, adjusting for relevant covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our study included 2332 patients with IBD (80.9%) on anti-TNF monotherapy and 549 (19.1%) on combination therapy. Mean age at inclusion was 35\u2009years, and 75.8% had CD. Mean follow-up duration was 3.3\u2009years. Over 1353 and 8031 person-years of follow-up, incidence rates of all cancers were 7.4 and 6.4 per 1000 person-years in the combination and monotherapy groups, respectively (P\u2009=\u2009.64). We observed no increased risk of cancer between groups for all cancers (adjusted HR 0.94, 95% CI, 0.47-1.89), skin cancer (adjusted HR 0.57, 95% CI, 0.07-4.51) or non-skin cancers (adjusted HR 1.00, 95% CI, 0.48-2.11). Age\u2009\u2265\u200960\u2009years and prior thiopurine exposure were associated with an increased risk of cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Combination anti-TNF and methotrexate therapy was not associated with an increased cancer risk compared to anti-TNF monotherapy in patients with IBD in our cohort.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ibd\/izag143","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T20:50:44Z","timestamp":1783457444000},"source":"Crossref","is-referenced-by-count":0,"title":["Cancer risk with methotrexate-TNF antagonist combination therapy compared to TNF-antagonist monotherapy in IBD"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7284-8735","authenticated-orcid":false,"given":"Sama","family":"Anvari","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Massachusetts General Hospital , Boston, MA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7221-4196","authenticated-orcid":false,"given":"Wasuwit","family":"Wanchaitanawong","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Massachusetts General Hospital , Boston, MA,","place":["United States"]},{"name":"Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine Chiang, Mai University ,","place":["Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Xiong","sequence":"additional","affiliation":[{"name":"Harvard T.H. Chan School of Public Health , Boston, MA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianxi","family":"Cai","sequence":"additional","affiliation":[{"name":"Harvard T.H. Chan School of Public Health , Boston, MA,","place":["United States"]},{"name":"Harvard Medical School , Boston, MA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9436-1821","authenticated-orcid":false,"given":"Ashwin N","family":"Ananthakrishnan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Massachusetts General Hospital , Boston, MA,","place":["United States"]},{"name":"Harvard Medical School , Boston, MA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,7]]},"reference":[{"key":"2026070716503639000_izag143-B1","doi-asserted-by":"publisher","first-page":"1225","DOI":"10.14309\/ajg.0000000000003465","article-title":"ACG clinical guideline: management of Crohn\u2019s Disease in adults","volume":"120","author":"Lichtenstein","year":"2025","journal-title":"Am J 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