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Inflammatory arthritis is frequently treated with methotrexate. Concurrent use of Non-Steroidal Anti-Inflammatory Medicines (NSAIDs), such as aspirin, paracetamol (acetaminophen), or both, has raised questions about their safety. The safety of methotrexate alone versus methotrexate combined with NSAIDs, such as aspirin, paracetamol, or both, has been compared in both randomized controlled trials and non-randomized studies in patients with inflammatory arthritis.