Which statement is true regarding NSAIDs in OA?

• A. Topical NSAIDs are recommended for knee OA
• B. Topical NSAIDs are never used in OA
• C. Oral NSAIDs are not recommended for any OA
• D. All NSAIDs are equally effective for all OA sites

Answer: (A)

The main idea is that NSAIDs can be used in OA, and topical forms offer targeted relief with a lower risk of systemic side effects. For knee OA, a topical NSAID such as diclofenac gel provides meaningful pain relief directly at the joint while minimizing gastrointestinal and cardiovascular risks that come with taking pills. Because of this favorable safety profile for knee OA, topical NSAIDs are recommended as a reasonable option, especially when there is a desire to limit systemic NSAID exposure or when GI risk is a concern.

Oral NSAIDs, while effective and commonly used for knee OA, carry a higher risk of systemic adverse effects and are not avoided entirely; they’re used with caution based on patient factors. The idea that topical NSAIDs are never used is incorrect, and the notion that all NSAIDs are equally effective for all OA sites is incorrect because efficacy and safety can vary by drug and by joint, with topical formulations having stronger support for knee and some superficial joints in guidelines.