What is an advantage of NSAIDs over glucocorticoids?

• A. NSAIDs are not immunosuppressive, whereas glucocorticoids are immunosuppressive.
• B. NSAIDs have a faster onset of drug action than glucocorticoids.
• C. NSAIDs are not controlled substances, but glucocorticoids are controlled substances.
• D. NSAIDs may be used topically, but glucocorticoids are not effective topically.

Answer: (A)

An important difference is how they affect the immune system. Glucocorticoids suppress immune function broadly, which helps control inflammation but can weaken host defenses and slow healing. NSAIDs reduce inflammation mainly by inhibiting prostaglandin synthesis with COX enzymes and do not broadly suppress the immune system. This means NSAIDs can provide anti-inflammatory relief without the systemic immunosuppression associated with glucocorticoids, making them advantageous when preserving immune function is desirable. The other statements aren’t consistently true: onset of action can vary and isn’t reliably faster for NSAIDs, many glucocorticoids are not controlled substances and NSAIDs aren’t inherently controlled substances either, and both classes can be used topically in many situations, so topical efficacy isn’t a unique advantage of NSAIDs.