Quitting Failure and Success With and Without Using Medication: Latent Classes of Abstinence and Adherence to Nicotine Monotherapy, Combination Therapy, and Varenicline

Abstract Introduction Nonadherence to pharmacotherapies complicates studies of comparative pharmacotherapy effectiveness. Modeling adherence and abstinence simultaneously may facilitate analysis of both treatment acceptability and effectiveness. Methods Secondary analyses of a three-arm randomized comparative trial of nicotine patch, varenicline, and combination nicotine patch and lozenge among adult daily smokers (N = 1086) were conducted. Adherence rates collected via interactive voice response systems during the first 27 days of quitting were compared across treatment conditions. Repeated measures latent class analyses of adherence and abstinence in 3-day parcels through 27 days of a quit attempt were conducted with treatment, demographic, and smoking history covariates. Results Adherence varied across treatments and was lowest for nicotine lozenge use in combination nicotine replacement therapy (NRT). Five latent classes that differed significantly in 6-month abstinence rates were retained, including three subgroups of adherent participants varying in treatment response and two nonadherent groups varying in abstinence probabilities. Nonadherence was more likely among those receiving varenicline and combination NRT, relative to patch monotherapy. Varenicline and combination NRT did not promote abstinence among adherent latent classes but did promote abstinence among those partially adherent, relative to patch alone. Combination therapy attenuated increased risk of treatment disengagement with more years smoking. Minority smokers, those high in dependence, and those with shorter past abstinence were at increased risk for low-adherence and low-abstinence latent classes. Conclusions Varenicline and combination nicotine patch and lozenge are less likely to be used as directed and may not increase first-month abstinence better than patch alone when taken adherently. Implications This secondary analysis of adherence and abstinence in a comparative effectiveness trial shows that adherence is highest for the nicotine patch, next highest for varenicline, and lowest for combination nicotine patch and lozenge therapy due to low lozenge use. Distinct latent classes were found that varied in both first-month abstinence and adherence. Varenicline and combination NRT may not enhance abstinence over patch alone among smokers who take medication adherently. Adherent use of medication especially benefits those who are low in dependence and have positive quitting histories; it is less beneficial to at-risk smokers and members of racial minorities.

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Abstract 15529: Multimorbidity Clusters in Patients Presenting to the Emergency Department With Potential Acute Coronary Syndrome

Circulation ◽

10.1161/circ.142.suppl_3.15529 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Katherine Breen ◽

Lorna Finnegan ◽

Karen M Vuckovic ◽

Anne M Fink ◽

Wayne D Rosamond ◽

...

Keyword(s):

Emergency Department ◽

Acute Coronary Syndrome ◽

Family History ◽

Chronic Conditions ◽

Latent Class ◽

Secondary Analysis ◽

Adverse Outcomes ◽

Coronary Syndrome ◽

Increased Risk ◽

Class 1

Introduction: The increasing prevalence of multimorbidity (> 2 chronic conditions) is a challenge for healthcare providers and systems. Multimorbidity complicates treatment and increases the risk of adverse outcomes. Objectives: To identify multimorbidity classes (clusters of > 2 specific chronic conditions) in a secondary analysis of a multi-site study about symptoms in patients presenting to the emergency department (ED) for potential acute coronary syndrome (ACS). Hypothesis: Specific multimorbidity classes can predict an ACS diagnosis. Methods: Chronic conditions were measured (Charlson Comorbidity Index and ACS Patient Information Questionnaire) in patients who underwent a cardiac evaluation in the ED. Latent class analysis was used to identify multimorbidity classes, and logistic regression determined whether multimorbidity classes were predictive of being ruled-in versus ruled-out for ACS. Results: The sample ( n = 935) was 38% female, with a mean age of 59 years. Four multimorbidity classes were identified and labeled: High multimorbidity (Class 1, hyperlipidemia, hypertension [HTN], obesity, diabetes, and respiratory disorders); Low multimorbidity (Class 2, obesity); Cardiovascular multimorbidity (Class 3, HTN, hyperlipidemia, and coronary heart disease); and Cardio-oncology multimorbidity (Class 4, HTN, hyperlipidemia, and cancer). Patients in Classes 3 and 4 had a 2.8-fold and 1.7-fold increased risk of ruling-in for ACS compared to those in Class 2 who were half as likely to rule-in for ACS (OR 0.45 95% CI 0.33 to 0.61 p=0.001). Class membership differed by sex, age, and family history. Females were more likely to be in Class 1 (44.2%), younger patients in Class 2 (mean age 43.4 ± 9.8 years), older patients in class 4 (mean age 80.0 ± 6.3 years), and those with a family history of sudden cardiac death (< age 55) in Class 3 (58.3%). Conclusion: Multimorbidity classes differed according to demographic and clinical variables. Membership in Classes 3 and 4 were predictive of an ACS diagnosis. Clustering patients by multimorbidity class may inform risk-stratification during evaluation for ACS.

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COVID-19 and cancer registries: learning from the first peak of the SARS-CoV-2 pandemic

British Journal of Cancer ◽

10.1038/s41416-021-01324-x ◽

2021 ◽

Author(s):

Alvin J. X. Lee ◽

Karin Purshouse

Keyword(s):

Risk Factors ◽

Performance Status ◽

Poor Performance ◽

Cancer Registries ◽

Adverse Outcomes ◽

Smoking History ◽

Poor Performance Status ◽

International Studies ◽

Patients With Cancer ◽

Increased Risk

AbstractThe SARS-Cov-2 pandemic in 2020 has caused oncology teams around the world to adapt their practice in the aim of protecting patients. Early evidence from China indicated that patients with cancer, and particularly those who had recently received chemotherapy or surgery, were at increased risk of adverse outcomes following SARS-Cov-2 infection. Many registries of cancer patients infected with SARS-Cov-2 emerged during the first wave. We collate the evidence from these national and international studies and focus on the risk factors for patients with solid cancers and the contribution of systemic anti-cancer treatments (SACT—chemotherapy, immunotherapy, targeted and hormone therapy) to outcomes following SARS-Cov-2 infection. Patients with cancer infected with SARS-Cov-2 have a higher probability of death compared with patients without cancer. Common risk factors for mortality following COVID-19 include age, male sex, smoking history, number of comorbidities and poor performance status. Oncological features that may predict for worse outcomes include tumour stage, disease trajectory and lung cancer. Most studies did not identify an association between SACT and adverse outcomes. Recent data suggest that the timing of receipt of SACT may be associated with risk of mortality. Ongoing recruitment to these registries will enable us to provide evidence-based care.

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THE RELATIONSHIP BETWEEN INFLAMMATORY DIETARY PATTERN AND INCIDENCE OF PERIODONTITIS

British Journal Of Nutrition ◽

10.1017/s0007114520005231 ◽

2021 ◽

pp. 1-36

Author(s):

Ahmed A. Alhassani ◽

Frank B. Hu ◽

Bernard A. Rosner ◽

Fred K. Tabung ◽

Walter C. Willett ◽

...

Keyword(s):

Confidence Interval ◽

Periodontal Disease ◽

Secondary Analysis ◽

Hazard Ratio ◽

Reduced Rank Regression ◽

Rank Regression ◽

Increased Risk ◽

Cox Proportional Hazard Models ◽

Study Population

ABSTRACT The long-term inflammatory impact of diet could potentially elevate the risk of periodontal disease through modification of systemic inflammation. The aim of the present study was to prospectively investigate the associations between a food based, reduced rank regression (RRR) derived, empirical dietary inflammatory pattern (EDIP) and incidence of periodontitis. The study population was composed of 34,940 men from the Health Professionals Follow-Up Study, who were free of periodontal disease and major illnesses at baseline (1986). Participants provided medical and dental history through mailed questionnaires every 2 years, and dietary data through validated semi-quantitative food frequency questionnaires every 4 years. We used Cox proportional hazard models to examine the associations between EDIP scores and validated self-reported incidence of periodontal disease over a 24-year follow-up period. No overall association between EDIP and the risk of periodontitis was observed; the hazard ratio comparing the highest EDIP quintile (most proinflammatory diet) to the lowest quintile was 0.99 (95% confidence interval: 0.89 -1.10, p-value for trend = 0.97). A secondary analysis showed that among obese non-smokers (i.e. never and former smokers at baseline), the hazard ratio for periodontitis comparing the highest EDIP quintile to the lowest was 1.39 (95% confidence interval: 0.98 -1.96, p-value for trend = 0.03). In conclusion, no overall association was detected between EDIP and incidence of self-reported periodontitis in the study population. From the subgroups evaluated EDIP was significantly associated with increased risk of periodontitis only among nonsmokers who were obese. Hence, this association must be interpreted with caution.

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Social Jetlag and Prostate Cancer Incidence in Alberta’s Tomorrow Project: A Prospective Cohort Study

Cancers ◽

10.3390/cancers12123873 ◽

2020 ◽

Vol 12 (12) ◽

pp. 3873

Author(s):

Liang Hu ◽

Andrew Harper ◽

Emily Heer ◽

Jessica McNeil ◽

Chao Cao ◽

...

Keyword(s):

Prostate Cancer ◽

Cancer Risk ◽

Cancer Incidence ◽

Repeated Measures ◽

Prospective Cohort ◽

Prostate Cancer Risk ◽

Absolute Difference ◽

Prostate Cancer Incidence ◽

Social Jetlag ◽

Increased Risk

We investigated the association of social jetlag (misalignment between the internal clock and socially required timing of activities) and prostate cancer incidence in a prospective cohort in Alberta, Canada. Data were collected from 7455 cancer-free men aged 35–69 years enrolled in Alberta’s Tomorrow Project (ATP) from 2001–2007. In the 2008 survey, participants reported usual bed- and wake-times on weekdays and weekend days. Social jetlag was defined as the absolute difference in waking time between weekday and weekend days, and was categorized into three groups: 0–<1 h (from 0 to anything smaller than 1), 1–<2 h (from 1 to anything smaller than 2), and 2+ h. ATP facilitated data linkage with the Alberta Cancer Registry in June 2018 to determine incident prostate cancer cases (n = 250). Hazard ratios (HR) were estimated using Cox proportional hazards regressions, adjusting for a range of covariates. Median follow-up was 9.57 years, yielding 68,499 person-years. Baseline presence of social jetlag of 1–<2 h (HR = 1.52, 95% CI: 1.10 to 2.01), and 2+ hours (HR = 1.69, 95% CI: 1.15 to 2.46) were associated with increased prostate cancer risk vs. those reporting no social jetlag (p for trend = 0.004). These associations remained after adjusting for sleep duration (p for trend = 0.006). With respect to chronotype, the association between social jetlag and prostate cancer risk remained significant in men with early chronotypes (p for trend = 0.003) but attenuated to null in men with intermediate (p for trend = 0.150) or late chronotype (p for trend = 0.381). Our findings suggest that greater than one hour of habitual social jetlag is associated with an increased risk of prostate cancer. Longitudinal studies with repeated measures of social jetlag and large samples with sufficient advanced prostate cancer cases are needed to confirm these findings.

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Risk of Nursing Home Use Among Older Americans: The Impact of Psychiatric History and Trajectories of Cognitive Function

The Journals of Gerontology Series B ◽

10.1093/geronb/gbab045 ◽

2021 ◽

Author(s):

Maria T Brown ◽

Miriam Mutambudzi

Keyword(s):

Nursing Home ◽

Cognitive Function ◽

Latent Class ◽

Study Data ◽

Psychiatric Training ◽

Psychiatric History ◽

Term Care ◽

Increased Risk ◽

Course Variables ◽

The Impact

Abstract Objectives Mental illness and cognitive functioning may be independently associated with nursing home use. We investigated the strength of the association between baseline (1998) psychiatric history, 8-year cognitive function trajectories, and prospective incidence of nursing home use over a 10-year period while accounting for relevant covariates in U.S. adults aged 65 and older. We hypothesized that self-reported baseline history of psychiatric, emotional, or nervous problems would be associated with a greater risk of nursing home use and that cognition trajectories with the greatest decline would be associated with a subsequent higher risk of nursing home use. Methods We used 8 waves (1998–2016) of Health and Retirement Study data for adults aged 65 years and older. Latent class mixture modeling identified 4 distinct cognitive function trajectory classes (1998–2006): low-declining, medium-declining, medium-stable, and high-declining. Participants from the 1998 wave (N = 5,628) were classified into these 4 classes. Competing risks regression analysis modeled the subhazard ratio of nursing home use between 2006 and 2016 as a function of baseline psychiatric history and cognitive function trajectories. Results Psychiatric history was independently associated with greater risk of nursing home use (subhazard ratio [SHR] 1.26, 95% confidence interval [CI] 1.06–1.51, p < .01), net the effects of life course variables. Furthermore, “low-declining” (SHR 2.255, 95% CI 1.70–2.99, p < .001) and “medium-declining” (2.103, 95% CI 1.69–2.61, p < .001) trajectories predicted increased risk of nursing home use. Discussion Evidence of these associations can be used to educate policymakers and providers about the need for appropriate psychiatric training for staff in community-based and residential long-term care programs.

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Examining Associations Between Race, Gender, Alcohol Use, School Performance, and Patterns of Bullying in the School Context: A Latent Class Analysis

Journal of Interpersonal Violence ◽

10.1177/0886260521999123 ◽

2021 ◽

pp. 088626052199912

Author(s):

Valdemir Ferreira-Junior ◽

Juliana Y. Valente ◽

Zila M. Sanchez

Keyword(s):

Alcohol Use ◽

Latent Class Analysis ◽

School Performance ◽

Latent Class ◽

School Context ◽

Bullying Victimization ◽

Latent Classes ◽

Class Analysis ◽

Seventh Grade ◽

Sociodemographic Variables

Although many studies addressed bullying occurrence and its associations, they often use individual variables constructed from few items that probably are inadequate to evaluate bullying severity and type. We aimed to identify involvement patterns in bullying victimization and perpetration, and its association with alcohol use, school performance, and sociodemographic variables. Baseline assessment of a randomized controlled trial were used and a latent class analysis was conducted to identify bullying patterns among 1,742 fifth-grade and 2,316 seventh-grade students from 30 public schools in São Paulo, Brazil. Data were collected using an anonymous self-reported, audio-guided questionnaire completed by the participants on smartphones. Multinomial logistic regressions were performed to verify how covariant variables affected bullying latent classes. Both grades presented the same four latent classes: low bullying, moderate bullying victimization, high bullying victimization, and high bullying victimization and perpetration. Alcohol use was associated with all bullying classes in both grades, with odds ratio up to 5.36 (95% CI 3.05; 10.38) among fifth graders from the high bullying victimization and perpetration class. Poor school performance was also strongly associated with this class (aOR = 10.12, 95%CI = 4.19; 24.41). Black/brown 5th graders were 3.35 times more likely to fit into the high bullying victimization class (95% CI 1.34; 8.37). Lack of evidence for association of sociodemographic variables and bullying latent class among seventh-grade students was found. Bullying and alcohol use are highly harmful behaviors that must be prevented. However, prevention programs should consider how racial and gender issues are influencing the way students experience violence.

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49 Longitudinal Change of Sleep in the Elderly and Its Associations with Health

Age and Ageing ◽

10.1093/ageing/afab030.10 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

pp. i12-i42

Author(s):

A Didikoglu ◽

A Maharani ◽

A Payton ◽

M M Canal ◽

N Pendleton

Keyword(s):

Older Adults ◽

Latent Class ◽

Sport Participation ◽

Sleep Time ◽

Sleep Efficiency ◽

Longitudinal Change ◽

Sleep Timing ◽

Increased Risk ◽

Health And Mortality ◽

Evening Class

Abstract Introduction In elderly populations, sleep quality deteriorates and sleep time shifts towards earlier times. These sleep characteristics have been associated with cardiovascular, metabolic and psychiatric disorders, cognitive decline and mortality. Our aims are to examine longitudinal changes of sleep in older adults and to investigate the relationship between sleep variations, general health and mortality. Methods The University of Manchester Longitudinal Study of Cognition in Normal Healthy Old Age cohort (6,375 participants, recruited in the North of England, between 1983 and 1993) was used. Mixed models were used to investigate individual sleep trajectories (5 waves in 30-year period). Sleep timing and efficiency trajectories were clustered using latent class analysis and analysed against daily habits, health and mortality. Results Older adults have decreased sleep efficiency (~20%) and early sleep time (~30 min) between 40 and 100 years of age. Those in the high sleep efficiency latent class had minimal decrease in their sleep efficiency as they aged. Belonging to the high sleep efficiency latent class was associated with having lower prevalence of hypertension, circulatory problems, arthritis, breathing problems and recurrent depression compared to the low efficiency latent class. Results showed a higher risk of hypertension and metabolic syndrome in the evening-type latent class compared to morning-type individuals. Evening class was associated with traits related to lower health such as reduced sport participation, increased risk of depression and psychoticism personality, late eating, increased smoking and alcohol usage. Survival analysis revealed that individuals in the evening class had 1.15-fold increased risk of all-cause mortality compared to those with morning preferences. Conclusion Ageing is associated with decreased sleep efficiency and early sleep timing. However, there are detectable subgroups of sleep traits that are related to prevalence of different diseases and longevity. Understating these subgroups may pave the way for new treatments for healthy sleeping habits in older population.

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Effect of janus kinase inhibitors and methotrexate combination on malignancy in patients with rheumatoid arthritis: a systematic review and meta-analysis of randomized controlled trials

Autoimmunity Highlights ◽

10.1186/s13317-021-00153-5 ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Vinod Solipuram ◽

Akhila Mohan ◽

Roshniben Patel ◽

Ruoning Ni

Keyword(s):

Rheumatoid Arthritis ◽

Combination Therapy ◽

Randomized Controlled Trials ◽

Random Effect ◽

Janus Kinase ◽

Controlled Trials ◽

Randomized Controlled ◽

Increased Risk ◽

Significant Difference ◽

Risk Of Malignancy

Abstract Background Rheumatoid arthritis (RA) is a systemic autoimmune disease. The combination therapy of methotrexate (MTX) and Janus kinase inhibitor (JAKi) is commonly used. Patients with RA are at increased risk of malignancy, however, it remains unclear whether the combination therapy is associated with a higher risk. Objective To assess the malignancy risk among patients with RA receiving combination therapy of JAKi and MTX compared to MTX alone. Methods PubMed, Cochrane and Embase were thoroughly searched for randomized controlled trials (RCTs) in patients with RA receiving JAKi and MTX, from inception to July 2020. Primary endpoints were malignancy events, Non melanomatous skin cancer (NMSC) and malignancy excluding NMSC and secondary endpoints were serious adverse events (SAE), deaths. Risk ratio (RR) and 95% CI were calculated using the Mantel–Haenszel random-effect method. Results 659 publications were screened and 13 RCTs with a total of 6911 patients were included in the analysis. There was no statistically significant difference in malignancy [RR = 1.42; 95% CI (0.59, 3.41)], neither NMSC [RR = 1.44 (0.36, 5.76)] nor malignancies excluding NMSC [RR = 1.12 (0.40, 3.13)]. No statistically significant difference between the two groups for SAE [RR = 1.15 (0.90, 1.47)] and deaths [RR = 1.99 (0.75, 5.27)] was found. Conclusion The adjunction of JAKi to MTX is not associated with an increased risk of malignancy when compared to MTX alone. There is no increased risk of SAE and deaths when compared to MTX alone in patients with RA.

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Mendelian randomization analysis of arsenic metabolism and pulmonary function within the Hispanic Community Health Study/Study of Latinos

Scientific Reports ◽

10.1038/s41598-021-92911-8 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Molly Scannell Bryan ◽

Tamar Sofer ◽

Majid Afshar ◽

Yasmin Mossavar-Rahmani ◽

H. Dean Hosgood ◽

...

Keyword(s):

Pulmonary Function ◽

Mendelian Randomization ◽

Smoking History ◽

Health Study ◽

Arsenic Metabolism ◽

Percentage Point Increase ◽

Point Increase ◽

Increased Risk ◽

Genotype Information ◽

Rice Consumption

AbstractArsenic exposure has been linked to poor pulmonary function, and inefficient arsenic metabolizers may be at increased risk. Dietary rice has recently been identified as a possible substantial route of exposure to arsenic, and it remains unknown whether it can provide a sufficient level of exposure to affect pulmonary function in inefficient metabolizers. Within 12,609 participants of HCHS/SOL, asthma diagnoses and spirometry-based measures of pulmonary function were assessed, and rice consumption was inferred from grain intake via a food frequency questionnaire. After stratifying by smoking history, the relationship between arsenic metabolism efficiency [percentages of inorganic arsenic (%iAs), monomethylarsenate (%MMA), and dimethylarsinate (%DMA) species in urine] and the measures of pulmonary function were estimated in a two-sample Mendelian randomization approach (genotype information from an Illumina HumanOmni2.5-8v1-1 array), focusing on participants with high inferred rice consumption. Among never-smoking high inferred consumers of rice (n = 1395), inefficient metabolism was associated with past asthma diagnosis and forced vital capacity below the lower limit of normal (LLN) (OR 1.40, p = 0.0212 and OR 1.42, p = 0.0072, respectively, for each percentage-point increase in %iAs; OR 1.26, p = 0.0240 and OR 1.24, p = 0.0193 for %MMA; OR 0.87, p = 0.0209 and OR 0.87, p = 0.0123 for the marker of efficient metabolism, %DMA). Among ever-smoking high inferred consumers of rice (n = 1127), inefficient metabolism was associated with peak expiratory flow below LLN (OR 1.54, p = 0.0108/percentage-point increase in %iAs, OR 1.37, p = 0.0097 for %MMA, and OR 0.83, p = 0.0093 for %DMA). Less efficient arsenic metabolism was associated with indicators of pulmonary dysfunction among those with high inferred rice consumption, suggesting that reductions in dietary arsenic could improve respiratory health.

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FRI0421 RATES OF PROGRESSION DIFFER BETWEEN STRUCTURAL PHENOTYPES OF KNEE OSTEOARTHRITIS: A SECONDARY ANALYSIS FROM THE FNIH COHORT

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.1802 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 808.1-809

Author(s):

F. Roemer ◽

J. Collins ◽

T. Neogi ◽

M. Crema ◽

A. Guermazi

Keyword(s):

Subchondral Bone ◽

Radiographic Progression ◽

Conditional Logistic Regression ◽

Secondary Analysis ◽

Sensitivity Analyses ◽

Case Group ◽

Composite Outcome ◽

Bone Phenotype ◽

Increased Risk ◽

Inflammatory Phenotype

Background:Imaging plays an important role in determining structural disease severity and potential suitability of patients recruited to disease-modifying osteoarthritis drug (DMOAD) trials. It has been suggested that there may be three main structural phenotypes in OA, i.e., inflammation, meniscus/cartilage and subchondral bone. These may progress differently and may represent distinct tissue targets for DMOAD approaches.Objectives:To stratify the Foundation for National Institutes of Health Osteoarthritis Biomarkers Consortium (FNIH) cohort, a well-defined subsample of the larger Osteoarthritis Initiative (OAI) study, into distinct structural phenotypes based on semiquantitative MRI assessment and to determine their risk for progression over 48 months.Methods:The FNIH was designed as a case-control study with knees showing either 1) radiographic and pain progression (i.e., “composite” cases), 2) radiographic progression only (“JSL”), 3) pain progression only, and 4) neither radiographic nor pain progression. MRI of both knees was performed on 3 T systems at the four OAI clinical sites. Two musculoskeletal radiologists read the baseline MRIs according to the MOAKS scoring system. Knees were stratified into subchondral bone, meniscus/cartilage and inflammatory phenotypes1. A secondary, less stringent definition for inflammatory and meniscus/cartilage phenotype was used for sensitivity analyses. The relation of each phenotype to risk of being in the JSL or composite case group compared to those not having that phenotype was determined using conditional logistic regression. Only KL2 and 3 and those without root tears were included.Results:485 knees were included. 362 (75%) did not have any phenotype, while 95 (20%) had the bone phenotype, 22 (5%) the cartilage/meniscus phenotype and 19 (4%) the inflammatory phenotype. The bone phenotype was associated with a higher risk of the JSL and composite outcome (OR 1.81;[95%CI 1.14,2.85] and 1.65; 95%CI [1.04,2.61]) while the inflammatory (OR 0.96 [95%CI 0.38,2.42] and 1.25; 95%CI [0.48,3.25]) and the meniscus/cartilage phenotypes were not (OR 1.30 95%CI [0.55,3.07] and 0.99; 95%CI [0.40,2,49]).In sensitivity analyses, the bone phenotype and having two phenotypes (vs. none) were both associated with increased risk of experiencing the composite outcome (bone: OR 1.65; 95% CI 1.04, 2.61; 2 phenotypes: OR 1.87; 95% CI 1.11, 3.16.Conclusion:The bone phenotype was associated with increased risk of having both radiographic and pain progression together, or radiographic progression alone, whereas the inflammatory phenotype or meniscus/cartilage phenotype each individually were not associated with either outcome. Phenotypic stratification appears to provide insights into risk for structural or composite structure plus pain progression, and therefore may be useful to consider when selecting patients for inclusion in clinical trials.References:[1]Roemer FW, Collins J, Kwoh CK, et al. MRI-based screening for structural definition of eligibility in clinical DMOAD trials: Rapid OsteoArthritis MRI Eligibility Score (ROAMES). Osteoarthritis Cartilage 2020;28(1):71-81Disclosure of Interests:Frank Roemer: None declared, Jamie Collins Consultant of: Boston Imaging Core Lab (BICL), LLC., Tuhina Neogi Grant/research support from: Pfizer/Lilly, Consultant of: Pfizer/Lilly, EMD-Merck Serono, Novartis, Michel Crema: None declared, Ali Guermazi Consultant of: AventisGalapagos, Pfizer, Roche, AstraZeneca, Merck Serono, and TissuGene

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