OBJECTIVES:   To compare the disease status and outcomes of patients with PsA receiving their first biologic in UK, Germany, France, Italy and Spain (5EU) with the US. METHODS:   A multi-country multi-center medical chart-review study of PsA patients was conducted among physicians (majority: rheumatologists) in hospitals/private practices to collect de-identified data on patients who were recently treated with a biologic as part of usual care. Physicians were screened for duration of practice and patient volume and recruited from a large panel to be geographically representative in each country. Eligible PsA patient charts (>3) were randomly selected from a sample of prospective patients visiting each center/practice during the screening period. Physicians abstracted patient diagnosis, treatment patterns/dynamics and patient symptomatology/disease status/outcomes. RESULTS:   In 4Q2012, 434 physicians (5EU:337, US:97) abstracted 790 eligible PsA patient charts (5EU:606, US:184); 674 (85%) (5EU:527, US:147) patients were on their first biologic (mean-age: 5EU:47.4yrs, US:47.6yrs; female: 5EU:48.6%, US:44.9%). Time-to-1st biologic from diagnosis (5EU:41.0months, US:27.2months) and time-on-current biologic (5EU:23.2months, US:36.7months) differed between regions. Top-2 biologic treatments observed were adalimumab (5EU:47%, US:47%) and etanercept (5EU:36%, US:32%). Among the top-4 reasons for biologic treatment initiation, ‘mechanism of action’, ‘improve signs/symptoms’, ‘positive personal experience’ and ‘prevention of structural damage’ were observed in both the 5EU and US. Key lab measures documented were: ESR (5EU:20.6mm/h, US:23.7mm/h) and CRP (5EU:9.4mg/dl, US:2.8mg/dl). Current disease severity per physician-judgment (mild:moderate:severe) was: 5EU-61%:33%:5%, US-73%:26%:1%. Among patients with available data, current HAQ (5EU:1.3, US:0.6), VAS provider score (5EU:3.1, US:2.6), VAS patient score (5EU:3.4, US:2.7) and Swollen Joint Count (5EU:2.0, US:1.7) differed across regions. CONCLUSIONS:   Among PsA patients receiving their first biologic, disease severity and outcomes differed between 5EU and US, with patients in 5EU with relatively higher burden and poorer outcomes.