OBJECTIVES: To assess treatment patterns and disease burden among PsA patients on 2nd-line biologics after 1st-line anti-TNF failure. METHODS: A multi-country chart-review study of PsA patients was conducted among physicians in hospitals/private practices to collect de-identified data on patients recently treated with a biologic as part of usual care. Physicians from UK/Germany/France/Italy/Spain (5EU) were screened for practice-duration and patient-volume and recruited from a large panel to be geographically representative in each country. Eligible patient charts (>2) 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. RESULTS: Between Jan2011-Dec2012, 454 PsA patients (mean age:48.8yrs;female:49.6%) on 2nd-line biologic after 1st-line anti-TNF failure were identified. Mean time-to-1st-line anti-TNF from diagnosis was 51.6months; mean time on 1st-line anti-TNF was 18.3months (patients <6/7-12/13-24/>24months:33%/21%/19%/27%). Top-3 1st line anti-TNFs observed were: etanercept(38%), adalimumab(32%), and infliximab(27%). The top-5 reasons for 1st-line anti-TNF discontinuation were ‘long-term efficacy failure’, ‘disease worsened’, ‘side-effects not tolerated’, ‘insufficient-improvement’, and ‘initial failure of efficacy’. Mean time on current 2nd-line biologic was 18.5months (patients <6/7-12/13-24/>24months:28%/21%/25%/27%). Current 2nd-line biologics (top-5) included: adalimumab(39%)/etanercept(31%)/infliximab(14%)/golimumab(11%)/abatacept(2%). Top-5 reasons for choice of 2nd-line biologic were ‘mechanism of action’, ‘prevention of structural damage’, ‘improve signs/symptoms’, ‘disease worsened’, ‘positive personal experience’. Key lab measures documented were: ESR-21.7mm/h and CRP-8.3mg/dl. Among patients with available data, current HAQ was 1.1, Swollen Joint Count was 1.9 and Tender Joint Count was 3.4. Current disease severity per physician judgment (mild:moderate:severe) were: 48%:47%:5%. Current disease severity (mild:moderate:severe) by time on 1stline anti-TNF biologic (<6/7-12/13-24/>24months) were 47%:48%:5% / 55%:42%:3% / 49%:48%:4% / 44%:49%:7% respectively. CONCLUSIONS: Among PsA pts on their 2nd biologic who experienced anti-TNF failure, 54% discontinued their 1st line anti-TNF regimen within 12months of initiation and continue to have considerable disease burden despite current 2nd line biologic.