OBJECTIVES: To assess disease burden of SPMS patients treated with DMTs in EU and the U.S. METHODS: A multi-country chart-review study of SPMS patients was conducted among neurologists in hospitals/private practices to collect de-identified data. Neurologists from UK/Germany/France/Italy/Spain (5EU) and US were screened for practice-duration (>=3yrs) and patient-volume (>=15MS patients/month) and recruited from a large panel to be geographically representative in each country. Charts of next 2 consecutive SPMS patients were selected by each neurologist. Neurologists abstracted patient diagnosis, treatment patterns and patient symptomatology/disease status. SPMS patients on DMTs were analyzed. RESULTS: In 4Q2012, 360 Neurologists (5EU:259; US:101) abstracted 699 eligible SPMS patient charts (5EU:497; US:202); 420 (5EU:274; US:146) patients were managed with DMTs. Mean age – 5EU:46.5yrs, US:49.2yrs; Female – 5EU:58%; US:66%. Mean time-to-1st DMT initiation (5EU/US; months) from diagnosis was 21/27; current DMT patterns (5EU/US) were: 1st line (25%/34%), 2nd line (39%/38%) & 3rd+ line (36%/28%). Interferon beta-1b (5EU) and glatiramer acetate (US) were predominantly observed in 1st/2nd line; fingolimod and natalizumab use was observed in 2nd-line but they dominated later lines. Mean time-to-1stDMT initiation (5EU/US: months) from diagnosis (1st:45/35, 2nd:13/30, 3rd+:12/10) and mean treatment time (5EU/US: months) on current 1st (85/91), 2nd (38/35; prior 1st line: 57/48) and 3rd+ line (19/24; prior 2nd line: 35/46) differed. Patients with severe disease and those with active/highly active disease (both, per physician judgment) were (5EU/US): 1st:15%/20%, 2nd:20%/18%, 3rd+:35%/37% and 1st:45%/61%, 2nd:63%/73%, 3rd+:57%/68% respectively; mean Expanded Disability Status Scale scores also differed (5EU/US): 1st:5.1/5.0, 2nd:5.6/5.5, 3rd+:5.8/6.1. CONCLUSIONS: Among SPMS patients currently managed with DMTs, the disease burden increased as the line of treatment increased, both in 5EU and the US. Patients in 2nd/3rd+line of treatments had progressed through earlier line(s) of treatment quickly. Further research is warranted to scrutinize the effectiveness of therapeutic options and sequencing strategies to alleviate patient burden.