OBJECTIVES: To report patient experience with self-injection and describe injection site reactions and reasons for treatment compliance/discontinuation. METHODS: In first quarter 2010, RA patients completed a cross-sectional, self-administered, Internet-based questionnaire.  In the survey, SC was defined as “medication administered via needle just under the skin”. Data were weighted to reflect general population proportions for age, gender, race, education, household income and region. RESULTS: Of 58 SC biologic patients, 67% experienced pain during or after receiving injections. On a scale from 1-10 describing severity of pain ( 1 = “not at all painful” and 10 = “extremely painful”), 9% during injection and 22% after injection rated severity of pain as ≥8. Stinging, bruising, pain, redness, burning and swelling were the most common injection site reactions experienced by biologic users.  Of these patients, 21% experienced at least one or more of these symptoms ‘most or all the time’.  Among the 58 SC biologic patients, 41% were  ‘somewhat willing’, 12% were ‘very willing” and 8% were ‘extremely willing’ to switch treatments as a result of injection site reactions. Among SC patients who self-reported that they did not take biologics as prescribed, 22% described injection fear and another 22% described general fear of needles as “very influential” in not complying with their treatment.  19% of patients who discontinued SC biologics (n=55) cited ‘felt uncomfortable about needles” as ‘very influential’ and ‘extremely influential’ reasons for discontinuation. CONCLUSIONS: In this analysis, many patients experience injection related pain associated with SC biologics and this may be impacting therapy compliance and continuation. Therefore, it may be important to evaluate different injection options within SC biologics when making treatment selection and patient access decisions.  Given the small sample size (n=58), further research is needed to quantify impact of injection experience on self-reported vs. observed compliance and treatment continuation.