OBJECTIVES: To compare the disease status and outcomes of patients with RA receiving adalimumab and etanercept monotherapy in Europe . METHODS: A multi-country, multi-center medical chart-review study of RA patients was conducted among rheumatologists in UK/France/Germany/Italy/Spain 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 (3-30 yrs) and patient volume (incl. >5 RA biologic patients/month) and recruited from a large panel to be geographically representative in each country. Eligible 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. Patients on adalimumab/etanercept monotherapy were analyzed. RESULTS: CONCLUSIONS: Among RA patients receiving adalimumab or etanercept monotherapy, disease severity was similar across the EU5, with patients in Spain and France having relatively lower, and patients in Italy, Germany, and UK having relatively higher burden and poorer treatment response. Factors influencing the observed patterns of geographic variation warrant further scrutiny to optimize therapeutic interventions and improve outcomes.