OBJECTIVES: To compare the disease status and outcomes of patients with AS receiving their first biologic in 5EU. METHODS: A multi-country multi-center medical chart-review study of AS patients was conducted among physicians (rheumatologists:97%) in hospitals and 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 (3-30 yrs) and patient volume (incl. >5AS 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. RESULTS: In 1Q2012, 1095 eligible AS patient charts were abstracted; 935 (85%) patients were on their first biologic (mean-age:42.6yrs, female:20%). Geographic distribution of patients were – UK:20%, Germany:18%, France/Italy:21%, Spain:19%. Time-to-1st biologic from diagnosis (range:28month (Italy)-59month (France)) and time-on-current biologic (range:24month (UK/Germany/Italy)-27month (France)) differed within 5EU. Among the top-3 reasons for biologic treatment initiation, ‘mechanism of action’ & ‘improve signs/symptoms’ were observed across 5EU, whereas ‘positive personal experience’ (UK/Germany/France) and ‘preservation of structural damage’ (Italy/Spain) were also observed. Key lab measures documented were: ESR (range:15.1mm/h (France)-21.0mm/h (Italy)) and CRP (range:5.6mg/dl (Spain)-12.5mg/dl (UK)). Current disease severity per physician-judgment (mild:moderate:severe) in 5EU were: UK-68%:22%:10%, Germany-57%:39%:5%, France-46%:47%:7%, Italy-64%:34%:2%, Spain-69%:27%:4%. Among patients with available data, current HAQ (range: 0.7(France)-1.5(Germany)), BASDAI (range:3.0(Spain)-3.4(UK)), 100mmVAS (range:19.0(France)-31.4(UK)) and Swollen Joint Count (range:0.5(France)-(3.7(UK)) differed within 5EU. Among patients with available data, response to current biologic per ASAS criteria were (%ASAS20:%ASAS40:ASAS5/6:%ASAS partial-remission): UK-12%:6%:0%:4%, Germany-20%:9%:9%:11%, France-13%:7%:7%:11%, Italy-30%:17%:13%:18%, Spain-19%:13%:5%:13%. CONCLUSIONS: Among AS patients receiving their first biologic, disease severity differed within 5EU, with patients in the UK with relatively higher burden and poorer treatment response. Impact of specific biologic treatments on the observed patterns warrants further scrutiny.