OBJECTIVES:  The German association for rheumatologists (DGRh) published a treatment algorithm for the sequential medical treatment of rheumatoid arthritis in the S1 guideline in 2012. As initial therapy, a conventional disease-modifying antirheumatic drug (cDMARD) is recommended (group I). In case of failure, treatment should be followed by either a cDMARD for patients with favourable prognostic factors (group II) or an early biologic DMARD (bDMARD), if the patient shows unfavourable prognostic factors (group III). After ≥ 2 cDMARD failures in total, patients should switch to a bDMARD (group IV). If the bDMARD treatment is insufficient a 2^nd bDMARD is recommended (group V). This project aims to explore treatment sequencing under everyday conditions in Germany. METHODS: Longitudinal German claims data (observation period: 2005 – 2012) from 3,906,818 insured persons were analyzed. All newly diagnosed adult patients with a rheumatoid arthritis (RA) ICD-10 code were observed and their treatment from first diagnosis till end of observation was analyzed. RESULTS:  Of the 3,906,818 insured persons, 28,810 incident cases were observed. In total, 11,621 patients received at least one prescription of a cDMARD or bDMARD of which 8,480 patients (73.0%) could be assigned to the above mentioned groups. Patients are distributed as follows, group I: 6,989 patients (82.4%), group II: 462 (5.4%), group III: 25 (0.3%), group IV: 637 (7.5%), group V: 367 (4.3%). Information about prognostic factors was not available to verify the differentiation between the groups II and III. CONCLUSIONS:  73% of the patients receiving DMARD treatment could be assigned to the groups described in the German guideline. The first biologic treatment was normally prescribed after ≥ 2 cDMARD failures (group IV vs group III). To strengthen the statement of this analysis and to evaluate further distinctions (e.g. prognostic factors), additional research would be useful.