OBJECTIVES:: Examine reasons for switching advanced therapy (AT; biologics, phosphodiesterase-4 inhibitor), and treatment failure and its impact on PsA patients. METHODS: Specialists (Rheumatologists, Dermatologists) from Brazil and Mexico (LatAm), North America, Europe, Asia Pacific, Turkey and the Middle East, and their AT treated PsA patients were included. Reasons for switching AT, including primary lack of efficacy (1°LE, initial non-response), secondary lack of efficacy (2°LE, loss of response over time) were captured in addition to patient reported HRQoL (SF-36, EQ-5D), work productivity and activity impairment (WPAI), disability (HAQ-DI). AT was determined ‘failed’ if: after ≥3 months specialists perceived disease severity had worsened, remained severe, was ‘unstable’ or ‘deteriorating’; they were dissatisfied with disease control; and/or did not consider treatment a ‘success’. RESULTS: 756 (LatAm: 84) specialists and 2,182 (LatAm: 263) patients participated. 83.5% (LatAm: 89.0%) had received 1 AT, 11.8% (LatAm: 8.0%) 2, and 4.7% (LatAm: 3.0%) >3 ATs. Of 326 (LatAm: 28) patients with known reasons for switching from 1st AT, 45.1% (LatAm: 46.4%) switched owing to 2°LE and 23.0% (LatAm: 32.1%) due to 1°LE. Despite 1°LE, patients (n=62) continued the 1st biologic for 9.0 months (mean). 14.1% (259/1763; LatAm:18.8% (36/192)) were determined as failing AT; 12.9% (183/1,422; LatAm: 15.9%, 28/176) on 1st, 17.8% (34/191; LatAm: 45.5%, 5/11) on 2nd, and 28.4% (21/74; LatAm: 3/5) on >3^rdAT. Failing patients reported worse EQ-5D utility (total: p<0.0001/ LatAm: p<0.0001), SF-36 physical component summary (p<0.0001/p=0.1245), mental component summary (p<0.0001/p=0.0009), and social function domain (p<0.0001/p=0.0014) scores than those not failing. Physical and social functioning were more impaired (HAQ-DI: p<0.00001/p=0.0117; WPAI: p<0.0001/p=0.0011). CONCLUSIONS: Switching biologic treatment among PsA patients was infrequent and delayed despite primary or secondary treatment failure. Patients experiencing failure have significantly decreased HRQoL, work productivity and physical functioning. The concept of tight disease control with timely treatment adjustment is needed in PsA.