For the estimated 2.1 million people in the United States with rheumatoid arthritis (RA), there are multiple disease modifying anti-rheumatic drugs (DMARDs) available for reducing the signs and symptoms of disease and halting the destructive course of disease to prevent debilitating joint damage. The American College of Rheumatology (ACR) guidelines recommend initiating RA therapy with the prescription of conventional DMARDs, which have lower prices and long-established efficacy and safety, before moving on to biological agents, including TNF-α inhibitors, selective costimulation modulators, B-cell inhibitors, and Interleukin-6 inhibitors. Using national patient-level claims data, this report analyzes physician adherence to treatment guidelines by exploring the use of key therapies in the newly diagnosed and recently treated RA patient populations. Among the newly diagnosed patients, our report provides a quantitative analysis of treatment patterns and share by line of therapy, as well as progression between lines, duration of treatment on each line, and use of concomitant treatment. Among recently treated patients, our report quantifies a drug’s source of business compared with its competitors, and details which drugs precede others through an analysis of add-versus-switch patterns. Additional analyses explore persistency and compliance by brand.