The aim of this retrospective study is to compare clinical efficacy of adalimumab (ADA) administered as first biologics (NG: n＝125) with that administered as second or third biologics (SG: n＝75) and to compare the efficacy of ADA switched from infliximab (IFX) with that switched from etanercept (ETN). Data was collected from 21 institutions in total. DAS28-ESR, EULAR criteria, serum CRP, serum MMP-3 and drug continuation rate (Kaplan-Meier method) were evaluated. There were no significant differences in baseline characteristics between NG and SG. Mean DAS28-ESR in NG and SG at 24 weeks were 3.84 and 4.40 (p＜0.05), respectively. Rate of remission evaluated by EULAR criteria at 24 weeks in NG and SG were 29.3% and 17.8%, respectively. Mean CRP at 24 weeks in NG and SG were 1.31 mg/dl and 1.90 mg/dl, respectively. Mean MMP-3 at 24 weeks in NG and SG were 215.2 ng/ml and 262.0 ng/ml (p＜0.05), respectively. Drug continuation rate in NG was significantly better than that in SG. Clinical outcomes of ADA switched from IFX were better than that switched from ETN, especially in drug continuation rate, EULAR response and MMP-3. In conclusion, efficacy of ADA in NG was better than that in SG and efficacy of ADA switched from IFX was better than that switched from ETN in clinical practice.