OBJECTIVES: Acromegaly is a rare, slowly progressing disorder resulting from excessive growth hormone. It is characterized by skeletal and soft-tissue enlargement and increased risk of cardiovascular death. Treatment may be long-term and complex, involving medications, surgery, and radiotherapy; and there are limited published data on treatment patterns. We used a novel graphical technique to analyze treatment patterns in acromegaly. METHODS: Combining two major US claims datasets (Thomson Reuters MarketScan and IMS Health PharMetrics), we identified acromegaly patients first treated between July 1, 2002-December 31, 2009.  Patients were followed for 6 months to 3 years, from first treatment until either end of enrollment or 6/30/10. We analyzed treatment patterns using an innovative method which produces high-resolution images combining thousands of individual patient histories. These images used multi-colored line segments to represent different treatments. Images were reviewed for segment length and changes in colors to evaluate treatment patterns over time. We compared graphical results to summary statistics. RESULTS: We identified 2,027 newly treated acromegaly patients. First observed treatment was surgery in 733 patients (36.2%), pharmacologic therapy in 1203 (59.3%) and radiation in 91 (4.5%). Octreotide acetate long-acting (LAR) for injection was the first treatment in 173 patients (8.5%).  Most users initiated therapy at 10-20mg/month (n=141, 81.5%).  Among these, 47 (33.3%) increased octreotide dose or switched to other treatments in the follow-up period.  Second treatment was octreotide 30mg/month in 39 (83.0%), 40mg/month in 7 (14.9%), and surgery in 1 (2.1%). Graphical analysis revealed patterns of treatment switching and medication persistence that differed depending on the initial therapy; multiple images from this analysis will be presented.  CONCLUSIONS:   Invasive treatments appeared less common than pharmacologic therapy as initial acromegaly treatments. Most octreotide LAR for injection users remained on their initial therapy without dose or treatment changes during observation. Graphical analysis provided detailed insights not immediately apparent in summary statistics.