Summary
Cagrilintide is a long-acting amylin analog that acts on both amylin and calcitonin receptors. Combined with semaglutide as CagriSema, it produced a mean weight loss of 20.4% over 68 weeks in the REDEFINE 1 trial (22.7% among participants who stayed on treatment).
Structure
Acylated analog of human amylin, a 37-residue hormone co-secreted with insulin by pancreatic beta cells.
How it works
Amylin slows gastric emptying, suppresses post-meal glucagon and promotes satiety through the area postrema in the brainstem. Cagrilintide is a non-selective agonist of amylin and calcitonin receptors with a half-life long enough for weekly dosing. Its satiety signal is distinct from GLP-1’s, which is the rationale for combining the two.
Research use cases
Areas where Cagrilintide has been studied. Inclusion here does not mean it works for that purpose.
- Obesity and overweight, alone and combined with semaglutide
- Type 2 diabetes in combination with semaglutide
What the research found
Monotherapy dose-finding
In a 26-week phase 2 trial of 706 adults, cagrilintide 4.5 mg produced 10.8% mean weight loss versus 3.0% on placebo and 9.0% on liraglutide 3.0 mg.1
CagriSema (REDEFINE 1)
In 3,417 adults with obesity, the combination of cagrilintide 2.4 mg and semaglutide 2.4 mg reduced weight by 20.4% at 68 weeks, compared with 11.8% for cagrilintide alone, 16.1% for semaglutide alone and 3.0% for placebo.2
Type 2 diabetes
In a 32-week phase 2 trial, CagriSema lowered HbA1c by 2.2 percentage points and body weight by 15.6%, more than either component alone.3
Safety and open questions
Gastrointestinal effects dominate, as with GLP-1 drugs. In REDEFINE 1, GI events were reported by about 80% of participants on the combination, mostly mild to moderate. Long-term data beyond the trial periods are limited.
Regulatory status
Investigational (Novo Nordisk). CagriSema, the fixed combination with semaglutide, was submitted to the FDA in December 2025; no approval as of our last review.
Status was accurate when this page was last reviewed on October 26, 2026. Regulations change; check with the relevant authority before relying on it.
Cagrilintide: common questions
What is CagriSema?
CagriSema is Novo Nordisk’s once-weekly combination of cagrilintide and semaglutide in one injection. It is investigational and was under FDA review as of late 2025.
How does amylin differ from GLP-1?
Both reduce appetite, but through partly different brain pathways. Amylin acts mainly through the area postrema and calcitonin receptor complexes; GLP-1 acts through its own receptor in the hypothalamus and brainstem. Combining them added weight loss in trials.
Is Cagrilintide approved for human use?
Investigational (Novo Nordisk). CagriSema, the fixed combination with semaglutide, was submitted to the FDA in December 2025; no approval as of our last review.
References
- Lau DCW, Erichsen L, Francisco AM, et al. (2021). Once-weekly cagrilintide for weight management in people with overweight and obesity: a multicentre, randomised, double-blind, placebo-controlled and active-controlled, dose-finding phase 2 trial. The Lancet.
- Garvey WT, Blüher M, Osorto Contreras CK, et al. (2025). Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity. New England Journal of Medicine.
- Frias JP, Deenadayalan S, Erichsen L, et al. (2023). Efficacy and safety of co-administered once-weekly cagrilintide 2·4 mg with once-weekly semaglutide 2·4 mg in type 2 diabetes: a multicentre, randomised, double-blind, active-controlled, phase 2 trial. The Lancet.
Links open a PubMed search for the exact title, or the original source where one is given.