Cagrilintide

In simple words

Cagrilintide is a synthetic analog of the hormone amylin that reduces appetite and slows stomach emptying. It is studied for weight loss, especially paired with semaglutide (the drug CagriSema), where some of the best results have been obtained.

What this molecule is

Analog of human amylin (IAPP) — 32 aa with modifications for stability. In CagriSema: combined with semaglutide in a single injection.

Why it is studied

REDEFINE 1 (NEJM 2025, n=3417): CagriSema → −20.4% over 68 weeks vs semaglutide −14.9%, cagrilintide −11.5%. REDEFINE 2 (n=1206, T2D): −13.7%, HbA1c <6.5% in 73.5%. The best result among all drugs in 2025.

How it works

GLP-1 component: ↓appetite, ↑insulin. Amylin component (CGRP-R): ↓rate of gastric emptying (stronger than GLP-1) + ↑satiation via the area postrema + ↑leptin sensitivity. Synergy of the two systems > the sum of the parts.

Doses used in studies

CagriSema was used only in studies under medical supervision. An FDA application was submitted in 2025.

Combined with in studies

• Tirzepatide — alternative at a plateau
• NOT with other GLP-1 agonists

Level of evidence

Level A Human clinical trials. There are randomized controlled trials (RCTs), or the compound has been approved by a regulatory agency. The most reliable level.

Important to know

Not approved (2025). Expected in 2026. Nausea at the start.

Studies in PubMed

1. Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity. (N Engl J Med, 2025)
2. Cagrilintide-Semaglutide in Adults with Overweight or Obesity and Type 2 Diabetes. (N Engl J Med, 2025)
3. 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. (Lancet, 2023)
4. Efficacy and Safety of Cagrilintide Alone and in Combination with Semaglutide (Cagrisema) as Anti-Obesity Medications: A Systematic Review and Meta-Analysis. (Indian J Endocrinol Metab, 2024)
5. Cagrilintide is not associated with clinically relevant QTc prolongation: A thorough QT study in healthy participants. (Diabetes Obes Metab, 2024)
6. 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. (Lancet, 2021)