Cagrilintide is a long-acting amylin analogue being developed by Novo Nordisk for chronic weight management. Unlike semaglutide or tirzepatide, it is not primarily a GLP-1 drug. It mimics amylin, a pancreatic hormone involved in appetite regulation and satiety.

What it does

Cagrilintide’s main effects under investigation are:

• Reduces appetite and hunger
• Increases feelings of fullness/satiety
• Reduces food intake
• Supports sustained weight loss
• Has a long duration that allows it to be studied as a once-weekly injection

This different mechanism is why researchers have been particularly interested in combining cagrilintide with GLP-1 drugs.

Cagrilintide by itself

Cagrilintide isn’t simply a companion drug for semaglutide. It has demonstrated meaningful weight loss on its own. Novo Nordisk reports that in a phase 3 REDEFINE 1 analysis, cagrilintide 2.4 mg once weekly produced about 11.8% average weight reduction at 68 weeks under an efficacy estimand, versus 2.3% with placebo. It has subsequently moved into the phase 3 RENEW development program.

Cagrilintide + semaglutide = CagriSema

This is where cagrilintide has attracted the most attention. Combining cagrilintide + semaglutide targets two different appetite pathways:

Cagrilintide → amylin pathway
Semaglutide → GLP-1 pathway

In the phase 3 REDEFINE 1 trial in adults with overweight/obesity without diabetes, the combination produced an estimated 20.4% mean weight reduction at 68 weeks, compared with 3.0% for placebo.