What is cagrisema and how does it work for weight loss?
The rise of obesity rates in the U.S. has Americans searching for effective ways to shed their excess weight. And with the popularity and success of GLP-1 receptor agonists like Ozempic/Wegovy (semaglutide), pharmaceutical companies are looking for the next best weight loss medication.
CagriSema is a new drug developed by Novo Nordisk A/S. It is being billed as an alternative to rival Eli Lilly’s Zepbound/Mounjaro (tirzepatide). CagriSema has not been approved by the Food and Drug Administration (FDA). It is currently in clinical trials as a treatment option for adults with type 2 diabetes (T2DM) and obesity. CagriSema is a combination of two medications: cagrilintide and semaglutide. While early results looked promising, the latest weight loss results have been underwhelming. In this blog, we will talk about how CagriSema works, its possible side effects, and the results from its clinical trials.
How does CagriSema work?
CagriSema contains two active ingredients, cagrilintide and semaglutide, in equal parts (2.4 mg of cagrilintide and 2.4 mg of semaglutide).
Cagrilintide is a new type of weight loss drug known as an amylin analogue. Amylin is a hormone produced by your pancreas after eating. It helps increase feelings of fullness, slows gastric emptying, and regulates your blood sugar levels.
Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist. GLP-1 is a hormone that is released in your gut in response to food. It also helps reduce your appetite, slows down digestion, improves blood glucose levels, and makes you feel fuller faster. The combination of these two medications has led to significant weight loss and improved glycemic control during clinical studies.
How much weight can you lose with CagriSema?
CagriSema is a once-weekly subcutaneous injection. Clinical trial results have shown significant improvements in A1C levels and weight loss.
A phase 3 trial called REDEFINE-1 included over 3,400 people who were overweight or obese with one or more comorbidities (like hypertension or cardiovascular disease), but not type 2 diabetes. It saw the participants lose 22.7% of their body weight. This was greater weight loss than semaglutide or cagrilintide alone, and was more than those taking a placebo. While these results are significant, it was below the almost 25% weight loss Novo had expected, according to a report from Reuters.
The results from the latest trial for this obesity drug were also not as good as the company had projected. The late-stage REDEFINE-2 trial included over 1,200 adults with type 2 diabetes who were overweight or obese. It showed that the “next-generation” weight loss treatment helped them achieve a 15.7% weight reduction after 68 weeks. This was compared to a 3.1% weight loss in those taking a placebo.
What are the side effects of using CagriSema for weight loss?
Safety and tolerability are important considerations for any new medication. Novo Nordisk has said that CagriSema is well-tolerated, and the most common adverse events were gastrointestinal (GI) related. This includes nausea, vomiting, constipation, abdominal pain, and diarrhea. The company also stated that these side effects were mild to moderate and would go away over time. With that being said, over one-third of participants in the trials did not progress to the highest dose, possibly because they could not tolerate the medication. Further studies are being conducted, so these will likely not be the only side effects of this medication.
Sources
- Novo Nordisk shares plunge after CagriSema obesity drug trial disappoints. Reuters. Accessed May 28, 2025.
- Novo Nordisk’s next-gen obesity drug CagriSema had investors excited. Now they’re not so sure. CNBC. Accessed May 28, 2025.
- Frias, Juan P et al. 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, Volume 402, Issue 10403, 720–730. Accessed May 28, 2025.
- Novo Nordisk A/S: CagriSema demonstrates superior weight loss in adults with obesity or overweight and type 2 diabetes in the REDEFINE 2 trial. Novo Nordisk. Accessed May 28, 2025.