Cagrilintide

Cagrilintide is a long-acting analog of amylin, a hormone co-secreted with insulin by pancreatic beta cells. Amylin promotes satiety, slows gastric emptying, and suppresses glucagon — an appetite-regulation route that is mechanistically distinct from the GLP-1/GIP incretin pathway. That distinction is the whole point of the program: because amylin and GLP-1 reduce appetite through different signaling, combining cagrilintide with semaglutide (the CagriSema combination) is expected to be additive rather than redundant. Engineered for once-weekly dosing to match its semaglutide partner.

Two phase 2 readouts anchor this. As a standalone agent, the dose-finding trial (Lau et al., 2021, Lancet) gave cagrilintide across a dose range in people with overweight or obesity; the top 2.4 mg dose produced roughly 10.8% mean weight loss over 26 weeks, with a liraglutide 3.0 mg active comparator in the same trial. That is respectable but not class-leading on its own. The more consequential data are combinational: in a phase 2 trial in type 2 diabetes (Frías et al., 2023, Lancet), CagriSema — cagrilintide 2.4 mg plus semaglutide 2.4 mg — drove larger weight and glycemic reductions than either component, which is the basis for the larger phase 3 program. Bottom line: as a solo drug the evidence is early and middling; as half of CagriSema it is one of the more interesting bets in the pipeline. Either way it is investigational, not approved.

• Up to ~10.8% mean weight loss as monotherapy at 2.4 mg over 26 weeks (phase 2)
• Larger weight and glycemic reductions when combined with semaglutide as CagriSema (phase 2, type 2 diabetes)
• Amylin mechanism is complementary to GLP-1, supporting the combination rationale
• Once-weekly dosing compatible with its semaglutide partner

• Not approved by any regulator — investigational, phase 2 only; long-term safety is unknown
• GI effects (nausea, vomiting) are the most common adverse events, as across appetite-suppressing agents
• Injection-site reactions reported in the dose-finding trial
• As an amylin analog it does not carry the GLP-1 class thyroid C-cell boxed warning — but the absence of that specific warning is not evidence of long-term safety, which remains untested
• Most of the compelling data are combinational (CagriSema); standalone evidence is thinner
• Investigational prescription-grade drug — sourcing outside a trial or licensed clinician is unsafe and outside any legal channel

In clinical trials. Under active investigation in human trials; not yet approved.

Goals studied: Fat loss, Body composition

Is cagrilintide a GLP-1 drug?

No. It is an amylin analog — a different appetite-regulating hormone pathway. That is precisely why it is being combined with the GLP-1 agonist semaglutide rather than positioned against it; the two mechanisms are complementary.

What is CagriSema?

CagriSema is the investigational fixed combination of cagrilintide and semaglutide. The idea is that pairing an amylin analog with a GLP-1 agonist suppresses appetite through two routes at once, producing more weight loss than either alone. It is in late-stage trials but not approved.

Can I buy cagrilintide now?

Not legitimately. It is an investigational compound with no regulatory approval, available only within clinical trials. Anything sold as cagrilintide on the research-chemical market is unverified and outside the legal and safety framework.

1. [1]
   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

   Lau DCW, Erichsen L, Francisco AM, Satylganova A, le Roux CW, McGowan BM, Pedersen SD, Pietiläinen KH, Rubino DM, Batterham RL · Lancet · 2021 · PMID 34798060 · model: human

   Phase 2 dose-finding RCT in overweight or obesity where cagrilintide produced up to ~10.8% mean weight loss at 2.4 mg over 26 weeks, with a liraglutide 3.0 mg active comparator.

2. [2]
   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

   Frias JP, Deenadayalan S, Erichsen L, Knop FK, Lingvay I, Macura S, Mathieu C, Pedersen SD, Davies M · Lancet · 2023 · PMID 37364590 · model: human

   Phase 2 RCT in type 2 diabetes showing the CagriSema combination (cagrilintide plus semaglutide, each 2.4 mg) produced greater weight and glycemic reductions than either agent alone.