Cagrilintide

Cagrilintide is a long-acting amylin receptor agonist (Novo Nordisk), developed both as a standalone weight-management compound and paired with semaglutide (as "CagriSema"). Real, large-scale Phase 2 data exists for both the standalone and combined forms.

Monotherapy dose-finding trial (n=706 total, 26 weeks): all tested doses (0.3-4.5mg weekly) produced greater weight loss than placebo (6.0%-10.8% vs. 3.0%). The top dose (4.5mg) outperformed liraglutide 3.0mg head-to-head (10.8% vs. 9.0% weight loss, P=0.03), with a clear, linear dose-response relationship. Lau et al., Lancet, 2021

Combined with semaglutide, type 2 diabetes (n=92, 32 weeks): the cagrilintide-only arm (30 participants) showed -8.1% body weight change and -0.9 percentage-point HbA1c change at week 32; the combination arm (CagriSema) outperformed both cagrilintide alone and semaglutide alone. Frias et al., Lancet, 2023

The monotherapy trial tested weekly subcutaneous doses of 0.3, 0.6, 1.2, 2.4, and 4.5mg, with 4.5mg the best-performing dose tested. The diabetes trial used 2.4mg weekly.

Gastrointestinal adverse events (nausea, constipation, diarrhea) were more common with cagrilintide than placebo across all doses — 41%-63% vs. 32%, with nausea specifically at 20%-47% vs. 18% on placebo. Injection-site reactions were also reported. In the diabetes-trial cagrilintide-only arm, 80% reported adverse events (predominantly mild-to-moderate GI), with no level 2/3 hypoglycemia and no fatal adverse events.

Both key trials measured outcomes at 26 weeks (monotherapy) and 32 weeks (diabetes/combination trial) — real human timepoints, not animal extrapolation.