What Is CagriSema?
CagriSema is a fixed-dose combination of cagrilintide and semaglutide, both developed by Novo Nordisk. Cagrilintide is a long-acting analogue of amylin — a hormone co-secreted with insulin from pancreatic beta cells that plays a role in satiety, gastric emptying, and glucose regulation. By combining it with semaglutide, Novo Nordisk targets two complementary hormonal pathways simultaneously.
The Role of Amylin
Amylin works alongside insulin to regulate blood sugar and appetite. It slows gastric emptying, suppresses glucagon, and signals satiety to the brain through pathways partially distinct from GLP-1. A synthetic amylin analogue called pramlintide was previously approved (as Symlin) for use with insulin in diabetes, but its short half-life required multiple daily injections. Cagrilintide is engineered for once-weekly dosing, making it practical as part of a combination product.
Early Trial Results
Phase 2 results from the COMBINE 1 trial showed CagriSema producing approximately 15% weight reduction compared to approximately 10% for semaglutide alone at the doses studied. More extensive trials have shown weight loss approaching 25% at highest doses, positioning CagriSema as Novo Nordisk's answer to tirzepatide's efficacy advantage over Wegovy.
Current Status
CagriSema is in Phase 3 clinical trials as of 2026. Novo Nordisk has positioned it as a potential successor to Wegovy for patients who need greater efficacy than semaglutide alone provides.
CagriSema represents Novo Nordisk's strategy for competing with tirzepatide's efficacy advantage — targeting a second hormonal pathway (amylin) rather than a second incretin (GIP) as Lilly did with tirzepatide.