What it is: A weekly injectable analog of amylin, a pancreatic hormone that signals fullness after meals and slows digestion.
Research suggests: Combined with semaglutide in the CagriSema trial, it showed greater weight loss than either compound alone, with results exceeding 15% body weight reduction.
Best for: Obesity and metabolic health researchers
Key thing to know: Not yet FDA approved on its own; currently in Phase 3 development as a fixed combination with semaglutide (CagriSema).
What is Cagrilintide?
Cagrilintide is a long-acting synthetic analog of amylin, a peptide hormone co-secreted with insulin by pancreatic beta cells in response to meals. Amylin plays a distinct but complementary role to insulin in metabolic regulation: it slows gastric emptying, suppresses post-meal glucagon secretion, and signals satiety through receptors in the brainstem. In people with type 2 diabetes, amylin secretion is impaired alongside insulin deficiency, contributing to post-meal glucose dysregulation and reduced satiety signaling.
Cagrilintide was engineered for once-weekly subcutaneous dosing, significantly extending the short duration of action of native amylin. It is being developed by Novo Nordisk and has gained particular attention as a component of CagriSema, a fixed-ratio combination of cagrilintide and semaglutide. This combination represents a dual-pathway approach to obesity treatment, targeting both the GLP-1 receptor and the amylin receptor simultaneously to produce greater appetite reduction than either agent alone.
Research interest is concentrated in obesity, type 2 diabetes, and the broader category of metabolic health, with Phase 3 trials ongoing through the REDEFINE program as of 2025.
How it works.
Amylin acts on receptors in the area postrema and nucleus tractus solitarius of the brainstem, regions involved in satiety signaling and nausea regulation. Activation of these receptors slows gastric emptying, reducing the rate at which food-derived glucose enters the bloodstream after a meal. It also suppresses post-meal glucagon secretion from the pancreas, which would otherwise raise blood glucose.
Centrally, amylin promotes satiety through pathways that are distinct from but additive to GLP-1 signaling.
Cagrilintide reproduces these effects with a duration of action suitable for once-weekly dosing. The rationale for combining it with semaglutide is that GLP-1 and amylin act through different but complementary brain circuits for appetite and food intake regulation. GLP-1 primarily targets receptors in the brainstem, hypothalamus, and vagal afferents.
Amylin primarily acts in the area postrema and nucleus tractus solitarius through a different receptor complex. Activating both pathways simultaneously produces greater total appetite suppression than saturating either pathway alone.
Think of GLP-1 as targeting one satiety pathway and amylin targeting another. When both are active together, the combined signal to reduce food intake is stronger than what either mechanism produces independently. Phase 2 trial data confirmed this additive effect in clinical practice, with the combination producing meaningfully greater weight loss than semaglutide alone at matched doses.
What the research shows.
Phase 2 trial data for CagriSema (cagrilintide plus semaglutide) showed average weight loss of approximately 15.6% over 32 weeks in adults with overweight or obesity, with the highest dose groups showing up to 17.1% reduction. These results exceeded those seen with semaglutide alone in comparable study populations, providing direct clinical evidence that the combination produces additive weight loss beyond GLP-1 monotherapy.
Cagrilintide studied as a monotherapy also shows meaningful weight loss and is generally well-tolerated, with a GI side effect profile similar to other incretin-class compounds during dose escalation. The Phase 2 data is well-constructed and provides a credible foundation for the ongoing Phase 3 program, though Phase 3 results had not been published at the time of this writing.
The key limitation is that Phase 3 trials are still ongoing. Phase 2 results, while compelling, involve smaller sample sizes and shorter durations than Phase 3 programs. Long-term safety, cardiovascular outcomes, and efficacy in more diverse populations are questions that Phase 3 data will address.
FDA approval is pending Phase 3 results and regulatory review.
Biomarkers to review first.
Research protocols for cagrilintide typically reference the following biomarkers as baseline context. Given its effects on metabolic function and glycemic regulation, understanding your current metabolic status is important before any protocol consideration.
What it's commonly researched with.
Cagrilintide is most notably studied in direct combination with semaglutide as the CagriSema formulation. Research also involves comparisons to other leading metabolic compounds. The combinations below reflect what researchers have studied, not recommendations for use.