Cagrilintide

What it is

Cagrilintide is a synthetic, long-acting analogue of amylin, a peptide hormone released together with insulin by pancreatic beta cells. Novo Nordisk developed it for once-weekly subcutaneous injection, first testing it alone in a phase 2 dose-finding trial (Lau et al. 2021) and then with semaglutide in the phase 3 REDEFINE program.

Mechanism of action

Amylin is released together with insulin after meals. It slows gastric emptying, reduces the rise in glucagon after a meal and promotes satiety, acting largely through receptors in the hindbrain. Native human amylin is short-lived and prone to aggregation, which limits its use as a research tool. Cagrilintide is an acylated analogue built for a long half-life suitable for once-weekly dosing, and it is described as an agonist at amylin receptors and at the closely related calcitonin receptor. Because amylin and GLP-1 act through different receptors and partly different brain pathways, researchers have hypothesized that combining the two could add to the reduction in food intake seen with either alone. The REDEFINE trials test that hypothesis directly by comparing the combination with each component given alone and with placebo.

What it’s most studied for

Cagrilintide is most studied for body weight reduction in adults with overweight or obesity. Early research tested it alone, at five once-weekly doses compared with placebo and with daily liraglutide. Most later research pairs it with semaglutide 2.4 mg, on the reasoning that amylin analogues and GLP-1 receptor agonists reduce food intake through complementary pathways. The phase 3 REDEFINE 1 trial compared the combination with each drug alone and with placebo, which lets researchers separate the contribution of cagrilintide itself. A companion phase 3 trial, REDEFINE 2, studied the combination in adults with type 2 diabetes.

Notable findings

Each finding carries the species or population it was observed in and the dose that study used. Doses are reported as research context, exactly as published. They are not guidance.

Study quality

Human evidence for cagrilintide is strong for an unapproved compound, but most of it concerns the combination with semaglutide rather than cagrilintide alone. The largest dataset is REDEFINE 1, a double-blind phase 3 trial in 3,417 adults with placebo and single-drug comparison arms, preceded by a 26-week phase 2 dose-finding trial of cagrilintide alone at 57 sites. The cagrilintide-only figures quoted here come from a sponsor presentation. The developer, Novo Nordisk, sponsored this work. Gastrointestinal events are the main safety finding: in REDEFINE 1 they affected 79.6% of the combination group versus 39.9% on placebo, mostly transient and mild to moderate. Weight results depend on the analysis (all randomized participants versus those who adhered to treatment), so the two sets of figures should not be mixed. Data on cagrilintide alone over long periods, and in populations beyond adults with overweight or obesity, remain limited.

On the research desk

Recent records on Cagrilintide from the Alpha Helix research feed, each with its evidence tier and citation.

• Cagrilintide-semaglutide in adults with overweight or obesity (REDEFINE 1)2026-01-15 · NCT05567796

References

1. 1
   Lau DCW, Erichsen L, Francisco AM, et al. (2021). 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. The Lancet. PMID 34798060
2. 2
   Garvey WT, Blüher M, Osorto Contreras CK, et al. (2025). Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity. New England Journal of Medicine. PMID 40544433 (NCT05567796)
3. 3
   Novo Nordisk (2025). Novo Nordisk presents phase 3 data for next-generation amylin cagrilintide, leading to advancement into dedicated clinical programme. Company press release (via BioSpace).