Supplement Monograph

Cagrilintide

Cagrilintide is an investigational long-acting amylin analog studied for weight loss, usually combined with semaglutide (CagriSema); not an approved drug.

What Is Cagrilintide?

Cagrilintide is an investigational long-acting amylin analog — a peptide that mimics the pancreatic hormone amylin (acting on amylin/calcitonin receptors) to slow gastric emptying and promote satiety. It is being developed for weight management, most prominently in a fixed combination with the GLP-1 agonist semaglutide (the combination is called CagriSema), on the rationale that amylin and GLP-1 pathways are distinct and additive. It is not an approved drug and is not a dietary supplement; it is available only within clinical trials (and, illicitly, as an unapproved research chemical). This entry is informational only.

Evidence

In a phase 1b randomised, controlled trial in adults with overweight/obesity, adding once-weekly cagrilintide to semaglutide 2.4 mg produced greater weight loss than semaglutide alone over 20 weeks, supporting an additive amylin + GLP-1 effect 1Reference 1Enebo LB et al. · 2021RCTSafety, tolerability, pharmacokinetics, and pharmacodynamics of concomitant administration of multiple doses of cagrilintide with semaglutide 2·4 mg for weight management — randomised controlled phase 1b trialView study →. A separate phase 2 dose-finding randomised, double-blind, placebo- and active-controlled trial of once-weekly cagrilintide monotherapy in overweight/obese adults reported dose-dependent weight loss and an acceptable tolerability profile 2Reference 2Lau DCW et al. · 2021RCTOnce-weekly cagrilintide for weight management in people with overweight and obesity — randomised, double-blind, placebo- and active-controlled, dose-finding phase 2 trialView study →. These early-phase results motivated the larger CagriSema (REDEFINE) programme, which was not individually retrieved and verified in this quick pass and should be added in a full pass. Reported adverse effects are predominantly gastrointestinal, consistent with the drug class. Long-term efficacy and safety are not yet established.

Dosage & Safety

The once-weekly subcutaneous doses studied (up to ~2.4 mg, titrated) are investigational and reported for information only 1Reference 1Enebo LB et al. · 2021RCTSafety, tolerability, pharmacokinetics, and pharmacodynamics of concomitant administration of multiple doses of cagrilintide with semaglutide 2·4 mg for weight management — randomised controlled phase 1b trialView study →2Reference 2Lau DCW et al. · 2021RCTOnce-weekly cagrilintide for weight management in people with overweight and obesity — randomised, double-blind, placebo- and active-controlled, dose-finding phase 2 trialView study →; they are not a recommendation. Cagrilintide is not approved, and material sold outside clinical trials is an unapproved research chemical of unverified identity and purity. Long-term safety, drug interactions, and use in pregnancy are not established and were not assessed in this pass. Informational only.

References

  1. Enebo LB, et al. (2021). Safety, tolerability, pharmacokinetics, and pharmacodynamics of concomitant administration of multiple doses of cagrilintide with semaglutide 2·4 mg for weight management — randomised controlled phase 1b trial. Lancet, 397:1736–1748. https://pubmed.ncbi.nlm.nih.gov/33894838/
  2. Lau DCW, et al. (2021). Once-weekly cagrilintide for weight management in people with overweight and obesity — randomised, double-blind, placebo- and active-controlled, dose-finding phase 2 trial. Lancet, 398:2160–2172. https://pubmed.ncbi.nlm.nih.gov/34798060/