Preserved supervised synthesis

Cagrilintide synthesis · version 2

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Supervised synthesis

What do selected human studies report about Cagrilintide?

Manually reviewed September 15, 2026 · version 2

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Six selected reports include cagrilintide alone and the cagrilintide-semaglutide combination known as CagriSema. The later combination trials address different populations and questions from the earlier cagrilintide-alone study.123456

Bottom line from this bounded source set

The selected cagrilintide-alone study reported weight reduction. Later combination trials reported weight or glycemic improvements, but their results cannot be attributed to cagrilintide alone. Gastrointestinal adverse events were common, and a correction to REIMAGINE 2 remains to be reconciled.123456

Reviewed study record

Phase 2 weight-management trial

Design

A multicenter, randomized, double-blind, placebo-controlled and active-controlled dose-finding trial assessed body-weight change over 26 weeks.1

Population

The trial randomized 906 adults without diabetes across 57 sites in ten countries: 706 to cagrilintide groups, 99 to liraglutide, and 101 to placebo. Participants had obesity, or overweight with hypertension or dyslipidemia.1

Outcomes reported

Reported mean body-weight reduction ranged from 6.0% to 10.8% across cagrilintide groups and was 3.0% with placebo. Gastrointestinal events occurred more often across cagrilintide groups than with placebo.1

Limitations

This was a sponsor-funded, 26-week Phase 2 dose-finding study in adults without diabetes, with a short off-treatment follow-up and no long-term clinical-outcomes assessment.1

Reviewed study record

REDEFINE 1: combination treatment without diabetes

Design

A blinded randomized phase 3a trial compared combination treatment, either component alone and placebo over 68 weeks under NCT05567796.2

Population

The trial randomized 3,417 adults with overweight or obesity without diabetes across four groups.2

Outcomes reported

The treatment-policy analysis reported mean weight changes of −20.4% with cagrilintide-semaglutide versus −3.0% with placebo. Gastrointestinal adverse events occurred in 79.6% and 39.9%, respectively.2

Limitations

These estimates concern the combination and cannot be attributed to cagrilintide alone. The abstract does not give the component-alone outcome estimates needed to assess each component’s contribution.2

Reviewed study record

REDEFINE 2: combination treatment with diabetes

Design

A blinded randomized placebo-controlled phase 3a trial assessed weight endpoints at 68 weeks under NCT05394519.3

Population

The study randomized 1,206 adults with type 2 diabetes and overweight or obesity.3

Outcomes reported

The treatment-policy analysis reported mean weight changes of −13.7% with cagrilintide-semaglutide versus −3.4% with placebo. Gastrointestinal adverse events occurred in 72.5% and 34.4%, respectively.3

Limitations

This comparison evaluates the combination against placebo, not either component alone. Weight and glycemic outcomes do not establish prevention of long-term complications.3

Reviewed study record

REIMAGINE 1: early type 2 diabetes

Design

A blinded randomized placebo-controlled phase 3a trial assessed 40-week HbA1c change under NCT06323174.4

Population

The trial randomized 189 adults whose type 2 diabetes was inadequately controlled with diet and exercise.4

Outcomes reported

Under the efficacy analysis, HbA1c fell by 1.8 and 1.5 percentage points in the combination groups versus 0.1 with placebo. Adverse events occurred in 79%, 75% and 66%, respectively, and were predominantly mild or moderate gastrointestinal events.4

Limitations

The efficacy estimand differs from the treatment-policy analyses in the REDEFINE reports. These populations, endpoints and analyses should not be combined into a simple treatment ranking.4

Reviewed study record

REIMAGINE 2: comparison with component treatments

Design

A blinded randomized trial compared cagrilintide-semaglutide with component treatments and placebo over 68 weeks under NCT06065540.5

Population

The report concerns adults with type 2 diabetes receiving metformin with or without an SGLT2 inhibitor.5

Outcomes reported

The primary comparison concerns HbA1c change with the combination versus semaglutide. A publisher erratum is linked to this report; its impact on the numerical comparison has not been reconciled here.5

Limitations

The exact treatment difference is withheld pending review of the linked correction. This source should not be used here to infer the size of an additional benefit or to rank treatments.5

Reviewed study record

REIMAGINE 3: combination treatment alongside basal insulin

Design

A blinded randomized placebo-controlled phase 3a trial assessed 40-week HbA1c change under NCT06323161.6

Population

The study randomized 274 adults with type 2 diabetes receiving basal insulin, with or without metformin.6

Outcomes reported

Under the efficacy analysis, HbA1c fell by 2.33 and 2.10 percentage points in the combination groups versus 0.66 with placebo. Gastrointestinal events were common; no severe hypoglycemia was reported.6

Limitations

The report recorded one death due to malignancy in an active group, considered unrelated to treatment. Absence of severe hypoglycemia in this study does not establish absence of risk, and the findings are not an individualized treatment recommendation.6

Reviewed source set

  1. PubMed · 34798060Once-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 ↗PubMed PMID 34798060 · EFetch XML reviewed 2026-08-19 · payload SHA-256 2d3444b94dda7415d38a86129963afa54c2b4c580ba9bcf476f3411f71a61c45
    No registered Crossref update in the reviewed snapshotChecked August 19, 2026 for DOI 10.1016/s0140-6736(21)01751-7. This bounded result is not proof that the publication has never been corrected or retracted. Open the pinned Crossref work endpoint ↗
  2. PubMed · 40544433Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity. ↗PubMed PMID 40544433 · EFetch XML reviewed 2026-09-15 · payload SHA-256 11e3e0de9860bd4ec6e03db65d1b6e40b2731f5bc7818904b72a8e04b3c0d77d
    No registered Crossref update in the reviewed snapshotChecked September 15, 2026 for DOI 10.1056/nejmoa2502081. This bounded result is not proof that the publication has never been corrected or retracted. Open the pinned Crossref work endpoint ↗
  3. PubMed · 40544432Cagrilintide-Semaglutide in Adults with Overweight or Obesity and Type 2 Diabetes. ↗PubMed PMID 40544432 · EFetch XML reviewed 2026-09-15 · payload SHA-256 d23f7edea7a684abf0d324dda051b8fb83ea814a8f06313783512df8e5c61219
    No registered Crossref update in the reviewed snapshotChecked September 15, 2026 for DOI 10.1056/nejmoa2502082. This bounded result is not proof that the publication has never been corrected or retracted. Open the pinned Crossref work endpoint ↗
  4. PubMed · 42251860Efficacy and safety of once-weekly cagrilintide-semaglutide (CagriSema) in adults with type 2 diabetes inadequately controlled on diet and exercise (REIMAGINE 1): a randomised, double-blind, placebo-controlled, phase 3a study. ↗PubMed PMID 42251860 · EFetch XML reviewed 2026-09-15 · payload SHA-256 11263729d3f0f7ef3fef3783c38343148228c91a9dcc6486a8e5d315c5eab2de
    No registered Crossref update in the reviewed snapshotChecked September 15, 2026 for DOI 10.1016/s2213-8587(26)00126-9. This bounded result is not proof that the publication has never been corrected or retracted. Open the pinned Crossref work endpoint ↗
  5. PubMed · 42251859Cagrilintide-semaglutide (CagriSema) versus semaglutide or cagrilintide in people with type 2 diabetes (REIMAGINE 2): a double-blind, randomised, controlled, phase 3 study. ↗PubMed PMID 42251859 · EFetch XML reviewed 2026-09-15 · payload SHA-256 37af409df5c7072a8e4b334dc072ca8deb7f9563442cb7f2ee20f1af862ee549
    Publication update registered by CrossrefErratum ↗ · publisher metadata · June 19, 2026 and August 1, 2026. Crossref metadata identifies the notice but does not by itself explain what wording changed.
  6. PubMed · 42251856Cagrilintide-semaglutide (CagriSema) as an add-on to basal insulin in adults with type 2 diabetes (REIMAGINE 3): a randomised, double-blind, placebo-controlled, multicentre, phase 3 study. ↗PubMed PMID 42251856 · EFetch XML reviewed 2026-09-15 · payload SHA-256 9f2cda3784ed8d76bc0e31467119bff480bfd5319cfb18fe87f2146faa74a7ad
    No registered Crossref update in the reviewed snapshotChecked September 15, 2026 for DOI 10.1016/s0140-6736(26)01022-6. This bounded result is not proof that the publication has never been corrected or retracted. Open the pinned Crossref work endpoint ↗