Since the approval of Saxenda (liraglutide) as the first GLP-1 weight loss injection in 2014, the market for weight loss drugs has exploded (1)(2). Pharmaceutical companies have been racing to develop more effective treatments, and the latest innovation is a drug called CagriSema.
CagriSema is a brand-new GLP-1 weight loss injection. The medication hasn’t been formally approved yet, but clinical trials suggest it could outperform other top weight loss treatments like Wegovy and Mounjaro (3)(4).
With this novel drug expected to launch in the UK, possibly as early as 2026, here we’ll break down what CagriSema is, how it works, and what the latest research says (5).
What is CagriSema?
CagriSema is an investigational weight loss treatment developed by Novo Nordisk, the company behind Saxenda and Wegovy. It combines two powerful medications into one injection:
Semaglutide – the active ingredient in Wegovy (the UK version of Ozempic)
Cagrilintide – a new drug designed to enhance semaglutide’s effects (6)
The novel drug contains these active ingredients in equal parts (2.4 mg of cagrilintide and 2.4 mg of semaglutide). The two medications work together to target weight loss more effectively than semaglutide alone (3).
What is semaglutide?
Semaglutide for weight loss is a once-weekly weight loss injection belonging to a group of drugs called GLP-1 receptor agonists (7). All drugs in this group mirror a natural hormone called GLP-1, which regulates blood sugar and appetite.
By mimicking the actions of this hormone, semaglutide reduces hunger cravings, helping you have better control over what you eat (8). It may also help food stay in the stomach longer (delayed gastric emptying), reducing your appetite and helping you feel fuller. You’ll consume less food and calories as a result and, over time, lose weight.
Semaglutide has been one of the most effective weight loss medications to date, with clinical trials showing up to 15% total body weight loss over 68 weeks (9). Currently, the only GLP-1 weight loss injection shown to outperform semaglutide is tirzepatide, the active ingredient in Mounjaro (10).
What is cagrilintide?
Cagrilintide is a new type of weight loss drug called an amylin analogue. Amylin is a hormone produced and released by the pancreas that helps you feel satisfied after eating, slows gastric emptying, and regulates blood sugar levels (11).
Cagrilintide works similarly to GLP-1s by targeting this hormone to help regulate appetite. However, while both have similar effects, they work on different brain regions to produce feelings of fullness (6). This prompted researchers to look into whether cagrilintide and semaglutide could work together.
Studies found that cagrilintide is a successful weight loss drug on its own, helping people with obesity lose 10.8% of their body weight after 26 weeks (12). But combining the drug with semaglutide has even greater effects, with initial Phase 1B clinical trials showing it could boost weight loss by 7.4% compared to semaglutide alone (13).
How has CagriSema performed in clinical trials?
CagriSema weight loss injections are currently in Phase 3 trials, meaning the drug has passed the initial testing and is now being studied at multiple centres on thousands of participants. After passing this stage of clinical testing, pharmaceutical companies can request a license to go to market (14).
So far, CagriSema has shown impressive results. Novo Nordisk News published the results of the first part of their latest trial, REDEFINE 1, in December 2024 (15)(16). The study with 3,417 participants found that over the 68-week study period, people on CagriSema lost 22.7% of their weight, compared to 11.8% with cagrilintide 2.4 mg and 16.1% with semaglutide 2.4 mg (15).
Novo Nordisk had predicted a loss of 25%, so CagriSema fell slightly short of expectations (17). However, 40.4% of study participants did manage to hit 25% weight loss after 68 weeks, and it’s still far more effective than either cagrilinitide or semaglutide alone (15).
What is next for CagriSema clinic trails?
The Phase 3 REDEFINE programme has three more stages that are currently underway to check the safety of the drugs in different groups before coming to market:
REDEFINE 2: The second part of the Phase 3 testing will look at the safety and weight loss effects of once-weekly CagriSema injections on people who are overweight or obese and have type 2 diabetes (18).
REDEFINE 3: This part of the clinical trial aims to test CagriSema on people with cardiovascular disease (conditions affecting the heart and blood vessels) to assess any cardiovascular outcomes (19).
REDEFINE 4: The final stage is a 72-week study that compares weekly CagriSema weight loss injections to tirzepatide injections. The study will check the effects and safety of both drugs in 800 adults with obesity (20).
Once all stages of the REDEFINE clinical trial programme are complete, the Novo Nordisk weight loss drug can be put forward for approval and licensing.
When will CagriSema be available?
If all Phase 3 clinical trials go smoothly, the Novo Nordisk obesity drug is expected to be submitted for approval in Q4 of 2025 (5). Once submitted, CagriSema will go through the Medicines and Healthcare Products Regulatory Agency (MHRA) for review (21).
The approval timeline depends on several factors, but here’s a general breakdown:
Submission for approval: Novo Nordisk will submit a request for approval and provide full clinical trial data to the MHRA at the end of 2025 for review.
MHRA evaluation: The MHRA assesses the safety, efficacy, and manufacturing processes of CagriSema. This typically takes around 6 to 12 months.
CagriSema launched in the UK: If approved, CagriSemi weight loss injections could become available in 2026 or early 2027.
This MHRA approval process can sometimes be fast-tracked to 150 days, especially for innovative weight loss treatments (22). However, you should expect a wait of at least a year after submission before CagriSema is available to buy in the UK.
Is CagriSema better than other weight loss injections?
Several weight loss injections are available, each working slightly differently. CagriSema is the latest contender, but how does the new Novo Nordisk weight loss drug compare to existing treatments?
The SURMOUNT-5 study, published in December 2024, was the first head-to-head trial comparing two weight loss drugs: tirzepatide and semaglutide (23). The study found that people taking tirzepatide (Mounjaro) lost 20.2% of their body weight, compared to 13.7% for those taking semaglutide (Wegovy/Ozempic), and that Mounjaro patients experienced 47% greater relative weight loss after 72 weeks (24).
However, trials suggest CagriSema could rival Mounjaro’s impressive results. In a study directly comparing CagriSema and tirzepatide, it was concluded that Cagrisema performed better for weight loss (4). Additionally, the REDEFINE 1 trial showed a 22.7% weight loss over 68 weeks with CagriSema, compared to 20.2% over 72 weeks in the SURMONT-5 study on Mounjaro.
So, what does this mean?
Mounjaro (tirzepatide) is currently the most effective weight loss injection available.
Wegovy (semaglutide) is still highly effective in helping people lose weight.
CagriSema may offer even greater weight loss than both, but more studies are needed.
And while this paints the picture at the moment, other new weight loss medications are in development. Retatrutide is the main one to watch. This drug mimics three glucagon hormones and has been developed by Lilly, the pharmaceutical company behind Mounjaro (25).
Phase 2 trials have shown that at its highest dose, retatrutide leads to 24% weight loss in as little as 48 weeks—the highest weight loss yet seen in trials (26).
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Citations
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