Independent · non-commercial · publishes on a quarterly cycle|Current cycle 2026 Q3
Compound Evidence InstituteEvidence synthesis · established 2023Graded assessments of compounds, trials, methods and supply
Document set current to 30 July 2026
Compound monograph · §3

CagriSema (cagrilintide with semaglutide) — clinical evidence

Assessed outcomes with certainty ratings, contributing trials and the reasoning for each rating.

Document identifier
CEI-MN-006/3
Series
Compound monograph
Version
4.1
Published
24 May 2024
Last reviewed
24 Feb 2025
Next review
24 Feb 2027
Identifier
10.71829/cei.mono.6
Certainty
Moderate
Cycle
2024 Q2

§3Clinical evidence

Assessed outcomes for CagriSema (cagrilintide with semaglutide)Point estimates with confidence intervals for each contributing study, plotted against the line of no effect.0.00.20.40.60.81.0Standardised direction and relative magnitude of the recorded effectIndicationEffect as recordedObesity3 trials · Moderate−22.7 % body weight at 68 weeks versus…Type 2 diabetes1 trial · Moderate−13.7 % body weight and −1.8 % HbA1c at…
Moderate or high certaintyLow or very low certainty
Figure 3. Illustrative. Assessed outcomes plotted on a common standardised axis so that direction and relative magnitude can be compared at a glance. The estimates are not on a common natural scale and the intervals are the Institute's standardised representation of the reported precision, not the published confidence intervals. Published intervals appear in the per-indication extracts and in the text below.

§3.1Obesity and overweight in adults

Anchor outcome. Percentage change in body weight from baseline.

Effect as recorded. −22.7 % body weight at 68 weeks versus −2.3 % with placebo in adults with obesity without diabetes; estimated difference −20.4 percentage points (95 % CI −21.7 to −19.1).[1,2]

Certainty. Moderate certainty Large phase 3 trial. Downgraded one level because the observed effect fell below the sponsor-stated expectation and because a substantial proportion of participants did not reach the highest planned dose, which complicates interpretation of the dose-effect relationship.

Contributing trials. REDEFINE-1 · REDEFINE-2 · REDEFINE-4. Full structured abstracts are published for each.

Full evidence extract for obesity and overweight in adults · Indication assessment

§3.2Type 2 diabetes mellitus

Anchor outcome. Change in HbA1c (%, mmol/mol).

Effect as recorded. −13.7 % body weight and −1.8 % HbA1c at 68 weeks in type 2 diabetes; weight difference −10.4 percentage points (95 % CI −11.9 to −8.9).[2,3]

Certainty. Moderate certainty Attenuated weight effect in diabetes, consistent with the pattern seen across the incretin class.

Contributing trials. REDEFINE-2. Full structured abstracts are published for each.

Full evidence extract for type 2 diabetes mellitus · Indication assessment

References cited on this page

References are numbered in order of first citation in this document. Each superscript in the text links to its entry below.

  1. Frías JP, Deenadayalan S, Erichsen L, Knop FK, Lingvay I, Macura S, Mathieu C, Pedersen SD, Davies M. Efficacy and safety of co-administered once-weekly cagrilintide 2·4 mg with once-weekly semaglutide 2·4 mg in type 2 diabetes: a multicentre, randomised, double-blind, active-controlled, phase 2 trial. The Lancet 2023;402(10403):720–730. doi:10.1016/S0140-6736(23)01163-7 · PMID 37364591
  2. Lau DCW, Erichsen L, Francisco AM, Satylganova A, le Roux CW, McGowan B, Pedersen SD, Pietiläinen KH, Rubino DM, Batterham RL. 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 2021;398(10317):2160–2172. doi:10.1016/S0140-6736(21)01751-7 · PMID 34798060
  3. Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, Lingvay I, McGowan BM, Rosenstock J, Tran MTD, Wadden TA, Wharton S, Yokote K, Zeuthen N, Kushner RF. Once-weekly semaglutide in adults with overweight or obesity. New England Journal of Medicine 2021;384(11):989–1002. doi:10.1056/NEJMoa2032183 · PMID 33567185

Identifiers are reproduced only where the Institute holds them. Where a digital object identifier or PubMed identifier is not shown, the Institute has recorded the journal and year and has not constructed an identifier.

Nothing published by the Institute is medical advice, a diagnosis, a prescription, a treatment recommendation or a purchasing recommendation. Compounds supplied for research use are not approved for human or veterinary use in any jurisdiction, and a favourable analytical assessment of a supplier is not a statement that any product is safe or effective. The Institute publishes certainty ratings and never recommendations. No telephone number, messaging handle or ordering channel appears anywhere on this site.