← Drug-vs-drug verdicts

CagriSema vs Retatrutide (2026): Next-Gen Obesity Drugs Compared

CagriSema (cagrilintide 2.4 mg + semaglutide 2.4 mg, Novo Nordisk) vs Retatrutide (retatrutide (LY3437943), Eli Lilly)

Last verified 2026-07-06

By Eli Marsden · Founding Editor
Editorially reviewed (not clinically reviewed) · How we verify contentLast reviewed

The verdict

CagriSema and retatrutide represent two of the most promising next-generation obesity therapies in development as of 2026, but neither is FDA-approved and cross-trial comparisons have significant limitations. In the Phase 3 REDEFINE-1 trial, CagriSema produced a mean weight loss of 20.4% at 68 weeks (treatment-policy estimand, N=2108); in Eli Lilly's Phase 2 trial, retatrutide achieved 24.2% at 48 weeks at the 12 mg dose (N=81 in that group). These figures cannot be compared directly: retatrutide's results come from a smaller Phase 2 study with a shorter follow-up and a population that may not have fully plateaued, while CagriSema's derive from a large, definitive Phase 3 trial. CagriSema is further along the regulatory pathway — Phase 3 data published in 2025 support an expected NDA decision in 2026 — whereas retatrutide's Phase 3 TRIUMPH program is ongoing with results expected in 2026–2027. Neither should be declared a clear winner until head-to-head or mature Phase 3 data are available for both.

Side-by-side comparison

FieldCagriSemaRetatrutide
Peak weight loss (trial)−20.4% at 68 wk (REDEFINE-1, treatment-policy estimand, N=2108)−24.2% at 48 wk (Phase 2, 12 mg dose, N=81 in that arm)
MechanismAmylin analog (cagrilintide) + GLP-1 receptor agonist (semaglutide)Triple agonist: GLP-1, GIP, and glucagon receptors
Trial stage / statusPhase 3 complete (REDEFINE-1 published Aug 2025); NDA submission to FDA anticipatedPhase 3 TRIUMPH program ongoing; results expected 2026–2027
AdministrationOnce-weekly subcutaneous injectionOnce-weekly subcutaneous injection
FDA statusNot yet approved; NDA submission anticipated 2025–2026, decision pendingNot approved; Phase 3 ongoing, earliest approval 2027–2028
GI side effectsReported in 79.6% of CagriSema group (nausea, vomiting, diarrhea; mostly mild–moderate)Dose-related GI events predominated in Phase 2; largely mild–moderate
Cardiovascular / CVOT dataREDEFINE-1 not a cardiovascular outcomes trial; dedicated CVOT ongoingNo CVOT data available; TRIUMPH cardiovascular outcomes arm not yet reported

Frequently asked questions

Is CagriSema or retatrutide more effective for weight loss?

Based on available trial data, retatrutide showed 24.2% mean weight loss in a Phase 2 trial (48 weeks, 12 mg, N=81), while CagriSema showed 20.4% in the Phase 3 REDEFINE-1 trial (68 weeks, N=2108). These are not comparable figures — different trial phases, sample sizes, and durations make a direct conclusion unreliable. Phase 2 trials often overestimate real-world efficacy. TRIUMPH Phase 3 results for retatrutide will be needed before any advantage can be confirmed.

When will CagriSema be FDA approved?

Novo Nordisk published Phase 3 REDEFINE-1 data in the New England Journal of Medicine in August 2025, supporting an NDA submission to the FDA. An FDA decision is anticipated in 2026, though regulatory timelines are not guaranteed. CagriSema is not approved as of mid-2026.

When will retatrutide be available?

Retatrutide (LY3437943) is undergoing Phase 3 TRIUMPH trials as of 2026. If results are positive, Eli Lilly may file for FDA approval in 2027, with a potential market launch in 2027–2028 at the earliest. It is currently available only through registered clinical trials — search clinicaltrials.gov for the TRIUMPH program.

How do CagriSema and retatrutide work differently?

CagriSema combines two drugs: cagrilintide (an amylin analog that reduces appetite and slows gastric emptying) and semaglutide (a GLP-1 receptor agonist). Retatrutide is a single molecule that activates three hormone receptors simultaneously — GLP-1, GIP, and glucagon. The glucagon component may amplify energy expenditure, a mechanism absent in CagriSema.

Is retatrutide better for type 2 diabetes than CagriSema?

No direct comparison exists. CagriSema has Phase 3 data in T2D (REDEFINE-2, NEJM 2025, PMID 40544432) showing 13.7% weight loss at 68 weeks in that population. Retatrutide's glucagon component could complicate glucose control in T2D, though Phase 2 data showed favorable glycemic effects overall. Neither is approved for T2D as of mid-2026.

Can I participate in a clinical trial for these drugs?

Yes. ClinicalTrials.gov lists ongoing TRIUMPH trials for retatrutide (NCT numbers within the TRIUMPH program) and any remaining REDEFINE trials for CagriSema. Eligibility typically requires a BMI of 30 or higher, or 27+ with a weight-related complication. Discuss with your physician whether you qualify.

References

  1. 1.Garvey WT, Blüher M, et al.; REDEFINE 1 Study Group Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity N Engl J Med. 2025. PMID: 40544433.
  2. 2.Jastreboff AM, Kaplan LM, Frías JP, et al.; Retatrutide Phase 2 Obesity Trial Investigators Triple-Hormone-Receptor Agonist Retatrutide for Obesity — A Phase 2 Trial N Engl J Med. 2023. PMID: 37366315.
  3. 3.Giblin K, Bethel MA, et al. Retatrutide for the treatment of obesity, obstructive sleep apnea and knee osteoarthritis: Rationale and design of the TRIUMPH registrational clinical trials Diabetes Obes Metab. 2026. PMID: 41090431.
  4. 4.Davies MJ, et al.; REDEFINE 2 Study Group Cagrilintide-Semaglutide in Adults with Overweight or Obesity and Type 2 Diabetes N Engl J Med. 2025. PMID: 40544432.

Related comparisons

See the full drug-vs-drug verdict index or provider rankings.