Cagrilintide

Cagrilintide is a long-acting analog of amylin, a hormone your pancreas releases alongside insulin whenever you eat. Amylin slows stomach emptying and signals fullness through a different brain pathway than GLP-1 — which is the entire reason anyone is interested in combining the two.

In the REDEFINE 1 trial, cagrilintide was tested three ways: alone, alongside semaglutide, and against placebo, in 3,417 adults with overweight or obesity. The combination produced an estimated mean weight change of −20.4% at week 68 versus −3.0% on placebo. Including a cagrilintide-alone arm let the investigators separate what amylin contributes from what semaglutide was already doing, which is unusual rigor for a combination program.

The appeal of the amylin pathway is that it is genuinely separate. Pushing harder on GLP-1 alone eventually runs into tolerability limits — nausea scales with dose. Adding a second satiety signal offers a route to more weight loss without simply escalating the first one, and it is why several companies now have amylin analogs in development.

The confusion to head off: cagrilintide is not itself a GLP-1 agonist, and it is not CagriSema, which is the combination product. It is also not approved — FDA states that cagrilintide cannot be used in compounding under federal law and is not a component of any FDA-approved drug. There is no legitimate way to buy it in the United States today.

For patients this is a term to recognize rather than act on. If a telehealth service offers it, that offer is the red flag, not the opportunity. Our cagrilintide evidence review and amylin pipeline explainer track where the class is heading.