Cagrilintide

Summary

Cagrilintide is a long-acting acylated amylin analogue developed by Novo Nordisk for the treatment of obesity and type 2 diabetes. It is being investigated as monotherapy and in fixed-dose combination with semaglutide (CagriSema) to provide complementary and potentially synergistic weight-lowering and glycemic control effects.

Mechanism of Action

Long-acting amylin receptor agonist that activates amylin receptors (CALCR/RAMP complexes) in the hypothalamus and brainstem, reducing appetite, slowing gastric emptying, and promoting satiety; also suppresses glucagon secretion in a glucose-dependent manner.

Routes of Administration

Goals & Uses

• Weight loss / anti-obesityMetabolicModerate
• Cardiovascular risk reductionCardiovascularLow
• Appetite suppressionMetabolicModerate
• Gastric emptying modulationGastrointestinalModerate
• Glycemic control in type 2 diabetesMetabolicModerate

Contraindications

• Personal or family history of medullary thyroid carcinomaOncologicHigh
• Multiple endocrine neoplasia syndrome type 2 (MEN2)OncologicHigh
• Hypersensitivity to cagrilintide or excipientsImmunologicHigh
• PregnancyPopulationHighPotential fetal risk or insufficient safety data

Adverse Effects

• HypoglycemiaMetabolicUncommonAbnormally low blood glucose
• Injection site reactionsLocalUncommon
• NauseaGastrointestinalCommonFeeling of sickness or urge to vomit
• VomitingGastrointestinalCommonForceful expulsion of stomach contents
• Decreased appetiteMetabolicCommonReduced desire to eat
• DiarrheaGastrointestinalCommonLoose or frequent stools

Drug Interactions

• InsulinModerateMay increase risk of low blood sugar
• Oral medications with narrow therapeutic indexModerate
• SulfonylureasModerateMay increase risk of low blood sugar
• SemaglutideLow

Population Constraints

• Severe renal impairmentOrgan ImpairmentRelative
• Pediatric patientsAgeRelative
• Pregnant or breastfeeding womenReproductiveRelative
• Severe hepatic impairmentOrgan ImpairmentRelative

Regulatory Status

• European UnionInvestigationalPhase 3 trials ongoing; no marketing authorization application submitted as of 2024.
• United StatesInvestigationalUnder Phase 3 clinical development (REDEFINE, REIMAGINE programs); NDA not yet submitted as of 2024.
• United KingdomInvestigationalNo approval; clinical trial participation ongoing.

Not yet approved in any jurisdiction as of 2024. Under clinical development by Novo Nordisk. Phase 3 trials (REDEFINE program) ongoing for obesity, and REIMAGINE program for type 2 diabetes in combination with semaglutide.

Evidence & Sources

No sources recorded yet.