Cagrilintide for Appetite Suppression — Weight & Metabolism
Long-acting amylin analog for weight loss through appetite suppression and delayed gastric emptying.
Overview
Cagrilintide is a long-acting amylin and calcitonin receptor agonist that works through different pathways than GLP-1 drugs. Phase 3 trials show 11.8% weight loss as monotherapy and 20.4% when combined with semaglutide (CagriSema). It targets both homeostatic and hedonic eating centers in the brain for powerful appetite suppression.
Indications
- Obesity (BMI ≥30) or overweight (BMI ≥27) with comorbidities
- Type 2 diabetes with obesity
- Patients seeking enhanced weight loss beyond GLP-1 monotherapy
- Combination therapy with GLP-1 agonists for maximum weight reduction
Mechanism of Action
Inadequate amylin signaling fails to regulate appetite at homeostatic and hedonic eating centers
Dosing
| Compound | Dose | Frequency | Notes |
|---|---|---|---|
| Cagrilintide | 2.4 mg | Once weekly | Standard dose for standalone amylin therapy: 11.8% weight loss (68 weeks) |
| Cagrilintide 2.4 mg + Semaglutide 2.4 mg | Fixed combination | Once weekly (fixed-dose combination) | Superior results: 20.4% weight loss in obesity, 13.7-15.7% in T2D |
Evidence Grade
GRADE B
Safety & Contraindications
- Phase 3 trials completed (REDEFINE program), regulatory submission expected 2025-2026
- Generally well-tolerated with better tolerability profile than some GLP-1s
- Mild-to-moderate GI symptoms (nausea, vomiting, diarrhea, constipation)
- Symptoms diminish over time with gradual dose escalation
- Lower discontinuation rates vs pure GLP-1 agonists in trials