Cagrilintide

Description

Cagrilintide is a long-acting amylin analog developed by Novo Nordisk as part of their next-generation obesity pipeline. Amylin is a pancreatic hormone co-secreted with insulin that plays a critical role in regulating postprandial glucose and satiety. Cagrilintide was engineered with fatty acid modifications to extend its half-life to approximately 7 days, enabling once-weekly dosing. In Phase III trials as part of the CagriSema combination (with semaglutide), it has demonstrated up to 22.7% body weight reduction — substantially exceeding the efficacy of semaglutide alone. This makes it one of the most promising agents in the obesity pharmacotherapy pipeline. Beyond weight loss, it improves glycemic control, reduces postprandial glucose excursions, and has favorable effects on lipid profiles.

Key Characteristics

Investigated Benefits

• Significant weight reduction
• Complementary to GLP-1 therapy
• Improved glycemic control
• Reduced appetite through central mechanisms

* Benefits based on preclinical/animal research unless otherwise noted.

Mechanism of Action

“A long-acting amylin analog that complements GLP-1 therapy for superior weight loss and metabolic control.”

Cagrilintide activates amylin receptors (AMY1, AMY2, AMY3) — which are calcitonin receptor/RAMP complexes — in the hypothalamus, brainstem (area postrema and nucleus tractus solitarius), and peripheral tissues. Receptor activation reduces food intake through two complementary mechanisms: centrally, it suppresses appetite signals in the hypothalamic arcuate nucleus; peripherally, it slows gastric emptying, reducing the rate of nutrient absorption and prolonging satiety. Cagrilintide’s mechanism is distinct from and complementary to GLP-1 receptor agonists, which act primarily through vagal afferent pathways and cAMP signaling in pancreatic beta cells. The combination of amylin and GLP-1 receptor activation produces synergistic weight loss that exceeds either agent alone, likely because they engage different neural circuits controlling energy homeostasis.

Reconstitution Guide

Per compounding pharmacy instructions

Compatible Peptides

Peptides commonly used alongside Cagrilintide for synergistic effects.