Efficacy and Safety of Co-Administered Once-weekly Cagrilintide 2.4 mg with Once-Weekly Semaglutide 2.4 mg in Type 2 Diabetes: a Multicentre, Randomised, Double-Blind, Active-Controlled, Phase 2 Trial

Lancet. 2023. DOI: 10.1016/ S0140-6736(23)01163-7

 Combining the GLP-1 RA semaglutide with the long-acting amylin analogue cagrilintide has been shown to have weight-loss benefits. However, the impact of the combination of cagrilintide and semaglutide (CagriSema) on HbA1c is unknown. In a 32-week, double-blind, phase 2 trial, 92 adults with T2D and a BMI ≥27 kg/m2 on metformin, with or without an SGLT2i, were randomised to once-weekly subcutaneous CagriSema, semaglutide or cagrilintide (all escalated to 2.4 mg). 

Treatment with CagriSema resulted in clinically relevant improvements in HbA1C and other measures of glycaemic control (including continuous glucose monitoring parameters). The mean change in HbA1c with CagriSema was greater vs cagrilintide, but not vs semaglutide. Treatment with CagriSema resulted in considerable weight loss, with significantly greater reductions versus semaglutide and cagrilintide. CagriSema also had an acceptable safety profile.


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