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Cagrilintide (AM833)

Amylin receptor agonist

Also known as AM833, Long-acting amylin analogue

A long-acting amylin analogue, mostly studied in combination with semaglutide. A different satiety pathway to the incretins, which is the point of it.

Guide updated Sep 2, 2026Literature checked Sep 2, 20261 curated study46 literature recordsBaseline editorial

Overview

In shortA long-acting copy of amylin, a hormone released alongside insulin. It is interesting because it produces fullness by a route largely separate from the GLP-1 drugs, which is the argument for combining the two rather than pushing either one higher. Most attention is on the combination with semaglutide; on its own the evidence is thinner than the coverage suggests.

Cagrilintide is a long-acting analogue of amylin, the hormone co-secreted with insulin by pancreatic beta cells. It is interesting because it targets satiety through a route that is largely independent of GLP-1, which is the mechanistic argument for combining the two rather than escalating either.

Most of the attention is on the fixed-dose combination with semaglutide. As a single agent its evidence base is thinner than the coverage suggests.

Mechanism

In shortAmylin acts on the brainstem, slowing stomach emptying, lowering glucagon and producing fullness by a different route from GLP-1. The reason to combine them is to get two fullness signals at moderate doses instead of one at a high dose, in the hope that the stomach side effects are easier to live with.

Amylin acts at receptors in the area postrema and other hindbrain regions, slowing gastric emptying, suppressing glucagon, and producing satiety through a pathway distinct from GLP-1 receptor signalling.

The combination rationale is additivity without additive toxicity: two satiety signals at moderate doses rather than one at a high dose, with the hope that gastrointestinal tolerability is better than pushing a single agent to its ceiling.

Evidence

In shortEarly human work. Mid-stage trials report meaningful weight loss on its own and more in combination with semaglutide. Late-stage trials are running and none has reported for the single drug. Combination results are the ones usually quoted, and quoting a combination result as evidence about one ingredient is one of the commonest errors in coverage of it.

Early clinical. Phase 2 work reports meaningful weight reduction as monotherapy and larger reduction in combination with semaglutide. Phase 3 programmes are running.

No completed phase 3 has reported for the monotherapy. Combination results are the ones most often quoted, and quoting a combination result as evidence about a single agent is one of the more common errors in coverage of this compound.

Safety

In shortStomach effects, especially nausea, dominate as with the GLP-1 drugs, and injection site reactions have been reported. An earlier amylin drug carries a boxed warning for severe low blood sugar when used with insulin. Whether that carries over here in people not using insulin is not established, and trials that mostly excluded such patients cannot tell you it does not.

Gastrointestinal effects, particularly nausea, dominate, as with the incretins. Injection site reactions have been reported.

Pramlintide, the earlier amylin analogue, carries a boxed warning for severe hypoglycaemia when used with insulin. Whether that transfers to cagrilintide in populations not using insulin is not established, and the absence of a signal in trials that largely excluded such patients is not evidence of absence.

Regulatory status

In shortInvestigational. Not approved anywhere on its own. Combination products are in late-stage development.

Investigational. Not approved anywhere as a single agent. Combination products are in late-stage development.

The literature

1 study indexed. Findings and limitations get equal weight, on purpose.

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Everything above is free to read. What an account opens is the evidence underneath it: 1 study with their limitations, and the regimen each trial actually reported.

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The wider literature

17 indexed papers and 29 registered trials mentioning Cagrilintide, straight from PubMed and ClinicalTrials.gov. 29 of 29 administer it; the rest measure it. These have not been read by us. Unlike the studies above, they carry no findings and no limitations written by anyone here, because writing either would mean claiming a reading nobody has done. They are a starting point for yours.

Registered trials (29)

  1. A Research Study to Compare Blood Levels of Cagrilintide After Multiple Doses of Different Versions of Cagrilintide in Adults With Overweight or Obesity

    Novo Nordisk A/S2026NCT07597018

    interventionalphase1recruitingn=234

  2. A Research Study on How Well Cagrilintide and CagriSema Work in Children and Adolescents With Excess Body Weight

    Novo Nordisk A/S2026NCT07253285

    interventionalphase3recruitingn=460

  3. A Research Study to See How Much CagriSema Lowers Blood Sugar and Body Weight Compared to Placebo in Children and Adolescents With Type 2 Diabetes

    Novo Nordisk A/S2026NCT07282613

    interventionalphase3not yet recruitingn=80

  4. A Research Study Looking Into How Cagrilintide Influences Food Intake and Appetite in People With Overweight or Obesity

    Novo Nordisk A/S2026NCT07557953

    interventionalphase1recruitingn=120

  5. A Research Study to Compare Two Different Versions of Injectable Cagrilintide and Placebo in People With Excess Body Weight

    Novo Nordisk A/S2026NCT07745504

    interventionalphase3not yet recruitingn=285

  6. A Research Study to Compare Blood Levels of Two Different Versions of Cagrilintide in Adults With Excess Body Weight

    Novo Nordisk A/S2026NCT07605052

    interventionalphase1active not recruitingn=50

  7. Understanding the Effect of CagriSema, Cagrilintide, and Semaglutide on Muscle Health (Role of Amylin Signature in Muscle Health)

    Novo Nordisk A/S2026NCT07527195

    interventionalphase1recruitingn=100

  8. A Research Study to Look at How Well CagriSema Helps People Living With Obesity Lose Weight and Maintain Weight Loss in the Long-term

    Novo Nordisk A/S2025NCT07011667

    interventionalphase3active not recruitingn=609

  9. Weight Loss in People Living With Overweight or Obesity Following Treatment With Cagrilintide

    Novo Nordisk A/S2025NCT07220642

    interventionalphase3active not recruitingn=300

  10. A Research Study to Investigate the Effects of CagriSema Compared to Placebo in People With Type 2 Diabetes and Painful Diabetic Peripheral Neuropathy

    Novo Nordisk A/S2025NCT06797869

    interventionalphase2active not recruitingn=142

  11. The Role of the Amylin Analogue Cagrilintide in Bone Metabolism

    Novo Nordisk A/S2025NCT07010432

    interventionalphase1recruitingn=144

  12. A Study to See How Metabolism is Influenced by Weight Loss Due to Intervention With Cagrilintide and Semaglutide Compared to Diet

    Novo Nordisk A/S2025NCT07184086

    interventionalphase1recruitingn=80

  13. Investigating How CagriSema, Semaglutide and Cagrilintide Regulate Insulin Effects in the Body of People With Type 2 Diabetes

    Novo Nordisk A/S2024NCT06403761

    interventionalphase1completedn=158

  14. Effects of NNC0194-0499, Cagrilintide, and Semaglutide Alone or in Combinations on Liver Damage and Alcohol Use in People With Alcohol-related Liver Disease

    Novo Nordisk A/S2024NCT06409130

    interventionalphase2completedn=270

  15. A Research Study to See How Much CagriSema Lowers Blood Sugar and Body Weight Compared to Placebo in People With Type 2 Diabetes Treated With Once-daily Basal Insulin With or Without Metformin

    Novo Nordisk A/S2024NCT06323161

    interventionalphase3completedn=274

  16. A Research Study to Look at How CagriSema Influences Food Intake, Appetite and Emptying of the Stomach in People With Excess Body Weight

    Novo Nordisk A/S2024NCT06207877

    interventionalphase1completedn=62

  17. A Research Study to See if Kidney Damage in People With Chronic Kidney Disease and Type 2 Diabetes Living With Overweight or Obesity Can be Reduced by CagriSema Compared to Semaglutide, Cagrilintide and Placebo

    Novo Nordisk A/S2024NCT06131372

    interventionalphase2completedn=626

  18. A Research Study to See How Much CagriSema Lowers Blood Sugar and Body Weight Compared to Placebo in People With Type 2 Diabetes Treated With Diet and Exercise

    Novo Nordisk A/S2024NCT06323174

    interventionalphase3completedn=189

  19. A Research Study to See How Much CagriSema Lowers Blood Sugar and Body Weight Compared to Tirzepatide in People With Type 2 Diabetes Treated With Metformin With or Without an SGLT2 Inhibitor

    Novo Nordisk A/S2024NCT06221969

    interventionalphase3completedn=1024

  20. A Research Study to Compare Blood Levels of Cagrilintide and Semaglutide After Single Doses of Different Versions of Injectable CagriSema in Adults With Overweight or Obesity

    Novo Nordisk A/S2024NCT06716307

    interventionalphase1completedn=18

  21. A Research Study to See How Much CagriSema Lowers Blood Sugar and Body Weight Compared to Tirzepatide in People With Type 2 Diabetes Treated With Metformin, SGLT2 Inhibitor or Both

    Novo Nordisk A/S2024NCT06534411

    interventionalphase3completedn=1023

  22. A Research Study Looking at How a Single Dose of the Medicine Cagrilintide Works in Participants With Reduced Liver Function and in Healthy Participants With Normal Liver Function and How Cagrilintide is Absorbed and Used by the Body

    Novo Nordisk A/S2023NCT05564104

    interventionalphase1completedn=32

  23. A Research Study to See How Well CagriSema Compared to Semaglutide, Cagrilintide and Placebo Lowers Blood Sugar and Body Weight in People With Type 2 Diabetes Treated With Metformin With or Without an SGLT2 Inhibitor

    Novo Nordisk A/S2023NCT06065540

    interventionalphase3completedn=2734

  24. A Research Study Looking at How Cagrilintide Works on the Heart Rhythm in Healthy Participants

    Novo Nordisk A/S2023NCT05804162

    interventionalphase1completedn=107

  25. A Research Study to See How Well CagriSema Helps People in East Asia With Excess Body Weight Lose Weight

    Novo Nordisk A/S2023NCT05813925

    interventionalphase3completedn=331

  26. A Research Study to See How Well CagriSema Helps People in China With Excess Body Weight Lose Weight

    Novo Nordisk A/S2023NCT05996848

    interventionalphase3completedn=300

  27. A Research Study to See How Well CagriSema Helps People With Excess Body Weight Lose Weight

    Novo Nordisk A/S2022NCT05567796

    interventionalphase3active not recruitingn=3400

  28. Research Study to Look at How Well Cagrilintide Together With Semaglutide Works in People With Type 2 Diabetes

    Novo Nordisk A/S2021NCT04982575

    interventionalphase2completedn=92

  29. A Research Study to Compare Blood Levels of Cagrilintide and Semaglutide After Combined Versus Separate Injections in People With Overweight or Obesity

    Novo Nordisk A/S2021NCT04940078

    interventionalphase1completedn=40

Papers (17)

  1. Long-acting amylin-related peptides as therapies for obesity and type 2 diabetes.

    Bailey CJ, et al.Peptides2026PMID 41747885

    journal articlereview

  2. Cagrilintide-semaglutide (CagriSema) versus semaglutide or cagrilintide in people with type 2 diabetes (REIMAGINE 2): a double-blind, randomised, controlled, phase 3 study.

    Buse JB, et al.The lancet. Diabetes & endocrinology2026PMID 42251859

    journal articlerandomized controlled trialclinical trial, phase iiimulticenter studycomparative study

  3. Novel GLP-1-based Medications for Type 2 Diabetes and Obesity.

    Son JW, et al.Endocrine reviews2026PMID 41054801

    journal articlereview

  4. Cagrilintide-Semaglutide in Adults with Overweight or Obesity and Type 2 Diabetes.

    Davies MJ, et al.The New England journal of medicine2025PMID 40544432

    journal articlerandomized controlled trialclinical trial, phase iiimulticenter study

  5. Weight management treatment in obesity.

    Rubio-Herrera MA, et al.Medicina clinica2025PMID 40865172

    journal articlereview

  6. The promise of glucagon-like peptide 1 receptor agonists (GLP-1RA) for the treatment of obesity: a look at phase 2 and 3 pipelines.

    Madsbad S, et al.Expert opinion on investigational drugs2025PMID 40022548

    journal articlereview

  7. Eloralintide (LY3841136), a novel amylin receptor agonist for the treatment of obesity: From discovery to clinical proof of concept.

    Briere DA, et al.Molecular metabolism2025PMID 41109426

    journal articleclinical trial, phase irandomized controlled trial

  8. Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity.

    Garvey WT, et al.The New England journal of medicine2025PMID 40544433

    journal articlerandomized controlled trialmulticenter studyclinical trial, phase iii

  9. Amylin, Another Important Neuroendocrine Hormone for the Treatment of Diabesity.

    Eržen S, et al.International journal of molecular sciences2024PMID 38338796

    journal articlereview

  10. Cagrilintide: A Long-Acting Amylin Analog for the Treatment of Obesity.

    D'Ascanio AM, et al.Cardiology in review2024PMID 36883831

    journal article

  11. Comparative effectiveness of GLP-1 receptor agonists on glycaemic control, body weight, and lipid profile for type 2 diabetes: systematic review and network meta-analysis.

    Yao H, et al.BMJ (Clinical research ed.)2024PMID 38286487

    systematic reviewjournal articlenetwork meta-analysis

  12. Efficacy and Safety of Cagrilintide Alone and in Combination with Semaglutide (Cagrisema) as Anti-Obesity Medications: A Systematic Review and Meta-Analysis.

    Dutta D, et al.Indian journal of endocrinology and metabolism2024PMID 39676787

    journal articlereview

  13. Amylin analogs for the treatment of obesity without diabetes: present and future.

    Panou T, et al.Expert review of clinical pharmacology2024PMID 39317404

    journal articlereview

  14. 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.

    Frias JP, et al.Lancet (London, England)2023PMID 37364590

    randomized controlled trialmulticenter studyclinical trial, phase iijournal articleresearch support, non-u.s. gov't

  15. Long-acting amylin analogue for weight reduction.

    Gadde KM, et al.Lancet (London, England)2021PMID 34798059

    journal articlecomment

  16. Development of Cagrilintide, a Long-Acting Amylin Analogue.

    Kruse T, et al.Journal of medicinal chemistry2021PMID 34288673

    journal articleresearch support, non-u.s. gov't

  17. Once-weekly cagrilintide for weight management in people with overweight and obesity: a multicentre, randomised, double-blind, placebo-controlled and active-controlled, dose-finding phase 2 trial.

    Lau DCW, et al.Lancet (London, England)2021PMID 34798060

    clinical trial, phase iijournal articlemulticenter studyrandomized controlled trial

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