Coadministration of the long-acting amylin analog cagrilintide plus semaglutide (CagriSema), resulted in significantly greater weight loss, along with improved measures of glucose control, in a short phase 2 trial of patients with type 2 diabetes

Amylin is co-stored and co-secreted with insulin by pancreatic islet β-cells. It inhibits food intake, delays gastric emptying and decreases blood glucose levels, leading to the reduction of body weight—all similar to actions of GLP-1 analogue. Previous dose ranging studies of Amylin analogue, Cagrilintide have shown efficacy to induce weight loss. In a phase 2 study presented at the American Diabetes Association (ADA) 83rd Scientific Sessions, and simultaneously published in The Lancet,^[1] the efficacy and safety of combining the GLP_1 analogue Semaglutide with Cagrilintide in people with type 2 diabetes was reported. The primary endpoint of the study was HbA1c reduction and secondary endpoint was weight loss. At 32 weeks, HbA1c reduction was reported to be −2.2%, −1.8% and −0.9% for CagriSema, semaglutide and Cagrilintide, respectively. Remarkably, % weight loss was a staggering −15.6% with Cagrisema compared to −5.1% and −8.1% with semaglutide and cagrilintide, respectively. Surprisingly, the gastrointestinal events was low—likely due to slower dose titration. The weight loss data here seems staggering and not previously reported with pharmacotherapies in this population, reassuringly with an acceptable safety profile. These data support further investigation of CagriSema in people with type 2 diabetes in longer and larger phase 3 studies.