February 02, 2026
2 min read
Key takeaways:
- In patients with type 2 diabetes, CagriSema lowered HbA1c to a greater degree than semaglutide at 68 weeks.
- CagriSema also conferred more weight loss than semaglutide in this population.
The combination of cagrilintide 2.4 mg and semaglutide 2.4 mg was superior to semaglutide alone for weight loss and HbA1c reduction at 68 weeks, according to topline results of the REIMAGINE 2 trial announced by Novo Nordisk.
In the REIMAGINE 2 trial, the fixed dose combination of the amylin receptor agonist cagrilintide and the GLP-1 semaglutide (CagriSema, Novo Nordisk), administered as a once-weekly injection, was compared with semaglutide alone (Ozempic/Wegovy, Novo Nordisk), according to a company press release.
The combination of cagrilintide 2.4 mg and semaglutide 2.4 mg was superior to semaglutide alone for weight loss and HbA1c reduction at 68 weeks.
The study included 2,728 people with type 2 diabetes inadequately controlled with metformin (mean baseline HbA1c, 8.2%; mean baseline body weight, 101 kg), approximately 40% of whom were taking an SGLT2 inhibitor. Patients were assigned to one of the following groups: CagriSema 2.4 mg/2.4 mg, CagriSema 1 mg/1 mg, semaglutide 2.4 mg, semaglutide 1 mg, cagrilintide 2.4 mg or placebo.
According to the efficacy estimand, at 68 weeks, the CagriSema 2.4 mg/2.4 mg group reached an HbA1c reduction of 1.91 percentage points compared with a reduction of 1.76 percentage points for the semaglutide 2.4 mg group and a gain of 0.09 percentage points in the placebo group. In addition, the CagriSema 2.4 mg/2.4 mg group had weight loss of 14.2% without a weight-loss plateau compared with 10.2%, the company stated in the release.
Weight loss of at least 15% was attained by 43% and weight loss of at least 20% was attained by 24% of the CagriSema 2.4 mg/2.4 mg group, according to the release.
According to the treatment-regimen estimand, at 68 weeks, HbA1c reduction was 1.8 percentage points in the CagriSema 2.4 mg/2.4 mg group and 1.68 percentage points in the semaglutide 2.4 mg group, and weight loss was 12.9% in the CagriSema 2.4 mg/2.4 mg group and 9.2% in the semaglutide 2.4 mg group.
The company stated in the release that CagriSema was safe and well tolerated, with most adverse events being mild to moderate, gastrointestinal in nature, diminishing over time and consistent with those seen in previous trials of incretin- and amylin-based therapies.
“We are very pleased by the clinical profile of CagriSema in type 2 diabetes patients, including a confirmation of the very strong weight-loss data seen with CagriSema in the obesity trials,” Martin Holst Lange, executive vice president, chief scientific officer and head of research and development at Novo Nordisk, said in the release. “By combining semaglutide and cagrilintide, we’re seeing superior outcomes in both blood glucose control and weight reduction beyond those achieved with each therapy individually. The results strengthen our belief that CagriSema could be the first amylin-based combination therapy and a promising treatment option for individuals with type 2 diabetes, who also has a focus on weight loss.”
Full results of the study will be presented at a scientific conference in 2026, according to the release.
The company stated in the release that it will pursue regulatory approval for CagriSema to treat type 2 diabetes after the results of REIMAGINE 1 and REDEFINE 3 are known, and that an application has been filed to the FDA for approval of CagriSema as a treatment for obesity based on the results of the REDEFINE 1 and REDEFINE 2 trials.
Sources/Disclosures
Source:
Press Release
Disclosures:
Lange is an employee of Novo Nordisk.
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