CagriSema vs tirzepatide: the next-generation obesity combo, compared
Novo's amylin/GLP-1 combination versus Lilly's dual-agonist tirzepatide. The REDEFINE trial data is in — here's what it actually shows.
CagriSema is a co-administered combination of cagrilintide (a long-acting amylin analog) and semaglutide, in Phase 3 with Novo Nordisk. Tirzepatide is Eli Lilly's already-FDA-approved dual GIP/GLP-1 agonist, sold as Zepbound for obesity and Mounjaro for T2D. Both target weight loss through multiple receptor pathways but via different mechanisms.
| Field | CagriSema | Tirzepatide |
|---|---|---|
| Brand names | cagrilintide + semaglutide | Mounjaro, Zepbound |
| Manufacturer | Novo Nordisk | Eli Lilly |
| FDA approved | Investigational (Phase 3) | 2022 (T2D), 2023 (obesity) |
| Indication | Chronic weight management (pending approval) | Type 2 diabetes and chronic weight management |
| Mechanism | Amylin analog (cagrilintide) + GLP-1 agonist (semaglutide) | Dual GIP / GLP-1 receptor agonist |
| Delivery | Once-weekly subcutaneous injection (fixed-dose combo pen) | Once-weekly subcutaneous injection |
| Avg weight loss | ~20.4% at 68 weeks (REDEFINE-1) | ~20.9% at 72 weeks (SURMOUNT-1, 15 mg) |
Primary sources
- CagriSema: REDEFINE-1 (NEJM, 2025)
- Tirzepatide: SURMOUNT-1 (NEJM, 2022)
Frequently asked
Is CagriSema approved yet?
Not as of April 2026. CagriSema completed Phase 3 (REDEFINE-1, REDEFINE-2) and Novo has submitted regulatory filings. FDA approval is expected in 2026 or 2027 depending on review timeline.
Why combine cagrilintide with semaglutide instead of using semaglutide alone?
Cagrilintide (an amylin analog) acts on a different satiety pathway than semaglutide (GLP-1). Combining them in REDEFINE-1 produced ~20.4% weight loss vs ~15% for semaglutide alone at comparable durations — a meaningful additive effect.
How does CagriSema compare to tirzepatide on efficacy?
In their respective Phase 3 trials, both produce around 20% mean weight loss at ~70 weeks. A head-to-head trial has not yet been published as of April 2026.
Will CagriSema replace tirzepatide?
Unlikely — they target different receptor pathways and will probably serve different patient responders. Both will compete on weight loss efficacy, tolerability, and price.
What about amycretin?
Amycretin is Novo's single-molecule amylin/GLP-1 agonist, still in earlier-phase trials. It aims to deliver CagriSema-like efficacy in one molecule rather than a combination.