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Cagrilintide development and structure What cagrilintide is: Synthetic long-acting amylin analog Modified 37-amino acid sequence Developed by Novo Nordisk Designed specifically for obesity treatment Based on natural amylin but optimized Key structural modifications: Amino acid substitutions for stability Prevented amyloid aggregation (major improvement) Extended half-life to ~7 days (vs minutes for natural amylin) Maintained receptor binding and activity Better pharmacokinetic profile Development timeline: Early 2010s: Initial development 2019-2020: Phase 2 trials (OASIS) 2021-2023: Phase 3 trials (REDEFINE as CagriSema) 2024-2025: FDA submission expected Likely approval 2025-2026 Why cagrilintide is breakthrough: First truly long-acting amylin agonist Weekly dosing (vs pramlintide 2-3x daily) Designed for weight loss (not diabetes adaptation) Proven synergy with semaglutide (CagriSema) Approaching availability Cagrilintide weight loss results Monotherapy clinical data (OASIS trials): Duration: 26-68 weeks Dose: 2.4mg weekly (standard) Average weight loss: 10-12% Some participants: 15%+ loss Well-tolerated at therapeutic dose Weight loss by dose: 0.6mg weekly: ~6% weight loss 1.2mg weekly: ~8% weight loss 2.4mg weekly: ~10% weight loss 4.5mg weekly: ~12% weight loss (higher side effects) CagriSema combination (cagrilintide + semaglutide): Both at 2.4mg weekly Average weight loss: 15.6% (REDEFINE-1) Excellent responders: 20-25% 50% more than semaglutide alone Game-changing results Real-world expectations: See our comprehensive cagrilintide weight loss guide

Its actions are incredibly diverse, affecting multiple pathways involved in tissue repair and remodeling

Kalich-Philosoph et al, 2013