While CagriSema bested Novo Nordisk’s Wegovy on blood sugar control in a late-stage trial, the next-gen weight loss drug still has not met the pharma’s 25% weight loss goal.
Novo Nordisk’s next-generation weight-loss drug CagriSema beat current blockbuster GLP-1 Wegovy at controlling blood sugar in a Phase III trial, while falling below the Danish pharma’s lofty 25% weight loss goal.
In the Phase III REIMAGINE 2 study, which enrolled more than 2,700 adults with type 2 diabetes, Novo tested a 2.4-mg dose of CagriSema delivered via a weekly subcutaneous injection. The company compared that against the same sized doses of semaglutide, the amylin analog cagrilintide alone and placebo. The trial also included a 1-mg dose arm for CagriSema compared with same doses of semaglutide, cagrilintide and placebo.
At 68 weeks, patients treated with 2.4-mg CagriSema saw a 1.91%-point reduction in HbA1c, a measure of average blood sugar over the past two to three months, according to a news release on Monday. HbA1c in patients on semaglutide dropped by 1.76%-points, whereas placebo comparators saw a 0.09%-point increase.
CagriSema’s treatment benefit was significantly stronger than semaglutide’s, Novo said.
Similarly, CagriSema elicited significantly greater weight-loss versus semaglutide. Patients on the investigational treatment lost 14.2% of their body weight at 68 weeks, as opposed to 10.2% in the semaglutide group. CagriSema had not yet shown a weight-loss plateau at the time of readout, Novo said.
Despite stronger weight reduction numbers of CagriSema, the drug still came far below Novo’s own target. In a June 23, 2025 note to investors, analysts at William Blair noted that the pharma had set a “lofty benchmark” of 25% placebo-adjusted weight-loss—a bar that the drug has yet to meet.
The closest Novo has so far come to hitting this target was in December 2024, when CagriSema in the Phase III REDEFINE 1 study elicited a 22.7% drop in body weight at 68 weeks, versus 2.3% in placebo. Topline data from a second study, dubbed REDEFINE 2 and released in March 2025, showed 15.7% weight-loss with CagriSema versus 3.1% in placebo.
Novo in December 2025 nevertheless pushed through with an FDA filing for CagriSema as a weight-loss medicine, proposing weekly use in patients with obesity or who are overweight with at least one related comorbidity. A similar application for diabetes is also planned, according to Monday’s news release, pending data from the REIMAGINE 1 and REDEFINE 3 trials. REIMAGINE 1 tests CagriSema in treating type 2 diabetes while REDEFINE 3 is for controlling cardiovascular disease.
CagriSema is a fixed-dose combination of the GLP-1 receptor agonist semaglutide and the long-acting amylin analog cagrilintide. If approved, the drug “could be the first amylin-based combination therapy” for weight-loss and type 2 diabetes on the market, Martin Holst Lange, Novo’s chief scientific officer, said in a statement on Monday.
Novo is also running a head to head study of CargiSema against Eli Lilly’s tirzepatide, with a readout expected this quarter.
