Novo Nordisk Files Combo Obesity Drug CagriSema For FDA Approval

Facade of Novo Nordisk's office in Fremont, California

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The filing comes as Novo fights tooth-and-nail with rival Lilly to regain its footing at the top of the weight loss market.

Novo Nordisk has filed a new drug application with the FDA for its once-weekly injectable obesity drug CagriSema, another lap in a heated race with rival Eli Lilly, whose own assets are racking up clinical wins in the $27 billion obesity market.

The filing covers the use of the drug in adults who have obesity or are overweight with at least one weight-related comorbidity, according to an announcement Thursday.

CagriSema is a combination of a long-acting amylin analogue, cagrilintide, and Novo’s GLP-1 receptor agonist semaglutide, already approved as Wegovy for obesity and Ozempic for diabetes. Novo touted CagriSema in its announcement as potentially the first injectable amylin-GLP-1 combination therapy on the market.

“Building on the well-established profile of semaglutide and combining it with a novel mechanism of action, CagriSema has the potential to represent a meaningful step forward in the holistic treatment of obesity,” CEO Maziar Mike Doustdar said in a statement.

The filing is based on results from Novo’s Phase III REDEFINE 1 trial. In December 2024, a readout from REDEFINE 1 showed CagriSema elicited 20.4% weight loss after 68 weeks, versus 11.5% with cagrilintide alone, 14.9% with semaglutide alone and 3% for the placebo group.

Another readout from the same REDEFINE 1 trial in June of this year saw 12% of patients reporting injection-site reaction adverse events. The cagrilintide component of the combination seemed to be at fault, as 17% on the amylin analogue alone reported the same events, versus 2.6% of patients who received semaglutide monotherapy. Analysts zeroed in on those reactions, noting that CagriSema’s efficacy seemed comparable to Eli Lilly’s GLP-1 Zepbound, though Lilly’s drug did not raise the same reactions.

In September, the company reported 11.8% weight reduction in patients who received CagriSema versus 2.3% for those in the placebo arm. Novo called the drug well-tolerated, with just 1% of patients who received it dropping out, compared to 0.1% in the placebo arm.

Novo is in a head-to-head battle with Eli Lilly to reclaim the obesity market. The Danish pharma is also awaiting a decision from the FDA on its oral semaglutide pill, due by the end of the year. Meanwhile, Lilly announced Thursday that its oral offering orfoglipron hit a key milestone, maintaining weight loss in patients who switched from Wegovy or Lilly’s GLP-1 Zepbound.

Lilly is also awaiting a decision from the FDA on a filing for orforglipron sometime in early 2026, though a Commissioner’s National Priority Voucher could move up that timeline.

Dan Samorodnitsk has a decade of experience covering biotech, genetics and medicine at BioSpace, Drug Discovery News and Massive Science. His writing has appeared in outlets such as Quanta, STAT, GROW and many others. You can follow him on LinkedIn.
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