If you have your finger on the pulse of what is happening in the world of weight loss medications, you may already be familiar with the name CagriSema. If not, it’s a name you are likely to become familiar with in the future. CagriSema, is a new medication currently under development by the Scandinavian pharmaceutical company Nova Nordisk. The company is presently evaluating its value as an anti-obesity treatment and as a drug for managing blood sugar levels in people with type 2 diabetes.
What is CagriSema?
CagriSema, a brand name for the combination of cagrilintide and semaglutide, brings together cagrilintide—a dual amylin and calcitonin receptor agonist—and semaglutide, a GLP-1 receptor agonist. Administered through a weekly injection, CagriSema is currently under investigation for its potential treatment benefits in type 2 diabetes and obesity.
Nova Nordisk it the company that developed semaglutide, a drug that is currently available with a prescription as Ozempic and Wegovy. Ozempic is a once-weekly injection for managaing the symptoms of type 2 diabetes. Wegovy, which is injected in a slightly higher dose, has FDA approval as a medication for managing chronic obesity.
Both medicatioins are very popular. With list prices of $1000 or more for a 4-week treatment, they are aslo very expensive. If CagriSema continues to perform well in clinical trials and gains FDA approval as a weight management medication or diabetes treatment, it seems likely it will have a similar price tag.
CagriSema is a combination drug that combine semaglutide with cagrilintide, an experimental drug that Nova Nordisk is currently evaluating for use in the same roles as Ozempic and Wegovy.
Like Ozempic and Wegovy, CagriSema is administerd to the body via a weekly injection, just under the skin. Nova Nordisk is also trialing the same drug combination in an oral form. Its Called Amycretin and has received significant media attention with many people referring to it as the new Ozempic pill.
Preliminary trial results suggest CagriSema may support greater levels of wight loss than either drug could achieve alone. The results of a 32-week clinical trial that compared the actions of the two drugs individually and together, show cagrilintide outperformed semaglutide. The patients receiving cagrilintide achieved an average weight loss of 8.1%. Among those receiving semaglutide injections, the average weight loss was only 5.1%. However, the patients given combination injections showed an average weight loss of 15.6%.
CagriSema also showed a superior ability to control blood sugar levels so preliminarily data suggests it has the potential to become one of the most popular medications of the decade. However, it’s important to remember many experimental drugs fail to attain FDA approval. Even if they work well , they also have to demonstrate an acceptable safety profile.
Related: MariTide weight loss drug – a new alternative to Ozempic and Wegovy
How CagriSema Works – Mechanism of Action
As with all fixed-dose combination medications, the two drugs in CagriSema appear to operate via a synergistic action that allows them to have greater abilities when they together than they do when acting alone.
Combination drugs can target multiple pathways or physiological processes simultaneously. This can result in better treatment outcomes compared to using each drug separately. For example, in the context of weight loss, a combination drug may suppress appetite, increase metabolism, and/or reduce fat absorption simultaneously, resulting in superior weight loss results.
Dose optimization is also an important consideration. During the drug developement stages, pharmacuetical companies generally monitor the way combination drugs pefrom in different ratios, pinpointing the combination that offers the greatest efficacy.
Semaglutide – Mechanism of Action and Potential Benefits
Semaglutide primarily functions by mimicking the activity of a hormone called glucagon-like peptide-1 (GLP-1). This hormone is released in the gut as a response to the the presence of food. It plays a key role in managing appetite and digestion. Drugs that work in this way are called GLP-1 receptor agonists.
After its release, GLP-1 stimulates the pancreas gland encouraging it to produce insulin. It also instructs the liver to stop making sugar. Semaglutide essentially provides a hormonal top-up that enhances this process, resulting in increases in insulin and even lower glucose production. By doing these things, it helps maintain healthy blood sugar levels, explaining its value as a treatment for type 2 diabetes.
Semaglutide’s value as a weight management drug is due to the way it influences appetite. It does this via more than one channel.
Firstly, the drug slows down gasteric emptying. This causes food to remain in the stomach for longer before emptying into the intestines. The food’s prolonged presence in the stomach, increases satiety, making the stomach feel fuller for longer.
Additionally, semaglutide acts on the areas of the brain that regulate appetite, reducing the desire for food. By slowing stomach emptying and reducing hunger cues, the drug makes it easier to remain within the constraints of a low-calorie diet. This can help people maintain the calorie deficit (shortage) that’s forces the body to breakdown stored fat and use it for energy, ultimately resulting in weight loss.
Related: Amycretin is a weight medicine that’s taken daily and used alongside diet and exercise to speed up the weight loss process. It’s a combination medication that pairs Semaglutide with an experimental drug called Cagrilintide.“
Cagrilintide – Physiological Actions and Benefits
Cagrilintide works by mimicking the effects of amylin, a hormone produced by the pancreas. Like GLP-1, amylin is released after eating. It helps to manage blood sugar levels by slowing down gastric emptying. This delay helps prevent sudden spikes in blood sugar, promoting a more gradual absorption of glucose into the bloodstream.
In addition to aiding in blood sugar control, cagrilintide influences weight management by activating receptors in the brain that regulate appetite, naturally reducing the desire to eat. This can lead to a decrease in overall calorie intake, supporting the efforts being made with diet and exercise.
Together, these actions help maintain stable blood sugar levels and assist in controlling appetite, making cagrilintide a potential tool for improving metabolic health and weight loss.
Although it manipulates the receptors of a different hormone, the actions of cagrilintide are comparable to those of semaglutide. The big difference is that Semaglutide has already gained FDA approval as a treatment for chronic obesity and type 2 diabetes, where cagrilintide has not.
CagriSema Side Effects, Safety Profile and Potential Health Risks
CagriSema is still in the development stage. This makes it hard to comment on the potential side effects or risks to the health it may present. The fact that one of the key components is another experimental drug makes it even harder to comment on the potential for negative outcomes.
However, in common with all GLP-1 receptor agonist drugs, semaglutide is asscocciated with a variety of side effects and has to be distributed with a boxed warning that points out it may have the poential to cause cause thyroid cancer and pancreatitis.
The most common side effects with GLP-receptor agonists are gasrointestinal issues such as nausea, vomitting, diahrea, and abdominal pain. Data collected so far suggests CagriSema may be less likely to cause gastrointestinal issues of this type but highlight the importance of futher investigation via longer and larger Phase 3 clinical trials.
CagriSema Weight Loss Injection Bottom Line
Although the prospect of any new weight loss drug always generates a lot of excitement, it’s important to remember pharmaceutical companies are developing new drugs all the time. Many of them never leave the planning stage, while others, that are submitted to the FDA for potential approval, fail to meet the standards required to prove their efficacy and safety.
The data so far suggests, CagriSema has a better chance than most. However, although it contains a drug that already has FDA approval for use in two roles, it also contains one that has yet to prove itself safe and effective. The future of CagriSema is unclear.
However, bearing in mind the cost of similar medications, it seems pretty clear that, if it ever does become available via prescription, CagriSema will be an expensive medication to use. Many potential users may find it probibitively expensive, while other may fear the potential side effects, but nothing is written in stone.
Sources
Coadministration of the long-acting amylin analog cagrilintide plus semaglutide (CagriSema), resulted in significantly greater weight loss, along with improved measures of glucose control, in a short phase 2 trial of patients with type 2 diabetes: https://dom-pubs.pericles-prod.literatumonline.com/doi/10.1002/doi2.68
GLP-1 Receptor Agonists and the Risk of Thyroid Cancer: https://diabetesjournals.org/care/article/46/2/384/147888/GLP-1-Receptor-Agonists-and-the-Risk-of-Thyroid
