Cagrilintide vs Semaglutide
Amylin against GLP-1, from the same company: one is the approved benchmark for weight loss, the other a different satiety hormone still proving it works alone.
Cagrilintide
A long-acting amylin analog with real Phase 2 monotherapy weight-loss data; its main clinical role is as the amylin half of CagriSema, and on its own it remains investigational.
Full Cagrilintide evidence reviewSemaglutide
Wegovy / Ozempic
~15% mean weight loss in STEP 1; the benchmark that opened modern obesity medicine.
Full Semaglutide evidence reviewSide by side
| Cagrilintide | Semaglutide | |
|---|---|---|
| Marketed for | Weight loss | Weight loss, type-2 diabetes |
| Evidence grade | Clinical data | FDA-approved |
| Family | GLP-1 / incretin | GLP-1 / incretin |
| Regulatory status | Investigational | FDA-approved |
| How it's obtained | Research-only | Rx product |
| Key human source | Phase 2 monotherapy RCT, Lancet 2021 | STEP 1, NEJM 2021 |
marks a row where the two differ. Evidence grades come from our evidence matrix, which grades each molecule on the human data for the use it is marketed for.
Our verdict
Semaglutide is approved and cagrilintide is not, which settles the practical question immediately. The interesting one is mechanistic: amylin is not a GLP-1. It signals satiation through largely separate machinery, slowing gastric emptying and acting through the hindbrain, which is precisely why Novo Nordisk pairs the two in CagriSema rather than choosing between them. On effect size the comparison is lopsided and cross-trial: semaglutide’s STEP 1 produced about 15% mean weight loss, while cagrilintide’s record is a 26-week phase 2 dose-finding trial. One caution worth stating plainly — a different mechanism is not a gentler one. Cagrilintide carries the gut-hormone class’s nausea-led tolerability profile, so it is not the softer option its separate pathway might imply.
Cagrilintide fits if
You are following the amylin pathway itself and want the standalone monotherapy data, rather than the combination it is most likely to reach patients inside.
Semaglutide fits if
You want a weight-loss medicine you can actually be prescribed, with a pivotal trial program and a cardiovascular outcomes trial behind it.