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Aminoscope
Head-to-head

CagriSema vs Tirzepatide

An approved dual incretin agonist against an investigational amylin plus GLP-1 combination; the reported magnitudes are close, the evidence maturity is not.

By Julian RothResearch & dataUpdated October 2026

Short answer

On weight loss, tirzepatide comes out ahead, with 20.9% at 72 weeks in SURMOUNT-1 against 20.4% at 68 weeks in REDEFINE 1 for CagriSema. Those figures come from separate trials, not a head-to-head study. Only tirzepatide is FDA-approved; CagriSema is still investigational in the US. Tirzepatide is a prescription drug, while CagriSema is legitimately available only inside clinical trials.

CagriSema

Clinical data

~20% in REDEFINE 1; amylin plus GLP-1 in one shot — promising, not yet approved.

Full CagriSema evidence review

Tirzepatide

Zepbound / Mounjaro

FDA-approved

Up to ~21% mean weight loss in SURMOUNT-1 — the most effective FDA-approved weight-management drug.

Full Tirzepatide evidence review

CagriSema vs Tirzepatide: head to head

FDA status / approved use

CagriSema

Investigational; Phase 3 REDEFINE trials completed, regulatory status still pending

Tirzepatide

Prescription drug sold as Mounjaro and Zepbound
Marketed for

CagriSema

Weight loss

Tirzepatide

Weight loss, type-2 diabetes
Outcome areas

CagriSema

Weight loss / appetite

Tirzepatide

Weight loss / appetite; Blood sugar / insulin sensitivity
Evidence grade

CagriSema

Clinical data

Tirzepatide

FDA-approved
How it works

CagriSema

Pairs an amylin analog with a GLP-1 agonist to curb appetite two ways

Tirzepatide

Dual agonist of the GLP-1 and GIP receptors
Route and dosing

CagriSema

Injection, once weekly

Tirzepatide

Subcutaneous, once weekly (Zepbound label); maintenance 5, 10 or 15 mg once weekly (10 or 15 mg for sleep apnea)
Headline human result

CagriSema

20.4% mean weight loss vs 3% on placebo at 68 weeks (REDEFINE 1, 2.4 mg + 2.4 mg weekly)

Tirzepatide

20.9% mean weight loss vs 3.1% on placebo at 72 weeks (SURMOUNT-1, 15 mg weekly)
Strongest evidence

CagriSema

REDEFINE 1, NEJM 2025CagriSema evidence reviewPubMed 40544433

Tirzepatide

SURMOUNT-1, NEJM 2022Tirzepatide evidence reviewPubMed 35658024
Key safety signal

CagriSema

GI side effects common; no long-term cardiovascular-outcomes evidence yet

Tirzepatide

Gastrointestinal side effects, the same class as semaglutide
How it is obtained

CagriSema

Legitimately available only inside clinical trials; vials sold online are gray-market research chemicals

Tirzepatide

Prescription. Manufacturer self-pay for Zepbound runs $299–$449 per fill, against a $1,086 list priceZepbound cost breakdown

marks a row where the two differ. “Not established” marks a cell the available evidence does not answer. Evidence grades come from our evidence matrix, which grades each molecule on the human data for the use it is marketed for.

FDA-approved:
Approved by the FDA for a defined indication, on the strength of pivotal human trials.
Clinical data:
Tested in humans — but investigational, discontinued, or proven only on a surrogate marker (not the marketed outcome).

Our verdict

Tirzepatide is approved and carries both pivotal data (SURMOUNT-1, up to roughly 20.9%) and a head-to-head win over semaglutide in SURMOUNT-5. CagriSema reported about 20% in REDEFINE 1, but it is investigational, cannot be prescribed, and has no long-term cardiovascular outcomes evidence; a notable share of participants also never reached the highest target dose, which shaped that headline figure. The two have not been compared directly, so similar-looking numbers should not be read as a tie.

CagriSema fits if

You are following amylin agonism as the next mechanism and want to see whether REDEFINE translates into an approval.

Tirzepatide fits if

You want an approved drug with the strongest head-to-head weight-loss evidence available today.

CagriSema vs Tirzepatide: common questions

Is tirzepatide FDA-approved but CagriSema not?
Yes. Tirzepatide is a prescription drug sold as Mounjaro and Zepbound. CagriSema is investigational; Phase 3 REDEFINE trials completed, regulatory status still pending.
Which has stronger human evidence, CagriSema or tirzepatide?
Tirzepatide. It has approval-level evidence (key source: SURMOUNT-1, NEJM 2022), while CagriSema has human clinical data (key source: REDEFINE 1, NEJM 2025).
What are the main safety concerns with CagriSema and tirzepatide?
For CagriSema, watch for common GI side effects; no long-term cardiovascular-outcomes evidence yet. For tirzepatide, watch for gastrointestinal side effects, the same class as semaglutide.

Key studies behind each

CagriSema

  1. Lau DCW, Erichsen L, Francisco AM, et al. (2021). Once-weekly cagrilintide for weight management in people with overweight and obesity: a multicentre, randomised, double-blind, placebo-controlled and active-controlled, dose-finding phase 2 trial. Lancet. PubMed 34798060
  2. Enebo LB, Berthelsen KK, Kankam M, et al. (2021). Safety, tolerability, pharmacokinetics, and pharmacodynamics of concomitant administration of multiple doses of cagrilintide with semaglutide 2.4 mg for weight management: a randomised, controlled, phase 1b trial. Lancet. PubMed 33894838
  3. Garvey WT, Blüher M, Osorto Contreras CK, et al. (2025). Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity (REDEFINE 1). N Engl J Med. PubMed 40544433
  4. Verma S, et al. (2026). CagriSema Reduces Blood Pressure in Adults With Overweight or Obesity: REDEFINE 1. Hypertension. PubMed 41328546

Tirzepatide

  1. Wilding JPH, Batterham RL, Calanna S, et al. (2021). Once-Weekly Semaglutide in Adults with Overweight or Obesity (STEP 1). N Engl J Med. PubMed 33567185
  2. Jastreboff AM, Aronne LJ, Ahmad NN, et al. (2022). Tirzepatide Once Weekly for the Treatment of Obesity (SURMOUNT-1). N Engl J Med. PubMed 35658024
  3. Frías JP, Davies MJ, Rosenstock J, et al. (2021). Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes (SURPASS-2). N Engl J Med. PubMed 34170647
  4. Aronne LJ, Horn DB, le Roux CW, et al. (2025). Tirzepatide as Compared with Semaglutide for the Treatment of Obesity (SURMOUNT-5). N Engl J Med. PubMed 40353578

The full evidence reviews

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