Podcast episode 91 (in German)
Cagrilintide – 22.7% and still “disappointing”
September 29, 2026
22.7 percent weight loss in 68 weeks — and the headlines spoke of a disappointment. The episode shows who was disappointed, and why the difference between two numbers from the same study matters more than any share price movement.
What it is about
Cagrilintide is a replica of amylin, a satiety hormone that is released together with insulin from the same cells. It is a second route to the same goal, independent of GLP-1 — and that is exactly what the combination CagriSema relies on, in which cagrilintide and semaglutide come in one injection. In the phase 3 trial REDEFINE 1, 3,417 adults with overweight or obesity lost 22.7 percent of their weight over 68 weeks versus 2.3 percent on placebo. The episode sorts out why the same result means something different for investors and for patients, what the second figure of 20.4 percent says, and why what you can buy on its own is not what was tested.
Key points
- Amylin is released together with insulin from the same cells and signals satiety to the brain — a second system alongside GLP-1 and not a marketing term.
- REDEFINE 1 included 3,417 adults with overweight or obesity over 68 weeks; the result was 22.7 percent weight loss versus 2.3 percent on placebo.
- The share price fell by 7 percent because 25 percent had been talked about beforehand; one analyst calculated that the drug was only 2 to 3 percentage points better than the competing product.
- The same study gives two figures: 22.7 percent for those who took the drug as intended, and 20.4 percent for all participants including those who discontinued.
- Almost 80 percent of participants had gastrointestinal complaints versus 40 percent on placebo; 6 percent discontinued because of them versus just under 4 percent.
- The episode gives human evidence 8, safety 7, use 4 and hype 5 with a positive direction — the 8 belongs to the combination and not to the single substance.
- The data are in the New England Journal of Medicine and the substance is in phase 3; anyone who can wait will get it later with a package leaflet and medical supervision.
Where the data stop
The study does not answer what happens after 68 weeks. What happens to body weight when someone stops the injection is not in it — and in everyday life that is the question that matters most. The result also belongs to the group in which it was measured: adults with overweight or obesity, not someone who wants to lose a few kilos for the summer.
The second limit concerns the product itself. What was studied was the combination of cagrilintide and semaglutide. Robust figures for cagrilintide alone were not available to the episode in citable form, and the whole point of the approach lies in the interplay of two pathways. Anyone who transfers the figures from REDEFINE 1 to the single substance is citing the study on a different product. Drugs of this kind belong in the hands of a physician, because losing 20 kilograms in one year is an intervention in metabolism that someone should oversee.
Listen (in German)
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Published on September 29, 2026.
The topic in the database
- A long-acting amylin analog, alone or combined with semaglutide as CagriSema – two satiety systems in one injection, in phase 3 with over 20 …Cagrilintide / CagriSema
Information only, not medical advice and not a usage or dosage recommendation. Prescription-only and unapproved substances belong in the hands of a physician. Last updated: 2026-09-19.