PMID-34798060 – Cagrilintide Phase 2 Weight Management Trial

PMID-34798060 – Cagrilintide Phase 2 Weight Management Trial

Lau DCW, Erichsen L, Francisco-Ziller NM, Saturni S, Skovgaard D, Syed SK, Vester-Andersen MK, Wieloch M, Woodward RM. 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. 2021;398(10317):2160-2172.

Quick Reference

Property Value
PMID 34798060
DOI 10.1016/S0140-6736(21)01751-7
Year 2021
Journal The Lancet
Study Type RCT
Evidence Level II
Sample 706 adults with overweight/obesity (BMI >=27)
Peptide(s) Studied Cagrilintide

Key Findings

  • 706 participants randomized to cagrilintide (0.3, 0.6, 1.2, 2.4, or 4.5 mg weekly), liraglutide 3.0 mg daily, or placebo
  • Mean weight loss from baseline: cagrilintide 6.0%-10.8% (dose-dependent) vs placebo 3.0%
  • Cagrilintide 4.5 mg produced 10.8% weight loss at 26 weeks
  • Cagrilintide 2.4 mg produced 9.0% weight loss — comparable to liraglutide 3.0 mg (9.0%)
  • Most common adverse events: GI (nausea, constipation, diarrhea) — typical of amylin analogs
  • Injection site reactions occurred but were generally mild

Study Design

Multicentre, randomised, double-blind, placebo-controlled and active-controlled (liraglutide 3.0 mg), dose-finding phase 2 trial. 26-week treatment period plus 6-week follow-up. Primary endpoint: percentage change in body weight from baseline to week 26.

Limitations

  • 26-week treatment duration; long-term effects unknown
  • Active comparator was liraglutide (not semaglutide, the current standard)
  • Population was relatively healthy (excluded T2D)
  • Industry-sponsored (Novo Nordisk)

Clinical Relevance

Pivotal dose-finding study establishing cagrilintide as a novel weight loss agent via amylin receptor agonism — a distinct mechanism from GLP-1 agonists. The comparable efficacy to liraglutide at the highest dose and the complementary mechanism led to the development of CagriSema (cagrilintide + semaglutide combination), which represents a new paradigm of dual-pathway obesity treatment.

Related

#research #RCT #cagrilintide #evidence-level-II