More Anti-Obesity Medicine Progress with Cagrilintide

Lancet this week published the biggest study yet of cagrilintide – evidence that we’re seeing success in progress with more options for anti-obesity medicines. In a commentary alongside this study, Kishore Gadde and David Allison call this promising news. They point to the advantage of having a new mechanism of action for treating obesity. Also, they note the potential for combining it with a GLP-1 agonist.

Research published earlier this year suggests the combination of cagrilintide and semaglutide might offer an important step forward in effectiveness.

Unique Among Anti-Obesity Medicines

cagrilintide is unique in comparison to other anti-obesity meds. It is a long-acting amylin analog that activates both amylin and calcitonin receptors. Its long duration of action means that dosing is only once a week, albeit by injection. It can give a satiety signal to the brain, acting on both homeostatic and hedonic areas of brain function that regulate hunger.

This is a phase 2 study. That means it is a primary test of whether a new drug is effective for its intended use. Next step comes phase 3. This phase involves very large, pivotal studies to show that a drug is both safe and effective in many patients.

Solid Results as a Single Agent

The study compares the effectiveness of cagrlinitide in various doses to a standard dose of liraglutide (Saxenda) for obesity. There was a placebo group, too. The drug is clearly effective for weight reduction. On average, patients lost from three to eight percent more weight with it than they did in the placebo group with just diet and exercise. Furthermore, at the highest dose, results were about two percent better than liraglutide.

In their commentary, Gadde and Allison offer perspective on these results. In short, they say it’s hard to draw definitive conclusions from this study about how cagrilintide will compare to other meds for obesity. Their reasons are very technical – all about the challenges of studying treatment for a condition like obesity. Because it is different for every person, responses vary. People drop out of studies. So comparing one drug to another – even in a well-controlled study – is difficult.

But one thing is clear. It is good to have more options coming for obesity treatment, especially options with new mechanisms of action. Drugs that work differently offer the potential for synergistic therapy. And the combination of cagrilintide with semaglutide – if it pans out – could bring some very important progress to obesity care.

That would be good news indeed.

Click here for the study in Lancet, here for the editorial by Gadde and Allison, here and here for further perspective. For more on progress with cagrilintide and the future of obesity care, click here.

Cyclist, painting by Natalia Goncharova / WikiArt

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November 20, 2021