CagriSema: Beauty in the Eye of the Beholder

Drug development is tricky. If you want evidence for just how tricky it is, a quick look at the experience with CagriSema will give you a pretty good idea. Yesterday, Novo Nordisk announced topline results of this drug from their REDEFINE 2 clinical trial. Their press release talked about “superior results” for people with overweight or obesity and type 2 diabetes. But for CagriSema, beauty is clearly in the eye of the beholder.

The stock market was unimpressed and sent Novo Nordisk shares immediately down by almost ten percent. This is the second plunge in Novo’s stock precipitated by clinical trial results for CagriSema. Back in December, results from the REDEFINE 1 study sent the stock down by 20 percent.

High Hopes

It is quite obvious that Novo Nordisk has high hopes for CagriSema. A year ago, the company’s chief of drug development, Martin Holst Lange, called that amylin “his secret love.” Amylin is the hormone that cagrilintide half of the CagriSema combo targets. The other half is semaglutide, which targets GLP-1. Lange said at the time, “Without giving 100% guarantees, I’m quite confident that this will read out in a very nice way.” He was talking about the phase 3 studies that have since left analysts feeling disappointed.

CEO Lars Fruergaard Jorgensen said just last month that he likes what he’s seeing in these clinical results and CagriSema “compares to the best weight loss agents out there.”

Ambiguous Advantages

Despite the enthusiasm from Novo Nordisk executives, the advantages of CagriSema are not yet obvious. The most generous assessment of the results we are seeing is that the weight loss outcomes are similar to what has already been seen with tirzepatide. In contrast, new compounds from rival Lilly have more obvious advantages. Orforglipron, for instance, is a small molecule that comes in the form of a daily pill. Because it is a small molecule, it might have advantages for cost and scale of manufacture. Retatrutide, also from Lilly, is an injectable that seems even more potent than tirzepatide.

None of this is meant to suggest that CagriSema is not a potent drug. It seems that it is. And it may yet have advantages beyond potency for weight loss that are not obvious thus far.

But for now, it seems that the beauty of CagriSema is in the eye of the beholder.

Click here for the latest announcement of topline results for CagriSema, here, here, and here for further reporting.

Woman’s Head with Beauty Spot, painting by Amedeo Modigliani / WikiArt

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March 11, 2025