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Cagrilintide (Cardiplin) is a new type of long-acting acylated pancreatic amylin analogue developed by Novo Nordisk. It is currently in the clinical research stage and has shown significant potential in the fields of metabolic diseases and weight management. Here are its detailed information:
I. Basic Information
• Type: Long-acting amylin analogue, a peptide-based drug.
• Research and development background: Designed based on the physiological function of natural pancreatic amylin, through chemical modification (such as acylation), the half-life is prolonged to achieve long-lasting effects.
• Chemical properties: The molecular formula is C_{194}H_{312}N_{54}O_{59}S_{2}, with a molecular weight of approximately 4287.05. It functions by mimicking the structure and function of natural pancreatic polypeptide.
II. Mechanism of Action
By activating the amylin receptor (AMYR) and the calcitonin receptor (CTR), it exerts multiple metabolic regulatory effects:
• Appetite suppression: Acts on the central nervous system (such as the hypothalamus), reduces hunger, increases satiety, and thereby decreases food intake.
• Gastrointestinal regulation: Slows down gastric emptying, prolongs the time for food digestion and absorption, and further reduces the desire to eat.
• Metabolic improvement: Reduces glucagon levels, enhances insulin sensitivity, and may also increase energy expenditure and promote weight loss.
• Cardiovascular protection: Studies have shown that it may slightly lower blood pressure and heart rate, reduce left ventricular mass, and potentially offer benefits to the cardiovascular system.
III. Clinical Research Progress
Currently, the main focus is on the treatment of obesity, overweight and type 2 diabetes. The key research results are as follows:
• Monotherapy for obesity: In a phase 2 clinical trial, obese patients were injected with 4.5mg of Cagrilintide weekly. After 26 weeks, the average weight loss was 10.8%, and the treatment was well tolerated.
• Combined with semaglutide (CagriSema):
In the Phase 3 trial REDEFINE 2, for patients with type 2 diabetes who were also obese or overweight, after 68 weeks of treatment with CagriSema (fixed-dose combination), the patients achieved an average weight loss of 15.7%, and 89.7% of the patients experienced a weight reduction of at least 5%.
Another study shows that the average weight loss of the adherent group over 68 weeks was 22.7%, which was significantly better than that of the single-drug treatment (Cagrilintide single-drug - 11.8%, Semaglutide single-drug - 16.1%). Among them, 40.4% of the patients lost at least 25% of their weight, and 23.1% lost at least 30%.
• Adjuvant treatment for type 2 diabetes: It can improve the level of glycosylated hemoglobin (HbA1c), and combined with weight loss effects, it helps to control blood sugar levels and slow down the progression of the disease.
IV. Usage and Dosage (Clinical Trial Phase)
• Administration method: Subcutaneous injection, once a week (long-acting formulation design to reduce the frequency of administration).
• Dose range: Depending on the research stage, the doses range from 1.2mg to 4.5mg. The specific dose needs to be adjusted according to the patient's condition (the final clinical dose has not yet been determined).
V. Adverse Reactions
• Common reactions: mainly gastrointestinal symptoms, such as nausea, vomiting, diarrhea, and abdominal distension. These symptoms are mostly mild to moderate and gradually subside as the treatment duration increases.
• Safety features: Overall, they are similar to GLP-1 receptor agonists (such as semaglutide), and no serious unexpected adverse reactions have been observed.
VI. Research and Development Prospects
As a new type of pancreatic amylin analogue, Cagrilintide, when used in combination with GLP-1 receptor agonists, can enhance the effects of weight loss and metabolic improvement through a complementary mechanism, and is regarded as a potential "blockbuster drug" for the treatment of obesity and metabolic diseases.
Novo Nordisk is advancing its fixed-dose combination of semaglutide (CagriSema) in late-stage clinical trials. If approved, it is expected to become an important new option for the management of obesity and type 2 diabetes.
(Note: Cagrilintide has not yet been officially approved for global market launch. The above information is based on publicly available clinical research data.)

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