In a significant development for the obesity drug market, Novo Nordisk announced that its experimental therapy CagriSema produced greater weight loss than Eli Lilly's Zepbound in a late-stage clinical trial. The results, released Tuesday, come as both companies face legal scrutiny over their GLP-1 drugs.
The trial, which enrolled patients with type 2 diabetes, showed that a 1 mg dose of CagriSema led to an average 12.4% weight reduction over 60 weeks. In comparison, patients taking Zepbound (tirzepatide) at a 5 mg dose achieved a 9.1% weight loss. Novo Nordisk highlighted that CagriSema's efficacy was achieved at a lower dose than Zepbound, suggesting a potentially stronger potency.
“The results from CagriSema are very encouraging, demonstrating the strong potency of the combination of semaglutide and cagrilintide,” said Martin Holst Lange, Novo Nordisk's chief scientific officer. “With only 1.0 mg/1.0 mg, CagriSema shows superior weight loss versus tirzepatide 5 mg as well as strong results across obesity and type 2 diabetes.”
In a separate trial, CagriSema reduced weight by 21% in overweight or obese adults without diabetes at 68 weeks compared with placebo, according to the company.
What is CagriSema?
CagriSema is a combination therapy developed by Novo Nordisk, widely seen as the successor to its blockbuster drug Wegovy, which loses patent protection in 2030. The drug pairs cagrilintide, a long-acting amylin analog, with semaglutide, the active ingredient in Wegovy and Ozempic. Cagrilintide works by targeting the area postrema and hypothalamus, brain regions that regulate hunger and satiety, as described by the Care Pharmacy.
The combination has shown significant weight loss in clinical studies, including results published in The New England Journal of Medicine.
Regulatory timeline
The U.S. Food and Drug Administration is expected to make a decision on CagriSema in the fourth quarter of 2026. The drug is not yet approved in the United States or Europe. As the market for weight-loss drugs expands, this trial outcome could intensify competition between Novo Nordisk and Eli Lilly, which has seen strong demand for Zepbound. The news also comes amid pending litigation against GLP-1 drugmakers, though Novo Nordisk did not comment on that directly.
For context, other developments in the GLP-1 space include political figures like Illinois Governor J.B. Pritzker revealing their use of these drugs, and studies examining potential side effects, such as a South Korean study linking weight regain after stopping diet pills to suicidal thoughts. Additionally, oral versions of these therapies are being explored for other conditions like sleep apnea.
Analysts will be watching whether CagriSema's superior efficacy translates into a competitive edge once it hits the market, and how payers and patients respond to the new option.
