In a late-stage trial, Novo Nordisk’s experimental drug CagriSema achieved greater weight reduction than tirzepatide at the 5 mg dose, signalling a potential breakthrough in diabetes and weight management treatments.
Novo Nordisk said its experimental obesity drug CagriSema produced greater weight loss than tirzepatide at the 5 mg dose in a late-stage study of adults with type 2 diabetes, while delivering similar improvements in long-term blood sugar control. The company announced on 21 September 2026 that participants receiving the 1.0 mg/1.0 mg combination lost an estimated 12.4% of body weight by week 60, compared with 9.1% for tirzepatide 5 mg, in the REIMAGINE 5 trial.
CagriSema combines cagrilintide, a long-acting amylin receptor agonist, with semaglutide, the active ingredient in Novo Nordisk’s Ozempic and Wegovy medicines. In the trial, adults with type 2 diabetes who were not adequately controlled on metformin, a sodium-glucose cotransporter 2 inhibitor, or both, were assigned to either CagriSema or tirzepatide. Novo Nordisk said the two treatments produced nearly identical reductions in HbA1c, a measure of average blood glucose, with CagriSema lowering the figure by 1.71 percentage points and tirzepatide by 1.67 percentage points.
The comparison is likely to be read carefully because tirzepatide is often used at higher doses than the 5 mg level tested here. Under its approved dosing schedule, treatment starts at 2.5 mg weekly and can be increased stepwise to a maximum of 15 mg. That makes the result clinically relevant, but not a direct statement about how CagriSema would compare with tirzepatide at the top end of the dose range. Pharmacy specialist Jennifer Goldman told Pharmacy Times that the finding shows how the specific doses performed against each other, rather than proving superiority across all tirzepatide strengths.
Novo Nordisk also reported positive results from REDEFINE 9, a separate study in adults with overweight or obesity. In that trial, the same 1.0 mg/1.0 mg dose of CagriSema was paired with diet and exercise advice and led to a 21.0% reduction in body weight by week 68, compared with 2.0% for placebo. The company said the treatment also improved supportive measures including systolic blood pressure, waist-to-height ratio and fasting lipids.
The latest results follow earlier phase 3 data published in The Lancet from REIMAGINE 3, a trial in adults with type 2 diabetes already using basal insulin. That study found that CagriSema cut HbA1c more than placebo and produced double-digit weight loss, while no severe hypoglycaemia was reported. The journal paper also noted mostly mild to moderate gastrointestinal side effects, which are common with incretin-based medicines.
CagriSema remains investigational. Novo Nordisk filed a US application for weight management in December 2025, and a regulatory decision is expected in the fourth quarter of 2026. Goldman said the full data set will matter most once adverse events, discontinuation rates and the complete analysis are available, adding that the best treatment is one patients can tolerate, obtain and continue.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
