Cagrilintide

Developed by Novo Nordisk on the human amylin backbone. A fatty-acid side chain and stabilizing changes give it a roughly one-week half-life, unlike the short-acting older amylin drug pramlintide.

Mimics amylin, a hormone released with insulin. In studies it acts on brainstem appetite centers to reduce meal size, slow stomach emptying and blunt glucagon after meals. Because amylin uses a different receptor family than GLP-1, it is studied as an add-on to GLP-1 drugs.

A 706-person phase 2 trial reported dose-dependent weight reductions of 6–11% over 26 weeks. In the phase 3 REDEFINE 1 trial, the cagrilintide-alone arm reported about 11.5–11.8% weight reduction over 68 weeks, versus about 16% for semaglutide alone and about 23% for the two combined. A small phase 2 diabetes arm also reported lower HbA1c. Novo announced a dedicated standalone phase 3 program (RENEW). Open questions include safety beyond 68 weeks and the meaning of common anti-drug antibodies.

Trials reported mostly mild-to-moderate nausea, vomiting, constipation and diarrhea, concentrated during dose increases, plus more injection-site reactions than placebo. Anti-drug antibodies were common (46–73% by week 26). The older amylin drug pramlintide carries a boxed warning for severe low blood sugar with insulin; that is class information, not cagrilintide data.

Not approved alone. It is also not approved as part of CagriSema, which Novo Nordisk filed with FDA in December 2025 (decision expected Q4 2026). It is in no approved drug, so it has no lawful compounding pathway. Not named on WADA's 2026 list, but as an unapproved substance it may fall under the S0 category.