Cagrilintide and CagriSema for weight reduction and metabolic risk modification in overweight or obesity: a systematic review and meta-analysis

In a meta-analysis of four randomized trials involving 5,023 adults with overweight or obesity, cagrilintide alone and CagriSema (cagrilintide plus semaglutide) produced clinically meaningful weight loss compared with placebo. CagriSema also reduced waist circumference and HbA1c, while cagrilintide alone showed modest blood pressure improvements. Adverse events were more frequent with active treatment, but discontinuation rates were similar to placebo.

Narrative review — Systematic review and meta-analysis of randomized controlled trials. Population: Adults with overweight or obesity. Sample size: 5,023 participants. Interventions: Cagrilintide; CagriSema (cagrilintide plus semaglutide).

In the pooled analysis of 4 trials including 5,023 participants, cagrilintide reduced percent body weight by a mean difference of -6.08% (95% CI -8.02 to -4.14) versus placebo, and CagriSema by -5.98% (95% CI -10.64 to -1.32). Absolute body weight was also significantly reduced with both interventions. CagriSema significantly reduced waist circumference and HbA1c, while cagrilintide alone showed modest blood pressure improvements without significant glycemic effects. Adverse events were more frequent with active treatment, but discontinuation rates were comparable to placebo.

Researchers working on cagrilintide would use this paper as pooled placebo-controlled evidence of its weight and cardiometabolic effects, both alone and combined with semaglutide as CagriSema, in adults with overweight or obesity. It does not establish long-term safety, hard cardiovascular outcomes, or dose- and regimen-specific recommendations.

Key findings

• Versus placebo, cagrilintide reduced percent body weight by a mean difference of -6.08% (95% CI -8.02 to -4.14).
• Versus placebo, CagriSema reduced percent body weight by a mean difference of -5.98% (95% CI -10.64 to -1.32).
• Both cagrilintide and CagriSema significantly reduced absolute body weight compared with placebo.
• CagriSema significantly reduced waist circumference and HbA1c, whereas cagrilintide alone showed no significant glycemic effects.
• Cagrilintide alone produced modest blood pressure improvements without significant glycemic effects.
• Adverse events were more frequent with active treatment than placebo, while discontinuation rates were comparable.

Limitations

• The abstract reports no author-stated limitations.
• The pooled analyses are based on only four RCTs, and the CagriSema estimate has a wide confidence interval.
• Dose, treatment duration, and participant comorbidity details are not reported in the abstract.
• Aggregate meta-analytic results cannot show individual-level responses or long-term outcomes.

The record

• Journal: Journal of diabetes and metabolic disorders 25(1): 140
• Published: 2026-05-20
• PMID: 42180166 — DOI: 10.1007/s40200-026-01942-3
• Author countries: Pakistan

Peptide profiles: Cagrilintide.

All indexed evidence: Cagrilintide trials & papers.

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