Cagrilintide/semaglutide

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Cagrilintide/semaglutide
Combination of
Cagrilintide Amylin receptor agonist
Semaglutide GLP-1 receptor agonist
Clinical data
Trade names CagriSema

Cagrilintide/semaglutide, marketed as CagriSema, is a combination of cagrilintide, a dual amylin and calcitonin receptor agonist, and semaglutide, a GLP-1 agonist. It is injected once weekly and is being tested in type 2 diabetes and obesity. Preliminary trial results found a greater weight loss compared to either medication alone. HbA1c was significantly improved compared to cagrilintide alone and non-significantly better than semaglutide alone. [1] [2] In a Phase II trial, weight loss averaged -15.6 percent after 32 weeks, making CagriSema comparable in efficacy to tirzepatide. [3] [4] A future trial sponsored by Novo Nordisk is comparing tirzepatide and CagriSema head-to-head. [5] As of 2023, CagriSema is in a Phase III trial. [6]

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<span class="mw-page-title-main">Incretin</span> Group of gastrointestinal hormones

Incretins are a group of metabolic hormones that stimulate a decrease in blood glucose levels. Incretins are released after eating and augment the secretion of insulin released from pancreatic beta cells of the islets of Langerhans by a blood-glucose–dependent mechanism.

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Liraglutide, sold under the brand names Victoza and Saxenda among others, is an anti-diabetic medication used to treat type 2 diabetes, and chronic obesity. It is a second-line therapy for diabetes following first-line therapy with metformin. Its effects on long-term health outcomes like heart disease and life expectancy are unclear. It is given by injection under the skin.

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<span class="mw-page-title-main">Semaglutide</span> Anti-diabetic and anti-obesity medication

Semaglutide is an antidiabetic medication used for the treatment of type 2 diabetes and an anti-obesity medication used for long-term weight management. It is a peptide similar to the hormone glucagon-like peptide-1 (GLP-1), modified with a side chain. It can be administered by subcutaneous injection or taken orally. It is sold under the brand names Ozempic and Rybelsus for diabetes, and under the brand name Wegovy for weight loss.

<span class="mw-page-title-main">Tirzepatide</span> Anti-diabetic medication

Tirzepatide, sold under the brand name Mounjaro among others, is an antidiabetic medication used for the treatment of type 2 diabetes and for weight loss. Tirzepatide is administered via subcutaneous injections.

Cagrilintide is a long-acting analogue of amylin. It is being tested to treat obesity and type 2 diabetes by itself and in combination with semaglutide as cagrilintide/semaglutide.

Dual amylin and calcitonin receptor agonists (DACRAs) are a class of drugs that act as agonists at the amylin receptor and calcitonin receptor that are under development as therapies for obesity and type 2 diabetes. Examples are cagrilintide and the KBP family derived from salmon calcitonin, including KBP‐042, KBP-066A, KBP-089, and KBP-336.

Petrelintide is an amylin analogue dosed once weekly, developed by Zealand Pharma for the treatment of type 2 diabetes and obesity. Preclinical data suggests it may be more effective in combination with semaglutide.

Mazdutide is a dual agonist of the GLP-1 receptor and glucagon receptor. It is an analog of oxyntomodulin (OXM). The drug is developed by Eli Lilly and is currently in a Phase II study.

GLP1 poly-agonist peptides are a class of drugs that activate multiple peptide hormone receptors including the glucagon-like peptide-1 (GLP-1) receptor. These drugs are developed for the same indications as GLP-1 receptor agonists—especially obesity, type 2 diabetes, and non-alcoholic fatty liver disease. They are expected to provide superior efficacy with fewer adverse effects compared to GLP-1 mono-agonists, which are dose-limited by gastrointestinal disturbances. The effectiveness of multi-receptor agonists could possibly equal or exceed that of bariatric surgery. The first such drug to receive approval is tirzepatide, a dual agonist of GLP-1 and GIP receptors.

References

  1. Enebo, Lone B; Berthelsen, Kasper K; Kankam, Martin; Lund, Michael T; Rubino, Domenica M; Satylganova, Altynai; Lau, David C W (May 2021). "Safety, tolerability, pharmacokinetics, and pharmacodynamics of concomitant administration of multiple doses of cagrilintide with semaglutide 2·4 mg for weight management: a randomised, controlled, phase 1b trial". The Lancet. 397 (10286): 1736–1748. doi:10.1016/S0140-6736(21)00845-X. PMID   33894838. S2CID   233354744.
  2. Frias, Juan P; Deenadayalan, Srikanth; Erichsen, Lars; Knop, Filip K; Lingvay, Ildiko; Macura, Stanislava; Mathieu, Chantal; Pedersen, Sue D; Davies, Melanie (August 2023). "Efficacy and safety of co-administered once-weekly cagrilintide 2·4 mg with once-weekly semaglutide 2·4 mg in type 2 diabetes: a multicentre, randomised, double-blind, active-controlled, phase 2 trial". The Lancet. 402 (10403): 720–730. doi:10.1016/S0140-6736(23)01163-7. PMID   37364590. S2CID   259237278.
  3. Idris, Iskandar (July 2023). "Coadministration of the long‐acting amylin analog cagrilintide plus semaglutide ( CagriSema ), resulted in significantly greater weight loss, along with improved measures of glucose control, in a short phase 2 trial of patients with type 2 diabetes". Diabetes, Obesity and Metabolism Now. 1 (7). doi: 10.1002/doi2.68 . ISSN   2688-8939.
  4. Holst, Jens Juul; Jepsen, Sara Lind; Modvig, Ida (April 2022). "GLP-1 – Incretin and pleiotropic hormone with pharmacotherapy potential. Increasing secretion of endogenous GLP-1 for diabetes and obesity therapy". Current Opinion in Pharmacology. 63: 102189. doi: 10.1016/j.coph.2022.102189 . PMID   35231672.
  5. "CTG Labs - NCBI". clinicaltrials.gov. Retrieved 5 December 2023.
  6. Jeon, Eonju; Lee, Ki Young; Kim, Kyoung-Kon (1 June 2023). "Approved Anti-Obesity Medications in 2022 KSSO Guidelines and the Promise of Phase 3 Clinical Trials: Anti-Obesity Drugs in the Sky and on the Horizon". Journal of Obesity & Metabolic Syndrome. 32 (2): 106–120. doi: 10.7570/jomes23032 . ISSN   2508-7576. PMC   10327684 . PMID   37349257.