By Dr. Asnat Raziel, bariatric surgeon specializing in obesity treatment, metabolic health and healthy longevity; Director of the Multidisciplinary Center for Obesity Treatment, Assia Medical, Assuta Ramat HaChayal, Tel Aviv
Waiting for CagriSema? What the studies mean for patients
Should you be waiting for CagriSema, or start treatment now? Patients have been asking me this since the results came out. So this article answers it from the patient’s point of view, based on the data. I cover the full scientific background of the trial program in my scientific review of the REDEFINE trials.
Studies of CagriSema show an average loss of about a fifth of body weight within 68 weeks. It is a weekly injection that combines two drugs in a single shot. However, the drug has not yet been approved for use. Below, I explain what was found and who the treatment may suit. I also cover the side effects and the questions that are still open.
What CagriSema is and how it works
CagriSema combines two drugs in one weekly injection. The first is semaglutide, the active ingredient in Wegovy, at a dose of 2.4 mg. The second is cagrilintide, also at 2.4 mg. Cagrilintide mimics amylin, a hormone the pancreas releases together with insulin after a meal.
The two hormones play complementary roles. GLP-1 slows stomach emptying and reduces hunger. Amylin strengthens the feeling of fullness and shrinks portion size. That is why researchers hoped the combination would work better than either drug alone. Many patients also describe less food noise, meaning the constant thoughts about food. A general overview of cagrilintide/semaglutide is also available in English.
CagriSema studies: the main results
The company’s trial program is called REDEFINE. Here I focus on the numbers that matter most to patients.
REDEFINE 1: people with obesity without diabetes
This trial enrolled 3,417 adults and lasted 68 weeks. The REDEFINE 1 results were published in NEJM. In the CagriSema group, weight dropped by an average of 20.4%, compared with 3.0% on placebo. The researchers also compared each drug alone: semaglutide led to a 14.9% loss, and cagrilintide to an 11.5% loss.
What’s more, a blood pressure analysis from the same trial showed a 10.9 mmHg drop in systolic pressure, compared with 2.8 on placebo. In addition, 39.6% of those taking blood pressure medication reduced or stopped it, compared with 18.8% on placebo.
REDEFINE 2: people with obesity and type 2 diabetes
This trial enrolled 1,206 adults with type 2 diabetes. In REDEFINE 2, weight fell by 13.7% with CagriSema, compared with 3.4% on placebo. At the same time, 73.5% of patients reached an HbA1c (a measure of average blood sugar over recent months) of 6.5% or less. In the placebo group, the rate was 15.9%. With other drugs, too, people with diabetes usually lose less weight.
REDEFINE 5: an East Asian population
Another trial included 331 participants from Japan and Taiwan. In REDEFINE 5, CagriSema led to an 18.4% loss, compared with 11.9% with semaglutide alone.
Waiting for CagriSema or choosing tirzepatide? The REDEFINE 4 data
In February 2026, Novo Nordisk released the REDEFINE 4 results. This open-label, 84-week trial compared CagriSema with tirzepatide, the active ingredient in Mounjaro, at 15 mg. Among those who stuck with treatment, CagriSema led to a 23.0% loss, compared with 25.5% on tirzepatide. So the trial missed its main goal of showing that CagriSema is not inferior to tirzepatide. For anyone waiting for CagriSema, that result matters. You will find a more detailed analysis in my article on CagriSema vs. tirzepatide in REDEFINE 4.
Side effects in the CagriSema studies
The common side effects involve the digestive system. In REDEFINE 1, they were reported in 79.6% of patients on CagriSema, compared with 39.9% on placebo. The main ones were nausea, vomiting, diarrhea, constipation and abdominal pain. According to the researchers, most were mild to moderate and eased over time.
In practice, a gradual dose increase is the key to good tolerance. On the other hand, some symptoms call for a doctor’s visit. These include severe, persistent abdominal pain, vomiting that does not stop or signs of dehydration. Good preparation for treatment is described in my article on what to know before starting Wegovy or Mounjaro, and the principles are similar.
Who are the CagriSema studies relevant to?
The trials included adults with a BMI of 30 or higher, or a BMI of 27 or higher with at least one related condition. Examples include high blood pressure, diabetes or abnormal blood fats. So if the drug is approved, its indication will likely be similar to that of Wegovy and Mounjaro.
In my clinic, I see two types of patients who find these findings especially interesting. The first did not reach their goal with semaglutide alone. The second struggle with strong hunger despite treatment. Both groups often ask me about waiting for CagriSema. Even so, the decision is always personal, and it depends on underlying conditions, medications and patient preferences.
Approval status: how long you may be waiting for CagriSema
Novo Nordisk submitted CagriSema to the US FDA in December 2025, based on REDEFINE 1 and REDEFINE 2. In early November 2026, the company said it expects a decision by the end of 2026 and a launch in early 2027. In other words, as of this writing CagriSema is not approved in the United States and is not available by prescription in Israel.
Several questions are still open:
- Effect on the heart: the REDEFINE 3 trial is examining cardiovascular events in 7,076 participants, and the results have not yet been published.
- Long-term treatment: there are still no data on use over many years, or on what happens after stopping.
- Higher dose: the company is planning a trial with semaglutide 7.2 mg within the combination.
- Price and availability: there is no information yet on price or on inclusion in Israel’s national health basket.
In the meantime, patients already have effective options today. An overview of current obesity medications will help you understand what suits you.
Waiting for CagriSema or starting treatment now?
If you are thinking about waiting for CagriSema, it helps to put the facts side by side:
- The FDA decision is expected only by the end of 2026, and the drug is not available by prescription in Israel.
- There is no information yet on price or on inclusion in the health basket.
- In the head-to-head trial, tirzepatide 15 mg led to a slightly larger loss: 25.5% vs. 23.0%.
- Obesity is a progressive disease, and effective treatments already exist today.
So in most cases, there is no reason to keep waiting for CagriSema. You can start an existing treatment and consider switching later, together with your doctor.
Bottom line: is waiting for CagriSema worth it?
Studies of CagriSema show that combining amylin and GLP-1 leads to about 20% weight loss in people without diabetes. It beats each of its components alone, but in a head-to-head trial it did not match tirzepatide. Its side effects are similar to those of Wegovy. For now, it is a drug awaiting approval, so there is no reason to postpone an effective treatment that already exists.
The information in this article is general and does not replace personal medical advice.
Questions and answers
Can I get CagriSema in Israel?
Not at the moment. The drug is still awaiting an FDA decision and is not available by prescription in Israel.
How much weight do people lose with CagriSema?
In REDEFINE 1, the average loss was 20.4% within 68 weeks. In people with type 2 diabetes, the loss was 13.7%.
Is CagriSema stronger than Mounjaro?
Not according to the head-to-head trial. In REDEFINE 4, the loss with tirzepatide 15 mg was slightly larger, 25.5% vs. 23.0%.
Is it worth waiting for CagriSema instead of starting treatment now?
In most cases, no. Obesity is a progressive disease, and effective treatments already exist. You can consider switching in the future, together with your treating doctor.
Sources
Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity
Cagrilintide-Semaglutide in Adults with Overweight or Obesity and Type 2 Diabetes
CagriSema Reduces Blood Pressure in Adults With Overweight or Obesity: REDEFINE 1
CagriSema demonstrated 23% weight loss in an open-label head-to-head REDEFINE 4 trial
Design and baseline characteristics of the CagriSema cardiovascular outcomes trial (REDEFINE 3)
The studies were funded by Novo Nordisk, the drug’s manufacturer.
