Novo Nordisk’s CagriSema outperforms tirzepatide on weight loss in REIMAGINE 5 trial

Novo Nordisk announces their new topline results from the Phase 3 REIMAGINE 5 and REDEFINE 9 trials evaluating once-weekly CagriSema, an investigational treatment representing the company’s next step in weight management and type 2 diabetes care. The findings were shared during Novo’s Capital Markets Day investor briefing.

In the REIMAGINE 5 trial, adults with type 2 diabetes who took CagriSema at the 1.0 mg/1.0 mg dose lost an estimated average of 12.4 percent of their body weight by week 60, outperforming tirzepatide at 5 mg, which produced average weight loss of 9.1 percent over the same period. CagriSema also proved non-inferior to tirzepatide when it came to lowering HbA1c, with reductions of 1.71 percent and 1.67 percent respectively.

Separately, in the REDEFINE 9 trial, adults living with overweight or obesity who received CagriSema at 1.0 mg/1.0 mg saw weight reduction of 21.0 percent by week 68, compared with just 2.0 percent among those on placebo, meeting the trial’s primary superiority goal. The treatment also outperformed placebo on several additional prespecified measures, including systolic blood pressure, waist-to-height ratio, and fasting lipid levels. Across both studies, CagriSema was generally well tolerated, and its safety profile matched what had been observed in earlier research.

Martin Holst Lange, executive vice president of research and development and chief scientific officer at Novo Nordisk, described the results as highly encouraging, pointing to the strength of combining semaglutide with cagrilintide. He noted that even at a relatively modest dose of 1.0 mg/1.0 mg, CagriSema outperformed tirzepatide at 5 mg on weight loss while also showing strong results across both obesity and type 2 diabetes. He acknowledged that CagriSema remains an investigational product, but said these findings build confidence in its potential, contribute to the expanding evidence base around amylin biology, and reinforce Novo’s broader ambition to develop the next generation of obesity and type 2 diabetes treatments.

Because treatment decisions in obesity and type 2 diabetes are frequently tailored to individual patients, not everyone ends up receiving or remaining on the highest available dose of existing therapies. These results offer meaningful evidence of what CagriSema at 1.0 mg/1.0 mg can achieve, and deepen understanding of how efficacy, tolerability, and dosing flexibility could support more personalized approaches to care.

During the same Capital Markets Day briefing, Novo also shared early data on painful diabetic neuropathy in type 2 diabetes for the first time, describing the results as promising, with additional details expected to follow at a later date.

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Related Topics and Keywords

CagriSema, Novo Nordisk, REIMAGINE 5 trial, tirzepatide