Cagrilintide: the long-acting amylin analogue, what it is and what the studies measured
· Novatheris
Cagrilintide is the peptide most often named next to the GLP-1s, and it is almost always explained wrong. It is not a GLP-1. It works on a different receptor, the amylin receptor, for a hormone many people have never heard of.
Here is what it is, how it differs, what the studies measured when it was used alone and in combination, and which questions are still open.
What amylin is
Amylin is a hormone the pancreas releases together with insulin, after a meal.
It does three things, according to the studies. It slows stomach emptying. It curbs glucagon release. And it acts in the brain on its own receptors to produce a feeling of fullness, or satiety.
Those receptors are the calcitonin receptor paired with proteins called RAMPs. They have nothing to do with the GLP-1 receptor.
What cagrilintide is
Cagrilintide, also known by its code AM833, is an analogue of human amylin built to last a long time. It was developed by Novo Nordisk.
Natural amylin has a problem for anyone working with it: it tends to stick to itself and form fibrils, thread-like clumps that inactivate it. Cagrilintide carries sequence changes that reduce that tendency, plus a fatty-acid chain that keeps it in the body longer. It is the same chemical principle semaglutide uses.
How it was designed, step by step, is in Kruse et al., J Med Chem 2021.
Today there is no commercial cagrilintide product, alone or combined. It only exists inside clinical trials.
Cagrilintide and GLP-1: how they differ
This is the most common confusion.
Semaglutide and the other GLP-1 analogues act on the GLP-1 receptor. Cagrilintide acts on the amylin receptors. They are two separate pathways that end in something similar in the studies: eating less.
That is why it was tested together with semaglutide. The idea is that acting on two different systems makes the effects add up. That combination is called CagriSema.
The chemistry
- Formula: C194 H312 N54 O59 S2.
- Molecular weight: 4409 Da.
- Structure: a lipidated analogue (carrying a fat chain) of human amylin, which has 37 amino acids, with mutations that reduce fibril formation.
- Half-life in humans: 159 to 195 hours depending on dose, measured in overweight or obese volunteers receiving it together with semaglutide, in a phase 1b study.
- Half-life in animals: no published data found.
- CAS: 1415456-99-3.
159 hours is more than six and a half days. It is a very long-acting molecule.
What the cagrilintide studies measured
Alone, in phase 2. 706 adults with overweight or obesity and without diabetes, at 57 sites in 10 countries, over 26 weeks. Weight loss was 6.0 % to 10.8 % depending on dose, versus 3.0 % with placebo. It is in Lau et al., Lancet 2021.
With semaglutide, in phase 1b. 95 adults with overweight or obesity, with doses rising through week 20. Weight loss was 15.4 % to 17.1 %, versus 8.0 % to 9.8 % with placebo. It is in Enebo et al., Lancet 2021.
CagriSema in phase 3, REDEFINE 1. 3417 adults with overweight or obesity, 2108 of them in the combined group, over 68 weeks. Weight loss was -20.4 %, versus -3.0 % with placebo. It is in Garvey et al., N Engl J Med 2025.
Kidney and liver. In adults with mild, moderate or severe renal or hepatic impairment, a single-dose study found no relevant differences in how much drug reached the blood compared with people with normal function. The samples were small, 33 and 32 people. It is in Nielsen et al., Clin Pharmacokinet 2026.
These figures are group averages inside a medical protocol. They do not say what happens in a single case and they are not a usage guide.
What is still unknown
The big number is from the combination. The -20.4 % that circulates most is from CagriSema, not cagrilintide alone. The monotherapy trial we could review in full is shorter, 26 weeks, and its results are more modest. REDEFINE 1 did include a cagrilintide-alone arm, 302 people, but its detailed result does not appear in the public abstract.
Almost all the data comes from the manufacturer. Novo Nordisk funded the three main clinical trials, and most of their authors are company employees or shareholders. We located no independent trial measuring weight loss with cagrilintide.
Stomach effects. Alone, 41 % to 63 % of those who received it had some gastrointestinal event, such as nausea, constipation or diarrhea, versus 32 % with placebo. 10 % stopped treatment, mostly because of adverse events. In CagriSema phase 3 those events rose to 79.6 %, versus 39.9 % with placebo, described as transient and mild to moderate.
Long term. The longest trial lasts 68 weeks. We located no studies that follow people for several years.
For the full picture of amylin as a research target, there are two recent reviews: Chung and Kim, J Obes Metab Syndr 2026 and Rejili et al., Vascul Pharmacol 2026. One more focused on the molecule is D'Ascanio et al., Cardiol Rev 2024.
How it is stored and what to check
As a powder, or lyophilized (freeze-dried), cagrilintide is stored at -20 °C, where it is stable. Reconstituted, 2 to 8 °C and only for the short term.
At Novatheris we work with Janoshik and Freedom Diagnostics and require +99.5 % purity. Each vial's page shows the purity and, when that batch has a published report, the link to the lab report.
For research
The cagrilintide we sell is a research reagent, not a medicine. We do not give doses or directions for use, and outside a clinical protocol there is no established dose.
The full fact sheet with every citation is on the cagrilintide page. It also comes in the tirzepatide kit and the retatrutide kit. Delivery takes 2 hours in the GAM (the Greater Metropolitan Area around San José) and 24 hours in the rest of Costa Rica.