Narrative review of amylin agonists reports CagriSema weight loss up to 22.7% in phase 3a trials

This is a narrative review of clinical trial findings in humans; it is not a new trial and reports no original data collection. The abstract states no pooled sample size and does not report the number of participants in any of the trials it summarizes.

The authors describe a search of PubMed/MEDLINE, Scopus and Google Scholar using what they call appropriate keywords, conducted until June 2026. Three agents are the focus: zenagamtide (formerly known as amycretin), eloralintide, and cagrilintide-semaglutide, the coformulation referred to as CagriSema.

For obesity, the review states that zenagamtide achieved weight loss up to 13.1% in a phase 1 study over 85 days as an oral formulation and up to 24.3% in a phase 1b/2a study over 36 weeks as a subcutaneous formulation. Eloralintide, described as a long-acting mostly amylin type 1 receptor agonist, is reported at up to 20.1% weight loss in a phase 2 study over 48 weeks, and CagriSema at up to 22.7% in a phase 3a study over 68 weeks. The authors write that all these agents reduced body mass index and waist circumference.

In type 2 diabetes, the review reports that CagriSema reduced HbA1c by up to 2.0% using the trial product estimand in a phase 3a study over 68 weeks, and calls it the most well-studied agent of the three in that setting. The authors also report diabetes remission in approximately one out of two CagriSema users in a 40-week phase 3a study of treatment-naive people, and a reduction of insulin dose by 20 units compared with the control arm among people receiving basal insulin.

On safety, the abstract states that the profile of amycretin and CagriSema is overall consistent with that of GLP-1 receptor agonists, while preliminary evidence suggests eloralintide was associated with a distinct adverse events profile including fatigue, headache and appetite loss. The abstract does not report any dosing regimen, schedule or injection amounts for cagrilintide or CagriSema.

This is a narrative review rather than a systematic review or meta-analysis, so the abstract describes no formal inclusion criteria, no risk-of-bias assessment and no pooled statistics. Sample sizes, comparator arms and participant characteristics for the cited trials are not given in the abstract.

Much of the evidence summarized is early: zenagamtide results come from phase 1 and phase 1b/2a studies, eloralintide from phase 2, and the eloralintide safety signal is described as preliminary. The authors themselves conclude that further trials are needed. Funding and author affiliations are not stated in the abstract excerpt.

Cagrilintide, also referred to in combination as CagriSema, is not an FDA-approved drug for any use, according to the site's regulatory review. This status is separate from the trial results summarized in this review.