CagriSema Achieves Superior HbA1c Reduction in REIMAGINE 2 Trial

Novo Nordisk A/S has unveiled significant breakthrough findings from its REIMAGINE 2 clinical trial, demonstrating that CagriSema—an innovative dual-component therapy combining cagrilintide and semaglutide—delivers superior HbA1c reduction and meaningful weight loss outcomes compared to individual component therapies in adults with type 2 diabetes. The trial results, disclosed at week 68, underscore the potential of this novel combination approach in addressing multiple metabolic challenges simultaneously.

Dual-Component Therapy Outperforms Single-Agent Treatments

The REIMAGINE 2 trial evaluated CagriSema as a once-weekly subcutaneous injection across multiple dosage levels. Results consistently showed that the combined formulation achieved an HbA1c reduction of 1.91%-points, significantly surpassing the efficacy of semaglutide monotherapy. Beyond blood glucose control, patients experienced weight loss of 14.2%—an important metric for individuals managing type 2 diabetes who face concurrent weight management challenges.

Crucially, superiority was confirmed on both primary efficacy measures against the individual components. This dual advantage reflects the complementary mechanisms of action: cagrilintide (an amylin receptor agonist) and semaglutide (a GLP-1 receptor agonist) work synergistically to optimize glycemic control while promoting sustained weight reduction.

Clinical Efficacy: Impressive HbA1c and Weight Loss Improvements

The favorable safety and tolerability profile of CagriSema aligns with what researchers anticipated from incretin and amylin-based therapies. This consistency across the treatment cohorts suggests that the combination maintains the well-established safety standards associated with each individual component while amplifying therapeutic benefits.

For the type 2 diabetes population, the HbA1c improvements represent a substantial clinical advance. An additional 1.91%-point reduction beyond existing treatments could meaningfully lower the risk of long-term diabetes complications and improve overall metabolic health outcomes. The simultaneous achievement of significant weight loss positions CagriSema as a comprehensive metabolic therapy.

Advancing Toward Regulatory Approval and Clinical Practice

Building on successful outcomes from the REIMAGINE 1 trial and earlier REDEFINE 3 results, Novo Nordisk plans to engage with regulatory authorities to chart the approval pathway for CagriSema in type 2 diabetes management. In a parallel development, the company submitted CagriSema for weight management indication to the US FDA in December 2025, based on data from the REDEFINE 1 and REDEFINE 2 pivotal trials.

Martin Holst Lange, Executive Vice President and Chief Scientific Officer at Novo Nordisk, noted that the combination strategy represents a meaningful innovation: “By pairing semaglutide with cagrilintide, we’re witnessing superior outcomes in both blood glucose control and weight management that exceed what either therapy achieves independently. These results strengthen our conviction that CagriSema could establish a new category as the first amylin-based combination therapy, offering a promising treatment option for type 2 diabetes patients who prioritize comprehensive metabolic improvement, including HbA1c control and weight reduction.”

The company plans to present comprehensive data from the REIMAGINE 2 trial at a major scientific conference in 2026, providing the research community with detailed insights into the trial design, HbA1c efficacy patterns, and long-term safety monitoring results. This positions CagriSema as a potential paradigm shift in how combination pharmacotherapy addresses the multifaceted challenges of type 2 diabetes management.