CagriSema misses its own 25 percent target, and the market notices
The amylin plus semaglutide combination produced large weight loss in REDEFINE 1, but fell short of the figure the company had signalled to investors.
What's new
Topline REDEFINE 1 results: 22.7% average weight loss on CagriSema at 68 weeks, versus 2.3% on placebo, under the "as if adherent" analysis.
Why it matters
Expectations, not efficacy, moved the share price. The result is still among the largest seen for an injectable at the time.
What's next
Full results, the type 2 diabetes trial (REDEFINE 2) and a regulatory filing plan.
Novo Nordisk reported that CagriSema, a once-weekly injection combining the amylin analogue cagrilintide with semaglutide, helped people with obesity lose an average of 22.7% of their body weight after 68 weeks in the REDEFINE 1 trial.
Why a big number disappointed
The company had previously pointed to around 25% as an expected outcome. Investors had priced in that figure, and shares fell sharply on the day of the announcement. Nothing in the efficacy data suggested the drug did not work; the gap was between hope and result.
A flexible dosing wrinkle
The trial let participants stay on a lower dose if they could not tolerate the top one. By the end, a bit over half of people in the CagriSema arm were on the highest dose. That design choice makes the average harder to compare with trials that forced everyone up to the maximum.
Two peptides in one pen
| Component | Hormone it mimics | Main effect |
|---|---|---|
| Cagrilintide | Amylin | Fullness, slower stomach emptying |
| Semaglutide | GLP-1 | Appetite, insulin release |
Amylin is co-released with insulin by the pancreas. Pairing it with GLP-1 is one of several strategies in the race to beat single-hormone drugs.
Read the estimand
The 22.7% figure is the "treatment regimen" estimate: what would have happened if everyone took the drug as planned. The "treatment policy" estimate, which counts everyone regardless of whether they stopped, is lower. Headlines rarely say which one they quote.
