CagriSema · 68 weeks
REDEFINE 2
In people with type 2 diabetes, CagriSema reduced weight by 13.7% at 68 weeks, compared with 3.4% on placebo.
Randomized controlled trial
REIMAGINE 2: CagriSema vs semaglutide in type 2 diabetes
At 68 weeks, HbA1c fell by 1.91 points on CagriSema 2.4 + 2.4 mg and 1.75 on semaglutide 2.4 mg alone; the estimated difference was −0.16 points (95% CI, −0.27 to −0.05; p = 0.0035), using the efficacy estimand.
Buse JB et al. Cagrilintide-semaglutide (CagriSema) versus semaglutide or cagrilintide in people with type 2 diabetes (REIMAGINE 2): a double-blind, randomised, controlled, phase 3 study. The Lancet Diabetes & Endocrinology, 2026. DOI: 10.1016/S2213-8587(26)00125-7
- Prepared by
- Alex Gonzalez
- Last updated
- Next review
- Sources
- 3 sources
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Key facts
- Drugs
- CagriSema and semaglutide
- Design
- Randomized controlled trial
- Participants
- 2,713
- Duration
- 68 weeks
- Funding
- Novo Nordisk
- Registry
- NCT06065540
- Population
- 2,713 adults with type 2 diabetes not controlled (HbA1c 7.0% to 10.5%) despite metformin, with or without an SGLT2 inhibitor, and a BMI of 25 or more, in 30 countries: 603 assigned to CagriSema 2.4 + 2.4 mg, 605 to semaglutide 2.4 mg, 152 to cagrilintide 2.4 mg, 595 to CagriSema 1.0 + 1.0 mg, 609 to semaglutide 1.0 mg and 149 to placebo. Mean baseline HbA1c was 8.2%. The ClinicalTrials.gov registry lists 2,734 participants.
- Primary outcome
- Change in HbA1c at 68 weeks with CagriSema (cagrilintide 2.4 mg plus semaglutide 2.4 mg, once weekly) versus semaglutide 2.4 mg alone.
What it found
At 68 weeks, HbA1c fell by 1.91 points on CagriSema 2.4 + 2.4 mg and 1.75 on semaglutide 2.4 mg alone; the estimated difference was −0.16 points (95% CI, −0.27 to −0.05; p = 0.0035), using the efficacy estimand. Of the participants, 95.7% completed the study and 87.6% were still on treatment at week 68. Adverse events occurred in 86.9% on CagriSema 2.4 + 2.4 mg, 81.2% on semaglutide 2.4 mg, 82.2% on cagrilintide 2.4 mg, 81.6% on CagriSema 1.0 + 1.0 mg, 78.5% on semaglutide 1.0 mg and 70.5% on placebo; the most common were digestive.
Limitations
Funded by Novo Nordisk, which makes CagriSema and semaglutide. The HbA1c advantage over semaglutide alone was small (0.16 points), although statistically significant. The main analysis used the efficacy estimand, which assumes everyone stayed on treatment. The paper’s abstract does not give the changes in weight. The product was not approved in any country as of the review date.
What it means for you
A single study is rarely enough to draw conclusions about a particular person: its results are averages from a selected group that was closely monitored. If this topic affects you, these figures are a good starting point for a conversation with your doctor.
Further reading
- How Much Weight Do People Lose on Ozempic, Wegovy or Zepbound? Trial Data
- Ozempic vs Mounjaro (and Zepbound): Real Differences From the Trials and Labels
- What Happens When You Stop Ozempic, Wegovy or Zepbound: Weight Regain, Explained
- CagriSema drug page
- Semaglutide guide
- GLP-1 drug pages
- All study summaries
- Original paper: doi.org/10.1016/S2213-8587(26)00125-7
Sources
The original paper and the records consulted for this summary, with the date they were accessed.
- The Lancet Diabetes & Endocrinology.Buse JB, et al. Cagrilintide-semaglutide (CagriSema) versus semaglutide or cagrilintide in people with type 2 diabetes (REIMAGINE 2). Lancet Diabetes Endocrinol. 2026;14(8):662-677.accessed .
- National Library of Medicine (PubMed).PubMed record PMID 42251859 (abstract).accessed .
- ClinicalTrials.gov (National Library of Medicine).ClinicalTrials.gov record NCT06065540 (REIMAGINE 2: registration, eligibility and enrollment).accessed .