A stronger Ozempic is coming. What to know about CagriSema, Novo Nordisk's new weight loss drug

Novo Nordisk, the company that started the weight loss drug boom with Ozempic and Wegovy, is working on a sequel

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An Ozempic needle injection pen is seen in this illustration photo in Warsaw, Poland on 03 September, 2023.
An Ozempic needle injection pen is seen in this illustration photo in Warsaw, Poland on 03 September, 2023.
Image: NurPhoto / Contributor (Getty Images)
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Novo Nordisk (NVO-0.09%) — the company credited with ushering in the current weight-loss drug revolution when it launched its blockbuster diabetes treatment Ozempic in 2017 — is working on its next act, a weight-loss drug called CagriSema

Ozempic works by mimicking a hormone that regulates blood sugar and suppresses appetite. In recent years, it has become highly sought after for its slimming side effects. In response, the Danish pharma giant in 2021 introduced a higher-dose version of Ozempic’s active ingredient, semaglutide, for the specific purpose of weight loss.

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Since then, demand for these medications has turned Novo Nordisk and its rival Eli Lilly (LLY+1.83%), the maker of competing medications Zepbound and Mounjaro, into the largest pharma companies in the world — potentially paving the way for the first $1 trillion pharma firms. Morgan Stanley (MS-0.62%) analysts anticipate the global market for these highly coveted treatments will reach $105 billion by 2030.

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Ozempic and prescription weight-loss drugs: How they work, what they cost, side effects, and everything to know

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Now, the company that started it all is working on a sequel: Novo Nordisk is currently developing an even more potent obesity and diabetes treatment.

What is CagriSema?

CagriSema is an experimental drug being developed by Novo Nordisk. It is currently undergoing late-stage clinical trials for the treatment of obesity and type 2 diabetes.

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How is CagriSema different from Ozempic and Wegovy?

The active ingredient of Ozempic and Wegovy is semaglutide, which is known as a glucagon-like peptide-1 receptor agonist (GLP-1 RAs). That means it works by mimicking the gut hormone GLP-1, which promotes the production of insulin, regulates blood sugar levels, slows the emptying of the stomach, and affects the area of the brain that controls satiety.

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CagriSema combines semaglutide with a dual amylin and calcitonin receptor agonist called cagrilintide — hence the name CagriSema.

How does CagriSema work?

In addition to mimicking GLP-1, CagriSema mimics two other gut hormones.

The first is amylin, a hormone that is co-secreted with insulin in the pancreas. Amylin works a lot like GLP-1 by regulating blood sugar levels, slowing the emptying of the gastrointestinal tract, and promoting satiety.

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CagriSema also mimics calcitonin, a hormone that regulates calcium levels in the blood.

How effective is CagriSema for weight loss?

A previous early-stage clinical trial of CagriSema found it helped patients lose an average of 15.6% of their weight over 32 weeks. For comparison, the highest dose of Wegovy led to an average of 15% weight loss after 68 weeks in clinical trials.

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Novo Nordisk executive president of development Martin Holst Lange recently told analysts he has “confidence” that the larger trials of the drug will show that CagriSema could help users lose up to 25% of their weight. Lange said the company used data from previous trials, including studies that tested cagrilintide on its own, to arrive at this figure.

When is CagriSema expected to be available?

Novo Nordisk is expected to release results for its two phase 3 trials of CagriSema later this year and in the first half of 2025.

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Depending on the outcome of the results, Novo Nordisk could soon file regulatory applications with health agencies like the U.S. Food and Drug Administration (FDA) and the European Medicines Agency (EMA). Reviews of these application can take up to a year.

In the meantime, Novo Nordisk will be working to make sure they are able to produce enough supply to meet anticipated demand for the new drug. Both Novo Nordisk and Eli Lilly have been struggling to produce enough of their current weight-loss drugs to meet skyrocketing demand. The pharma giants have since both invested billions to ramp up their manufacturing capacity.

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If everything goes according to plan, Novo Nordisk could launch CagriSema in the United States and Europe in late 2025 or early 2026.