Comparisons
Eloralintide and CagriSema are the two best-known amylin-pathway programs. They are built differently: one is a single amylin agonist, the other pairs an amylin analogue with a GLP-1 medicine. The honest comparison is of design and of each trial on its own terms.
Different builds on the same pathway
CagriSema combines semaglutide, a GLP-1 receptor agonist, with cagrilintide, a long-acting amylin analogue that a 2026 review describes as acting on both the amylin and calcitonin receptors. Eloralintide is a single peptide reported to prefer the amylin 1 receptor. A GLP-1 component is a different intervention from a pure amylin one, so a result for the combination says little about what the amylin part alone does. See eloralintide and cagrilintide for the amylin-to-amylin comparison.
The CagriSema result
REDEFINE 1 randomised 3,417 adults without diabetes, in a 21 to 3 to 3 to 7 ratio, to the combination, semaglutide alone, cagrilintide alone or placebo for 68 weeks. Under the treatment-policy estimand, the estimated mean change in body weight was -20.4% with the combination against -3.0% with placebo, a difference of -17.3 percentage points (95% confidence interval -18.1 to -16.6). Gastrointestinal adverse events affected 79.6% on the combination and 39.9% on placebo, mostly transient and mild to moderate. In the type 2 diabetes trial, REDEFINE 2 (1,206 adults), the figures were -13.7% against -3.4% at 68 weeks, with gastrointestinal events in 72.5% against 34.4%.
[Verified V-52] From the PubMed abstracts of Garvey et al. (PMID 40544433, DOI 10.1056/NEJMoa2502081) and Davies et al. (PMID 40544432, DOI 10.1056/NEJMoa2502082), New England Journal of Medicine, 2025, read 2026-10-02. The sponsor’s press release, cited on the pipeline page, headlined 22.7% for REDEFINE 1. The abstract does not describe how that figure was derived, so this site does not reconcile the two and presents the peer-reviewed abstract figure first.
The eloralintide result
In the 48-week Phase II trial, fixed-dose groups had mean body-weight changes from -9.4% at 1 mg to -20.1% at 9 mg, against -0.4% on placebo, in the efficacy analysis that included all randomly assigned participants. Nausea was reported by 11% to 64% of dose groups against 14% on placebo. Eloralintide has also been tested together with tirzepatide, which is a combination question of its own; see the EloraTZP announcement and its limits.
[Verified V-06, V-08] Figures as already confirmed against the ClinicalTrials.gov results record and the Lancet abstract.
Why the two cannot be ranked
A 48-week Phase II trial of 263 people and a 68-week Phase III trial of 3,417 are not measuring the same thing, and the combination adds a GLP-1 medicine whose own effect is large. A higher number in one trial does not show that one approach works better, and neither sponsor has run the two against each other. Nor can the stomach-effect figures be lined up, because the trials count events differently.
What the evidence does and does not allow
It allows two accurate descriptions of two different programs. It does not allow a statement about which is more effective or better tolerated, and it gives no guidance on using either. Eloralintide is investigational and not approved. Novo Nordisk says it filed a New Drug Application with the FDA in December 2025 and expects a decision in the fourth quarter of 2026, and in its 30 September 2026 announcement it still calls CagriSema investigational. That is the sponsor’s account, not an FDA record, so check the FDA before relying on it.
Related
See the comparison methodology, the obesity research pipeline and eloralintide and semaglutide.