Cagrilintide: The Hunger Suppressor

What is Cagrilintide?

Cagrilintide is a long-acting analogue of the hormone amylin, which is a hormone naturally produced by the pancreas that plays a crucial role in the body’s regulation of feelings of fullness and controlling food intake. Long-acting analogs are a type of insulin that is designed to provide a sustained release of insulin over an extended period to assist with managing glucose levels while Amylin analogues specifically are injectable drugs used in the treatment of type 1 and type 2 diabetes. These analogues work by mimicking the hormone amylin and help to lower blood sugar levels through several mechanisms such as glucagon secretion, the delay of gastric emptying and the signaling of satiety to the body resulting in the suppression of food intake.

How does Cagrilintide work?

The primary mechanism of Cagrilintide involves its interaction with AMYRs and CTRs, which are expressed in the brain and necessary for keeping a subject’s satiety controlled. AMYRs refer to amylin receptors and CTRs refer to calcitonin receptor which both can be targeted to improve metabolic function and regulation. By targeting these two different types of receptors, Cagrilintide effectively communicates a sense of “fullness” to the brain thus reducing a subject’s desire to eat and therefore decrease their overall food intake. Less food intake is almost guaranteed to lead to weight loss.

Benefits of Cagrilintide:

• Appetite Suppression & Weight Loss:
  • Cagrilintide is a dual amylin and calcitonin (AMYR and CTR) receptor agonist that slows gastric emptying and reduces food intake via homeostatic/hedonic brain pathways.
• Synergistic Metabolic Effects:
  • In combination with other weight loss peptides, weight loss reached an additionally improved 17–22% in scientific trials. Combinations also led to better glycemic control versus subjects taking either or peptide.
• Improved Glycemic Control:
  • After bloodwork was conducted on subjects who had utilized both GLPs and Cagrilintide, results showed lowered HbA1c by ~2.2% and fasting glucose by ~3.3%.
• Potential Cardiometabolic Benefits:
  • Preclinical models suggest enhanced cardiovascular outcomes such as:
    • Lowered blood pressure
    • Increased limpid metabolism
    • Better liver protection
    • Possible benefits to reduce alcohol related illnesses

FDA Approval Status:

Cagrilintide, also referred to as peptide AM833, is currently being engineered by Novo Nordisk and aimed at addressing obesity and type 2 diabetes. Cagrilintide is being tested alongside Semaglutide (GLP-1) and together have been appropriately named CagriSema. The ongoing phase 3 clinical trials from the REDEFINE and REIMAGINE programs aim to deliver the most extensive data on the combined effects of cagrilintide and semaglutide for weight loss and type 2 diabetes management. The different trials have projected completion dates ranging from 2025 to 2027 but are nearing completion. Across all studies, the combination of cagrilintide and semaglutide showed superior results compared to either compound alone.

Cagrilintide Dosage:

Weekly subcutaneous dosing with gradual titration is the standard protocol similar to all of the GLPs. Dosing depends on the individual, but most dosage recommendations prefer to start small at 100-250 mcg per week for the first four weeks and then titrate up from there. See chart below for additional recommendations:

Possible Cagrilintide Side Effects:

Side effects that have occurred during Cagrilintide trials tend to primarily be dose-dependent, with gastrointestinal issues being the most usually reported. These effects are usually temporary and can often be managed by slowly increasing or decreasing the weekly dose depending upon the individual. Additional lifestyle modifications, such as staying hydrated, increasing fiber intake, and maintaining regular physical activity, may help ease side effects.

• Other observed side effects:
  • Indigestion
  • Headache
  • Loose stools
  • Vomiting
  • Fatigue
  • Constipation
  • Nausea

*Effects such as injection site reactions and allergic reactions can be found among any peptide use and are not solely because of Cagrilintide*

In conclusion, Cagrilintide represents another tool to combatting obesity and being overweight by better enabling the body’s natural mechanisms for regulating appetite and food intake. With a longer duration of action, this unique peptide offers a promising new option for subjects seeking long-term weight loss solutions and should become a medical mainstay in combatting weight induced illnesses.