Can CagriSema Help Novo Nordisk Close the Gap With LLY in Obesity?
Ahan Chakraborty
Mon, August 31, 2026 at 7:30 PM GMT+5:30
5 min read
Novo Nordisk NVO is counting on CagriSema as one of its most important next-generation cardiometabolic assets. The once-weekly injectable combines the long-acting amylin analog cagrilintide 2.4 mg with its blockbuster GLP-1 RA Wegovy (injectable semaglutide 2.4 mg) for obesity and type II diabetes (T2D). NVO has already filed for U.S. approval of CagriSema for weight management, with an FDA decision expected in the fourth quarter of 2026. The candidate could give Novo Nordisk a new growth avenue beyond its established semaglutide franchise.
CagriSema’s obesity data have been encouraging, meeting the primary goals in two late-stage studies and supporting the FDA filing. In the phase III REDEFINE 1 study, CagriSema achieved a mean weight loss of 22.7% after 68 weeks, assuming all participants adhered to treatment, compared with 16.1% for Wegovy and 11.8% for cagrilintide. In the REDEFINE 2 study, which enrolled people with obesity or overweight and T2D, treatment with CagriSema achieved a mean weight loss of 15.7%, assuming all participants adhered to treatment. Both studies demonstrated statistically significant weight-loss benefits versus placebo.
We note that despite the positive results, Novo Nordisk faced significant setbacks following the announcement of these data in late 2024 and early 2025, respectively, as CagriSema demonstrated a lower-than-expected weight loss relative to investor expectations. The concern became more relevant after the phase III REDEFINE 4 head-to-head study against Eli Lilly‘s LLY obesity drug, Zepbound (tirzepatide 15 mg). CagriSema achieved 23% weight loss after 84 weeks, but failed to demonstrate non-inferiority to Zepbound, which delivered 25.5% weight loss under the efficacy estimand. The results make it difficult for CagriSema at its current dose to establish a clear efficacy advantage over Lilly’s leading obesity therapy.
NVO Needs CagriSema to Diversify Beyond Semaglutide
The need for new growth drivers has become more pressing as NVO’s core GLP-1 franchise faces increasing competition. In the first half of 2026, Novo Nordisk reported total sales of DKK 175.3 billion, but adjusted sales rose only 2% at constant exchange rates. The company has also guided for 2026 adjusted sales growth of 0% to -6% at CER, despite raising the outlook following stronger-than-expected GLP-1 momentum in the second quarter
Eli Lilly illustrates the competitive pressure. Mounjaro (for T2D) generated $18.6 billion in first-half 2026 sales, up 106% year over year, while Zepbound generated $9.1 billion, up 60%. LLY’s first-half 2026 revenues increased 51%, driven primarily by volume growth from the two tirzepatide products. This momentum has made it increasingly important for Novo Nordisk to develop products that can expand beyond its marketed semaglutide franchise
