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Novo's CagriSema delivers superior weight loss versus tirzepatide in REIMAGINE 5 trial

Key Takeaway: Novo Nordisk announced positive topline results from the phase 3 REIMAGINE 5 trial, showing that CagriSema (cagrilintide and semaglutide) achieved a superior average weight loss of 12.4% compared to tirzepatide's 9.1%. Additionally, CagriSema demonstrated non-inferior HbA1c reduction. The findings suggest strong potential for CagriSema in treating obesity and type 2 diabetes, with further data expected on diabetic neuropathy.
Price reaction · baseline $38.74 (2026-09-23T14:36:00.000Z) · hit during market hours · 1 other NVO headline(s) in the window, move may be shared
day 0 close · peak
-1.5%

Market Sentiment Analysis

POSITIVE FACTORS

  • CagriSema shows superior weight loss compared to tirzepatide.
  • Demonstrates strong efficacy in reducing HbA1c levels.
  • Promising results in both obesity and type 2 diabetes management.
  • Potential for individualized treatment options.

BiopharmaWatch Analysis

From our catalyst data and publicly available data · not financial advice
Best trade, last catalyst
+46%
120-day peak, hindsight
Typical move
2.9%
average across 15 past catalysts
Lead asset
NNC0487-0111
Phase 3 · Obesity

Full Press Release Details

MISSISSAUGA, ON , Sept. 23, 2026 /CNW/ -- Novo Nordisk this week announced topline results from the phase 3 REIMAGINE 5 and REDEFINE 9 trials of once-weekly CagriSema (cagrilintide and semaglutide), an investigational product, and Novo's next innovation in weight management and type 2 diabetes. The findings were highlighted at Novo's Capital Markets Day investor briefing.
In REIMAGINE 5, CagriSema 1.0 mg/1.0 mg was superior to tirzepatide 5 mg for weight loss, achieving an estimated average weight loss of 12.4%, compared with 9.1%, respectively. CagriSema also confirmed non-inferior reduction in HbA 1c (1.71%) versus tirzepatide (1.67%).
In REDEFINE 9, CagriSema 1.0 mg/1.0 mg provided a weight reduction of 21.0% versus 2.0% for placebo, and the primary superiority endpoint was met. CagriSema also showed greater improvements than placebo across prespecified supportive endpoints, including systolic blood pressure, waist-to-height ratio and fasting lipid profile.
"The results from CagriSema are very encouraging, demonstrating the strong potency of the combination of semaglutide and cagrilintide. With only 1.0 mg/1.0 mg, CagriSema shows superior weight loss versus tirzepatide 5 mg as well as strong results across obesity and type 2 diabetes," said Martin Holst Lange, executive vice president, Research & Development and chief scientific officer at Novo. "CagriSema remains investigational, but these findings strengthen our confidence in its potential, add to the growing evidence for amylin biology and reinforce our ambition to advance the next generation of treatments for obesity and type 2 diabetes."
Treatment decisions in obesity and type 2 diabetes are often individualised, and not all patients receive or remain on the highest available dose of current therapies. These data provide important evidence of the potential of CagriSema 1.0 mg/1.0 mg, and expand our understanding of how efficacy, tolerability and dose flexibility may support individualised care.
Also during Capital Markets Day, Novo presented data on painful diabetic neuropathy in type 2 diabetes for the first time, showing promising results. More details will be presented at a later time.
Adults with type 2 diabetes (inadequately controlled on metformin, SGLT2i, or both)
CagriSema 1.0 mg/1.0 mg vs. tirzepatide 5 mg
Weight loss: 12.4% (CagriSema) vs. 9.1% (tirzepatide) – superior
HbA 1c reduction: 1.71% (CagriSema) vs. 1.67% (tirzepatide) – non-inferior
Adults with overweight or obesity (adjunct to diet & exercise)
2) Proportion achieving ≥5% weight reduction
Weight loss: 21.0% (CagriSema) vs. 2.0% (Placebo) – superior
About the REIMAGINE 5 trial REIMAGINE 5 was a phase 3 trial investigating once-weekly CagriSema 1.0 mg/1.0 mg compared with tirzepatide 5 mg in participants with type 2 diabetes inadequately controlled on metformin, an SGLT2 inhibitor or both. The dual primary endpoints were change in HbA 1c and relative change in body weight from baseline to week 60.
About the REDEFINE 9 trial REDEFINE 9 was a phase 3 trial investigating once-weekly CagriSema 1.7 mg/1.7 mg and CagriSema 1.0 mg/1.0 mg compared with placebo, as an adjunct to a reduced-calorie diet and increased physical activity, in participants living with overweight or obesity. The primary endpoints were relative change in body weight and the proportion of participants achieving at least 5% body-weight reduction from baseline to week 68.
About CagriSema Once-weekly subcutaneous CagriSema is being investigated by Novo as a treatment for adults with overweight or obesity (REDEFINE program) and as a treatment for adults with type 2 diabetes (REIMAGINE program). CagriSema is a fixed-dose combination of a long-acting amylin receptor agonist, cagrilintide, and a GLP-1 receptor agonist, semaglutide.
Novo filed a New Drug Submission with Health Canada and a New Drug Application with the U.S. Food and Drug Administration (FDA) in December 2025 for CagriSema for weight management, demonstrating the company's commitment to lasting health innovation in obesity. Health Canada and FDA decisions are expected in Q4 2026.
Novo is the global healthcare company that believes lasting health starts now. For over a century, we've combined leading scientific expertise with a deep understanding of people's lives. We develop treatments and support that help millions of people make progress they can see, feel and sustain now and in the future. Every day, over 67,000 employees around the world advance our purpose to drive change for lasting health. Through our partnerships, programs and investments, we're working to prevent disease, expand access to treatments and reduce our environmental impact to help even more people live healthier lives. For more information, visit novonordisk.ca and follow us on Instagram, LinkedIn, TikTok, Facebook, X and YouTube.

Frequently Asked Questions

What were the results of the REIMAGINE 5 trial?

CagriSema achieved an average weight loss of 12.4%, surpassing tirzepatide's 9.1%.

How did CagriSema perform in HbA1c reduction?

CagriSema showed a non-inferior reduction in HbA1c at 1.71% compared to 1.67% for tirzepatide.

What is the primary focus of the REDEFINE 9 trial?

REDEFINE 9 investigates CagriSema's effectiveness for weight management in adults with obesity.

What is the composition of CagriSema?

CagriSema is a combination of cagrilintide, an amylin receptor agonist, and semaglutide.

When are FDA decisions for CagriSema expected?

FDA decisions for CagriSema are anticipated in Q4 2026.

Last updated: Sep 23, 2026