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Compound monograph · evidence extract

Cagrilintide in type 2 diabetes mellitus — evidence extract

The Institute's graded assessment of Cagrilintide for type 2 diabetes mellitus, with the contributing trials and the domain-by-domain certainty reasoning.

Document identifier
CEI-MN-005/EV-T2DM
Series
Evidence extract
Version
4.3
Published
06 Nov 2023
Last reviewed
06 Feb 2025
Next review
06 Feb 2027
Identifier
10.71829/cei.mono.5
Certainty
Low
Cycle
2023 Q4

§1Evidence extract: Type 2 diabetes mellitus

§1.1Question and anchor outcome

Population
A disorder of glucose regulation characterised by insulin resistance with relative insulin deficiency, diagnosed by glycated haemoglobin, fasting plasma glucose or oral glucose tolerance criteria.
Intervention
Cagrilintide, subcutaneous once weekly
Comparator
As used in each contributing trial; reported per trial rather than pooled across comparator types
Anchor outcome
Change in HbA1c (%, mmol/mol)

Additional outcomes the Institute extracts for this indication: Proportion achieving HbA1c <7.0 % and ≤6.5 %; Change in fasting serum glucose; Change in body weight; Documented symptomatic hypoglycaemia.

§1.2Contributing trials

Table 1. Trials contributing to the assessment of Cagrilintide in type 2 diabetes mellitus.

TrialPhaseDesignRandomisedDurationYear
CAGRI-SEMA-PH2-T2D2Randomised, double-blind, active-controlled9232 weeks2023

§1.3Certainty assessment

Certainty assessment by domainDowngrading decision recorded for each certainty domain.Certainty domainNo concernSeriousVery seriousEffect on ratingRisk of biasno downgradeInconsistencydowngrade one levelIndirectnessdowngrade one levelImprecisionno downgradePublication biasno downgradeTotal downgrading: 2 levelsLow certainty
Figure 2. Domain-by-domain certainty assessment for Cagrilintide in type 2 diabetes mellitus. The starting rating for a body of randomised evidence is high; each serious concern reduces it by one level and each very serious concern by two.

Table 2. Reasoning recorded against each certainty domain.

DomainRatingReasoning
Risk of biasNo concernNo serious concern identified in this domain.
InconsistencySeriousToo few contributing studies to assess consistency formally.
IndirectnessSeriousAn outcome that would answer the question was not measured in any contributing trial.
ImprecisionNo concernNo serious concern identified in this domain.
Publication biasNo concernNo serious concern identified in this domain.
Overall rating: Low certainty. Confidence in the effect estimate is limited. The true effect may be substantially different from the estimate.

§1.4What this extract does not establish

References cited on this page

References are numbered in order of first citation in this document. Each superscript in the text links to its entry below.

  1. Lau DCW, Erichsen L, Francisco AM, Satylganova A, le Roux CW, McGowan B, Pedersen SD, Pietiläinen KH, Rubino DM, Batterham RL. Once-weekly cagrilintide for weight management in people with overweight and obesity: a multicentre, randomised, double-blind, placebo-controlled and active-controlled, dose-finding phase 2 trial. The Lancet 2021;398(10317):2160–2172. doi:10.1016/S0140-6736(21)01751-7 · PMID 34798060
  2. Frías JP, Deenadayalan S, Erichsen L, Knop FK, Lingvay I, Macura S, Mathieu C, Pedersen SD, Davies M. Efficacy and safety of co-administered once-weekly cagrilintide 2·4 mg with once-weekly semaglutide 2·4 mg in type 2 diabetes: a multicentre, randomised, double-blind, active-controlled, phase 2 trial. The Lancet 2023;402(10403):720–730. doi:10.1016/S0140-6736(23)01163-7 · PMID 37364591
  3. Hollander PA, Levy P, Fineman MS, Maggs DG, Shen LZ, Strobel SA, Weyer C, Kolterman OG. Pramlintide as an adjunct to insulin therapy improves long-term glycemic and weight control in patients with type 2 diabetes: a 1-year randomized controlled trial. Diabetes Care 2003;26(3):784–790. doi:10.2337/diacare.26.3.784 · PMID 12610038

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