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Compound Evidence InstituteEvidence synthesis · established 2023Graded assessments of compounds, trials, methods and supply
Document set current to 30 July 2026
Evidence synthesis · §4

CagriSema (cagrilintide with semaglutide) in type 2 diabetes mellitus: effect on the anchor outcome — summary of findings

Outcome-by-outcome summary with effect, certainty and the reason for each downgrade.

Document identifier
CEI-ES-057/4
Series
Evidence synthesis
Version
2.0
Published
20 Nov 2025
Last reviewed
20 Nov 2025
Next review
20 May 2027
Identifier
10.71829/cei.syn.57
Certainty
Moderate
Cycle
2025 Q4
Review type
Intervention review
Search executed
29 Jul 2025

Templated review frame. This review question was generated by crossing an indication with a compound for which contributing trials exist. Its prose frame is templated and is shared with other questions of the same shape. Its included studies, its summary of findings and its certainty rating are computed from the underlying records and are not templated. The Institute publishes these questions because the alternative is to leave a question the document set can answer unanswered, and it labels them because the alternative is to present a templated frame as an authored one.

§4Summary of findings

§4.1Summary of findings

Table 7. Summary of findings for CagriSema (cagrilintide with semaglutide) in type 2 diabetes mellitus: effect on the….

OutcomeParticipants (studies)Effect as reportedCertaintyReason for downgrade
Change in HbA1c (%, mmol/mol)The outcome the Institute designates as anchor for this indication.1,298 (2)Mean change −15.7 % versus −3.1 % with placeboModeratepublication bias
Discontinuation for adverse eventsReported as a summary-of-findings row rather than in a tolerability annex, following a public submission.1,183 (2)Reported per contributing trial; see the included-studies tableModerateinconsistency
Serious adverse eventsEvent counts are low; the estimate is imprecise by construction.1,280 (2)Reported per contributing trial; see the included-studies tableLowrisk of bias
Any adverse eventAscertained by spontaneous report in the contributing trials.1,247 (2)Reported per contributing trial; see the included-studies tableLowindirectness, imprecision
Proportion achieving HbA1c <7.0 % and ≤6.5 %A secondary outcome for this indication. Its hierarchical position within each contributing trial is recorded on that trial's abstract where the Institute holds it.1,167 (1)Reported as a secondary outcome in a subset of contributing trialsLowrisk of bias, indirectness
Change in fasting serum glucoseA secondary outcome for this indication. Its hierarchical position within each contributing trial is recorded on that trial's abstract where the Institute holds it.645 (1)Reported as a secondary outcome in a subset of contributing trialsLowindirectness, publication bias
Certainty ratings describe confidence in the effect estimate for the stated outcome. They are not recommendations and do not transfer between outcomes.

§4.2Forest plot

Contributing estimatesPoint estimates with confidence intervals for each contributing study, plotted against the line of no effect.0.751Ratio measure, log scale (1 = no effect)Contributing studyEstimate (95 % CI)REDEFINE-22025 · n=1,2060.70 (0.58 to 0.83)CAGRI-SEMA-PH2-T2D2023 · n=920.71 (0.57 to 0.84)Pooled estimate0.71 (0.62 to 0.80)
Study estimatePooled estimate
Figure 1. Illustrative. Contributing estimates plotted against the line of no effect. The point estimates and intervals are the Institute's standardised representation of the contributing evidence on a common ratio scale, generated deterministically from the record identifiers; they are not the published estimates, which appear in their own units in the included-studies table and on each trial abstract. The figure is published to convey the dispersion of the evidence base, not to supply a number.

§4.3Certainty assessment for the anchor outcome

Certainty assessment by domainDowngrading decision recorded for each certainty domain.Certainty domainNo concernSeriousVery seriousEffect on ratingRisk of biasno downgradeInconsistencyno downgradeIndirectnessno downgradeImprecisionno downgradePublication biasdowngrade one levelTotal downgrading: 1 levelModerate certainty
Figure 2. Domain-by-domain certainty assessment for the anchor outcome of this review.

Table 8. Reasoning recorded against each certainty domain for the anchor outcome.

DomainRatingReasoning
Risk of biasNo concernNo serious concern identified in this domain.
InconsistencyNo concernNo serious concern identified in this domain.
IndirectnessNo concernNo serious concern identified in this domain.
ImprecisionNo concernNo serious concern identified in this domain.
Publication biasSeriousToo few contributing studies for a formal assessment; the risk cannot be excluded.
Overall: Moderate certainty. The true effect is likely to be close to the estimate, but there is a possibility that it is substantially different. Further research is likely to have an important impact on confidence in the estimate.

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. 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
  2. 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

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