Novo Nordisk to affirm superiority of CagriSema in obesity market

The medication contains tirzepatide, the same active ingredient in Lilly’s diabetes drug Mounjaro.

In response to Zepbound’s approval, Novo Nordisk has launched a phase 3 trial of its new pipeline drug CagriSema . In a previous phase 2 trial, CagriSema was found to be safe and well-tolerated.

Back in March, Martin Holst Lange, executive vice president at Novo Nordisk Development, said he was ‘encouraged’ by the ‘impressive phase 2 results.

“The results indicate that CagriSema reduces blood sugar more than semaglutide alone, and the weight loss seen in the trial confirms the substantial weight lowering potential of CagriSema,” he said.

CagriSema is anticipated to compete directly with Zepbound once it reaches the market. Therefore, Novo Nordisk has set out to challenge Eli Lilly’s therapy to affirm its superiority prior to regulatory approval, according to data and analytics company GlobalData.

The obesity market​ is predicted to reach $37.06 billion in 2031, with 70.9% of the market​ to be dominated by GLP-1R agonists, GlobalData reveals.

The potential of GLP-1RAs within the obesity space is undisputed and this incentive is driving Eli Lilly and Novo Nordisk, two major players within this market, into a head-to-head competition for primacy.

Costanza Alciati, pharma analyst at GlobalData, comments: “Novo Nordisk’s GLP-1 agonist Wegovy (semaglutide) has, until now, monopolized the obesity market. However, in type 2 diabetes clinical trials, tirzepatide has proved its superior efficacy to semaglutide due to its dual agonist properties, and thus the Danish company could lose its market share to its competitor.”

Novo Nordisk’s phase 3 trial will compare the efficacy and safety of the maximum dose of Zepbound to its late-stage therapy CagriSema, a fixed-dose combination therapy of 2.4mg semaglutide with 2.4mg cagrilintide, in obesity patients.

While semaglutide is a GLP-1RA treatment that works by increasing glucose-dependent insulin secretion, and exerting anorectic properties, Cagrilintide is a long-acting amylin analogue that works to potentiate semaglutide’s weight loss effects.

Alciati continues: “Data from previous clinical trials on CagriSema and Zepbound show that CagriSema demonstrates efficacy benefits that are superior to those seen with Zepbound for weight loss."

In the phase 3 trial, at 72 weeks of treatment with the maximum dose of Zepbound, patients achieved a decrease in body weight from the baseline of 20.9%.

On the other hand, in CagriSema’s phase 2 trial, the combination therapy caused a decrease in bodyweight at week 32 of treatment of 15.6% from baseline.

These results from different clinical trials suggest that in a fixed amount of time, CagriSema may achieve a greater decrease in patients’ body weight compared to Zepbound.

Alciati concludes: “Nonetheless, the final verdict will come from the results of Novo Nordisk’s new phase 3 combo trial comparing the two drugs on equal grounds. Novo Nordisk is not going to give up its obesity market share without a fight, and the launch of this combo trial is proof of their willingness to maintain their superiority in the GLP-1RA space.”