CagriSema Demonstrates Superior HbA1c Reduction in REIMAGINE 2 Trial, Marking Major Advancement for Type 2 Diabetes Treatment

Novo Nordisk’s latest clinical trial results reveal a significant breakthrough in diabetes management. The REIMAGINE 2 trial shows that CagriSema, an innovative fixed-dose combination therapy, achieves superior HbA1c reduction compared to semaglutide alone across all tested doses in adults with type 2 diabetes. This represents a meaningful step forward in addressing both blood glucose control and weight management—two critical factors in diabetes treatment outcomes.

Dual Mechanism Shows Stronger HbA1c Control and Weight Management

The 68-week trial demonstrated that CagriSema achieved an HbA1c reduction of 1.91%-points and weight loss of 14.2%. Notably, these results exceeded what either component achieved individually, establishing clear superiority in both HbA1c improvement and weight reduction. CagriSema combines a long-acting amylin receptor agonist (cagrilintide) with a long-acting GLP-1 receptor agonist (semaglutide), creating a synergistic effect that outperforms single-agent therapy. For patients seeking comprehensive diabetes management, the ability to achieve stronger HbA1c control while simultaneously reducing weight addresses a key clinical need.

The trial also evaluated the drug’s safety profile, confirming that CagriSema maintained tolerability consistent with other incretin and amylin-based therapies. This favorable safety data strengthens the overall clinical case for the treatment.

Clinical Development and Regulatory Pathway

Novo Nordisk is advancing CagriSema through two parallel clinical programs. The REIMAGINE programme focuses on type 2 diabetes patients, while the REDEFINE programme evaluates the therapy for weight management in adults with overweight or obesity. The company is administering CagriSema as a once-weekly subcutaneous injection in both programs.

Following positive results from REIMAGINE 1 and REDEFINE 3 trials, Novo Nordisk plans to engage with regulatory authorities to discuss the pathway forward for CagriSema approval in type 2 diabetes. Additionally, the company has already submitted CagriSema for weight management to the US FDA in December 2025, based on data from the REDEFINE 1 and REDEFINE 2 pivotal trials. Detailed findings from the REIMAGINE 2 trial are expected to be presented at a major scientific conference in 2026.

Industry Perspective and Market Response

Martin Holst Lange, Novo Nordisk’s executive vice president and chief scientific officer, emphasized the significance of combining the two active agents: “By combining semaglutide and cagrilintide, we’re seeing superior outcomes in both blood glucose control and weight reduction beyond those achieved with each therapy individually. The results strengthen our belief that CagriSema could be the first amylin-based combination therapy and a promising treatment option for individuals with type 2 diabetes who also focus on weight loss.”

The market has responded cautiously to the announcement. On the trading day following the headline results release, Novo Nordisk shares closed 0.8% lower at $58.93 on the NYSE, though overnight trading showed a modest recovery with shares gaining approximately 0.4% to $59.19. This mixed reaction reflects typical market dynamics around clinical announcements, balancing enthusiasm for the trial success against broader market conditions.

The successful demonstration of superior HbA1c reduction in the REIMAGINE 2 trial positions CagriSema as a potential game-changer in type 2 diabetes treatment, offering physicians and patients a new option that addresses multiple therapeutic goals simultaneously.