Cagrilintide

Metabolic

Also known as AM833, NNC0174-0833

Long-acting amylin analogue. Investigational.

Read this first

Storage and stability are undocumented, the trial product is an aqueous solution in a pen cartridge, not a lyophilised vial, so there is no published guidance on reconstituting or storing powder.

How it works

Activates all three amylin receptor subtypes and the calcitonin receptor. Amylin signalling promotes satiety and slows gastric emptying through a pathway separate from GLP-1, which is why it is being developed alongside semaglutide rather than instead of it.

Subcutaneous

In the body

Half-life

7.4 days

Time to peak

24 h

90% gone after

24.5 d

Builds up to

2.07×

Steady state after about 37.3 d at once weekly.

Shape of a single dose, modelled as one compartment with first-order absorption. The peak is normalised to 100% because bioavailability and volume of distribution are not published for most of these compounds.

Measured at 159 to 195 hours across the 0.16 to 4.5 mg range, so roughly 7 days.

What happens, and when

0 min, 12 hAbsorbing.
12 h, 2 dPeak plasma levels, median around 24 hours.
2 d, 7 dSlow decline. About 52% of peak still present at day 7.

Doses

300 mcg, 4.5 mgonce weeklyClinical trial

Phase 2 studied 0.3 through 4.5 mg. The dose used inside CagriSema is 2.4 mg.

Phase 2 escalation to 4.5 mg

NCT03856047 protocol, Table 7-2 · 26 weeks total

wk 1, 2600 mcg2 weeks
wk 3, 41.2 mg2 weeks
wk 5, 62.4 mg2 weeks
wk 7, 264.5 mg20 weeks

Every step is exactly two weeks. The protocol allowed a step to be held an extra week for tolerability, which stretches the climb to 4.5 mg from 6 weeks out to 9.

Side effects

Nausea, 46.5% at 4.5 mg against 17.8% on placebo in phase 2
Constipation and decreased appetite, both dose-related
Injection site erythema, 16.8% at 4.5 mg, and zero on placebo
Transient activation of the renin-angiotensin-aldosterone system, resolving about 2 weeks after each escalation

Cautions

Not an approved medicine. No label, no established monitoring, no verified supply.

Status

Investigational. No FDA approval; exists commercially only as a component of CagriSema.

Sources

Reference information for personal record-keeping. Not medical advice, and not a recommendation to use any of these compounds.