Novo Nordisk CagriSema lowers food‑cue brain activity, cuts organ fat and shows bone‑marker reassurance

Key highlights
  • CagriSema produced a 22.4% body‑weight reduction versus placebo at 52 weeks in the fMRI study (estimated treatment difference, p<0.0001).
  • A 52‑week fMRI trial showed reduced brain reactivity to high‑calorie food cues and sustained reductions in cravings, hunger, appetite and food‑related thoughts.
  • In REIMAGINE 1, CagriSema 2.4 mg/2.4 mg achieved a 14.3% body‑weight reduction at week 40 and significant reductions in abdominal, liver and pancreas fat versus placebo.
  • A post hoc analysis from REIMAGINE 2 reported bone biomarkers consistent with maintained bone balance alongside a 14.2% body‑weight reduction at week 68, described as preliminary reassurance.

Brain effects and eating behaviour

In a 52‑week functional MRI study in adults with overweight or obesity, CagriSema modified brain responses to high‑calorie food cues in regions linked to cravings, reward, sensory processing and behavioural control. These neural changes were accompanied by sustained reductions in self‑reported food cravings, hunger, appetite and food‑related thoughts, and improved craving control; the study recorded a 22.4% reduction in body weight versus placebo at 52 weeks (estimated treatment difference, p<0.0001).

Organ fat and metabolic findings in type 2 diabetes

A diabetes MRI sub‑study within the phase 3 REIMAGINE 1 trial found that once‑weekly CagriSema 2.4 mg/2.4 mg significantly reduced abdominal fat and ectopic fat in the liver and pancreas versus placebo, alongside a 14.3% body‑weight reduction at week 40.

Bone biomarkers and mechanistic implications

A post hoc analysis of bone markers from REIMAGINE 2 indicated a balance in bone maintenance concurrent with a 14.2% body‑weight reduction at week 68, which the study authors described as preliminary reassurance regarding bone changes. Novo Nordisk and investigators highlight that the amylin component of CagriSema may influence disease biology across brain and multiple organs beyond effects on weight and glycaemia.

Regulatory and development status

Novo Nordisk submitted a US New Drug Application for CagriSema for weight management in December 2025; a regulatory decision is expected in Q4 2026. A high‑dose phase 3 trial of CagriSema 2.4 mg/7.2 mg in adults with obesity was initiated in 2026.

Source: Novo Nordisk

chemXplore Weekly

The week’s project milestones and project news from the chemical industry, free every Wednesday.

Free. One email a week. Unsubscribe any time.

Related articles

21 September 2026
Novo Nordisk: CagriSema outperforms tirzepatide 5 mg for weight loss

CagriSema 1.0/1.0 delivered greater weight loss than tirzepatide 5 mg and 21% vs 2% vs placebo in obesity trial; HbA1c reduction was non‑inferior. FDA decision expected Q4 2026.

23 February 2026
Novo Nordisk: CagriSema Shows 23% Weight Loss in Trial, Misses Primary Endpoint

CagriSema achieved 23% weight loss in 84 weeks but didn't match tirzepatide. Further trials will explore higher doses. Safe profile with mild gastrointestinal effects.

8 June 2026
Lilly's Foundayo (orforglipron) outperforms oral semaglutide, dapagliflozin and placebo in ACHIEVE trials

Oral GLP‑1 orforglipron reduced A1C and body weight more than oral semaglutide, dapagliflozin or placebo across three Phase‑3 trials; FDA filing planned by end of Q2 2026.

7 June 2026
Novo Nordisk CagriSema Phase 3 trials show large HbA1c and weight reductions

Once‑weekly cagrilintide+semaglutide reduced HbA1c by up to 2.33 percentage points and bodyweight by up to 14.2% across REIMAGINE 1–3 versus comparators.

28 April 2026
Novo Nordisk to present Wegovy and next‑generation obesity data at ECO 2026

Presenting 52 abstracts at ECO: data on semaglutide (injectable and oral), higher‑dose 7.2 mg, CagriSema combo, menopause effects, CV risk, weight‑loss timelines and real‑world outcomes.