Novo Nordisk's latest clinical trial, REIMAGINE 2, has delivered compelling findings, indicating that their novel combination therapy, CagriSema, surpasses semaglutide in achieving significant reductions in body weight and improved glycemic control. This extensive 68-week study revealed that CagriSema, administered once weekly, offered superior efficacy across all tested dosages, alongside a reassuring safety and tolerability profile, making it a promising advancement for individuals battling type 2 diabetes and obesity.
Breakthrough in Diabetes and Weight Management: Novo Nordisk's CagriSema
In a landmark announcement on Monday, February 2, 2026, pharmaceutical giant Novo Nordisk A/S (NYSE: NVO) disclosed the highly anticipated top-line results from its global REIMAGINE clinical trial program, specifically the REIMAGINE 2 phase 3 trial. This pivotal study, investigating the efficacy and safety of CagriSema for weight management, comes on the heels of the drug's submission to the U.S. Food and Drug Administration (FDA) in December 2025, building upon data from earlier REDEFINE 1 and REDEFINE 2 trials.
The REIMAGINE 2 trial was a comprehensive 68-week investigation that enrolled 2,728 participants diagnosed with type 2 diabetes, whose condition was not adequately managed by metformin, with or without an SGLT2 inhibitor. Approximately 40% of these individuals were already utilizing an SGLT2 inhibitor prior to commencing the trial. The study meticulously compared two distinct doses of subcutaneous CagriSema (a fixed-dose combination of cagrilintide and semaglutide) – 2.4 mg/2.4 mg and 1.0 mg/1.0 mg – against equivalent doses of semaglutide (2.4 mg and 1.0 mg), as well as against cagrilintide (2.4 mg) alone, and a placebo.
The findings unequivocally demonstrated that CagriSema led to a more substantial reduction in HbA1c levels and greater weight loss at the 68-week mark, outperforming semaglutide across all dosage comparisons. Specifically, participants receiving CagriSema 2.4 mg/2.4 mg achieved an average HbA1c reduction of 1.91%-points from a baseline mean of 8.2%, a superior outcome compared to the 1.76%-points observed with semaglutide 2.4 mg. Furthermore, in terms of weight reduction, individuals on CagriSema 2.4 mg/2.4 mg experienced an impressive average weight loss of 14.2% from a mean baseline body weight of 101 kg, in contrast to 10.2% with semaglutide 2.4 mg. Notably, the trial observed no plateau in weight loss for CagriSema even at week 68, with 43% of patients achieving at least 15% weight loss and 24% surpassing 20% weight loss.
When analyzed using the treatment regimen estimand, CagriSema 2.4 mg/2.4 mg still showed an HbA1c reduction of 1.80%-points versus 1.68%-points for semaglutide 2.4 mg, and a 12.9% weight loss compared to 9.2% for semaglutide 2.4 mg. Throughout the trial, CagriSema maintained a safe and well-tolerated profile. The most commonly reported adverse events were gastrointestinal in nature, predominantly mild to moderate, and tended to subside over time, consistent with known effects of incretin and amylin-based therapies.
Despite these encouraging results, Novo Nordisk shares saw a slight decline of 0.61%, trading at $59.07 at the time of publication on Monday, according to Benzinga Pro data.
The successful outcome of the REIMAGINE 2 trial signifies a potential paradigm shift in the treatment landscape for type 2 diabetes and obesity. CagriSema's ability to offer enhanced glycemic control and more pronounced, sustained weight loss could provide a crucial new option for patients who struggle with these interconnected health challenges. This development underscores the ongoing commitment to innovation in metabolic health and offers a beacon of hope for improved patient outcomes.
