CagriSema vs Tirzepatide

CagriSema

Once-weekly fixed-dose combination of Cagrilintide and Semaglutide. The leading 'next-generation' obesity treatment in Phase 3, delivering roughly 20% weight loss in late trials.

Best for

Best if the combination approach appeals and you want Semaglutide plus an amylin analog working together.

Tirzepatide

Dual GIP and GLP-1 agonist. Beats Semaglutide head-to-head on weight loss and glycaemic control, and is becoming the default first-line choice when both are available.

Best for

Best if you prefer one proven molecule and one injection with the largest real-world track record.

CagriSema

Novo Nordisk's REDEFINE Phase 3 programme covers REDEFINE 1 (obesity without diabetes), REDEFINE 2 (obesity with type 2 diabetes), and REDEFINE 3 (cardiovascular outcomes). REDEFINE 1 reported in 2025 (NEJM) showed 22.7% weight loss at 68 weeks vs 15% for Semaglutide alone. Approval submissions are pending. The combination has not been compared head-to-head with Tirzepatide or Retatrutide.

Tirzepatide

FDA-approved 2022 for type 2 diabetes (Mounjaro) and 2023 for chronic weight management (Zepbound); EMA approval followed. The SURPASS 1–5 diabetes trials and SURMOUNT 1–4 obesity trials constitute the largest randomised dataset of any dual incretin. SURMOUNT-1 vs STEP 1 is the cleanest head-to-head proxy, and SURPASS-2 was a direct comparison: Tirzepatide came out ahead on both weight and HbA1c.