This desk already covers cagrilintide-semaglutide for weight, in what a combination adds. This is a different trial asking a different question: what happens when the combination is added to basal insulin in people whose type 2 diabetes is not controlled [1].
The effect on blood sugar is large. Against a mean baseline HbA1c of 8.8%, the combination produced falls of 2.33 and 2.10 percentage points at the two dose levels, against 0.66 on placebo. For a population already on insulin and still above target, reductions of that size are the kind that change what other medication is needed.
The trial is small for a phase 3, at 274 participants over 40 weeks, and it was masked within each dose level with visually identical placebo, which is a reasonable design for a two-injection regimen. Randomization was stratified by baseline HbA1c and by country.
Nothing here is purchasable. CagriSema is not approved or on sale anywhere, so this is a map of what may arrive rather than a comparison a reader can act on — the same status as the fortnightly injection trial. Where these agents sit against the marketed drugs on weight, at the evidence grades currently available, is set out on this site’s sister publication.
For anyone currently on insulin and considering a GLP-1 addition, the practical point is that insulin doses generally have to come down when one is added, which is a prescriber’s adjustment rather than a self-managed one. What that looks like in ordinary practice, and what it does to the monthly cost of insulin alongside, is covered in what swapping mealtime insulin actually buys and what a GLP-1 actually costs.