SynthesisDiabetes, obesity & metabolism2026

Efficacy and Safety of Cagrilintide and Cagrisema Versus Semaglutide as Anti-Obesity Medications: A Systematic Review, Meta-Analysis and Meta-Regression.

Muhammad Ahmed, Muhammad Hassan, Muhammad Tahir, Muhammad Hussain, Faisal Islam, Ghulam Taha Khan, Muhammad Ahsan, Shaheer Bin Shafiq, Ahmed Ibrahim, Ammad Uddin and 1 more

Abstract readSystematic ReviewMeta-AnalysisComparative Study
PubMed Publisher
In one paragraph

Synthesis in Diabetes, obesity & metabolism, 2026. The graph read 3 numbers from its abstract, feeding 2 cells of the map, but none could be read as for or against, so it casts no vote. Cited by 3 papers.

3numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

Read, but not usablea number the graph found but could not read as for or against

Adverse events & safetycomparator not stated · obesityfeeds 2 cells of the map
RR 1.641.01 to 2.66
Overall and serious adverse events were comparable between cagrisema and semaglutide, but combination therapy increased administration-site conditions [RR 3.27 (95% CI: 1.27, 8.46)] and nausea [RR 1.64 (95% CI: 1.01, 2.66)].
Adverse events & safetycomparator not stated · obesityfeeds 2 cells of the map
RR 3.271.27 to 8.46
Overall and serious adverse events were comparable between cagrisema and semaglutide, but combination therapy increased administration-site conditions [RR 3.27 (95% CI: 1.27, 8.46)] and nausea [RR 1.64 (95% CI: 1.01, 2.66)].
Adverse events & safetycomparator not stated · obesityfeeds 2 cells of the map
RR 1.831.03 to 3.24
Cagrilintide monotherapy had a higher risk of serious adverse events [RR 1.83 (95% CI: 1.03, 3.24)] compared to semaglutide.

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

GIP/GLP-1 & amylin agonists×adverse events & safety

No readable resultOpen on the map →What to test next →

4 readable studies in this cell: 2 favour the treatment, 2 find no difference, 0 favour the comparator.

Belief with this paper
0.00contested · 0 families support, 3 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
0 · no effect
NCT0498257592 enrolled · 2021
Δ -0.30-0.79 to 0.19
NCT0408133755 enrolled · 2020
Δ -0.03-0.05 to -0.02
NCT0405055342 enrolled · 2020
Δ -0.89-4.10 to 2.33

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

GLP-1 receptor agonists×adverse events & safety

No readable resultOpen on the map →What to test next →

40 readable studies in this cell: 45 favour the treatment, 14 find no difference, 2 favour the comparator.

Belief with this paper
0.00contested · 0 families support, 39 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
0 · no effect
NCT017204463,297 enrolled · 2013
Δ -0.66-0.80 to -0.52
NCT036893742,274 enrolled · 2018
Δ -0.29-0.38 to -0.20
NCT013360231,663 enrolled · 2011
Treatment contrast -0.64-0.75 to -0.53
NCT040178321,441 enrolled · 2019
Δ -0.20-0.30 to -0.10
NCT018365231,398 enrolled · 2013
Δ -0.20-0.32 to -0.07
NCT019301881,231 enrolled · 2013
Δ -1.06-1.21 to -0.91
NCT007344741,202 enrolled · 2008
Δ -0.71-0.87 to -0.55
NCT008389031,049 enrolled · 2009
Δ -0.91-1.16 to -0.65
NCT009606611,036 enrolled · 2009
Δ -0.04-0.18 to 0.11
NCT050350821,018 enrolled · 2021
Δ -0.24-0.44 to -0.04
NCT01064687978 enrolled · 2010
Δ -1.05-1.22 to -0.88
NCT01117350978 enrolled · 2010
Δ 2.54-3.88 to 8.93

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

4 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

5 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Article
6 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

7 · Who and what money

Authors and funding

11 authors.

Muhammad AhmedDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.ORCID 0009-0002-5578-2022
Muhammad HassanDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.ORCID 0009-0005-9895-7170
Muhammad TahirDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Muhammad HussainDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Faisal IslamDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Ghulam Taha KhanDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Muhammad AhsanDepartment of Medicine, Ziauddin Medical University, Karachi, Pakistan.
Shaheer Bin ShafiqDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Ahmed IbrahimDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Ammad UddinDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Saad Ahmed WaqasDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.ORCID 0009-0008-9051-6081

Funding

No grant is acknowledged in the PubMed record.

8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

backgroundObesity is a complex chronic disease requiring effective long-term management. We performed a systematic review and meta-analysis to evaluate the efficacy and safety of cagrisema and cagrilintide monotherapy compared with semaglutide in individuals with obesity.

methodsWe searched MEDLINE, Embase, Scopus, Cochrane, and ClinicalTrials.gov for randomized controlled trials accessing cagrisema or cagrilintide versus semaglutide for weight loss. Efficacy outcomes were percentage change in body weight, absolute change in body weight, fasting plasma glucose, HbA1c, and BMI. Lipid parameters included total cholesterol, LDL-C, HDL-C, VLDL-C, and triglycerides. A random-effects model was used to estimate mean differences (MD) or risk ratios (RR) with 95% CIs.

resultsThree RCTs (n = 3545) were included. Cagrisema produced significantly greater percentage [MD -7.47% (95% CI: -10.58, -4.36); p < 0.001] and absolute [MD -7.60 kg (95% CI: -10.33, -4.86); p < 0.001] weight loss than semaglutide. Cagrilintide monotherapy weight loss was comparable to semaglutide. Lipids parameters were mostly similar between groups, though LDL-C was modestly higher with combination therapy versus semaglutide [MD 0.29 mmol/L (95% CI: 0.02, 0.55); p = 0.03]. Overall and serious adverse events were comparable between cagrisema and semaglutide, but combination therapy increased administration-site conditions [RR 3.27 (95% CI: 1.27, 8.46)] and nausea [RR 1.64 (95% CI: 1.01, 2.66)]. Cagrilintide monotherapy had a higher risk of serious adverse events [RR 1.83 (95% CI: 1.03, 3.24)] compared to semaglutide.

conclusionCagrisema is more effective than semaglutide in reducing weight and increasing glycemic control. Cagrisema is safe and has a comparable side effect profile to currently accepted treatments. This regimen has enormous potential in dual-agonist therapy for obese patients.

Indexed as

Anti-Obesity AgentsGlucagon-Like PeptidesObesityBlood GlucoseHumansRandomized Controlled Trials as TopicSemaglutideTreatment OutcomeWeight LossAnti-Obesity AgentsBlood GlucoseGlucagon-Like PeptidesSemaglutideantidiabetic drugantiobesity drugGLP‐1obesity therapyweight management

Identifiers

PMID41834765

What OpenQuestion holds

Texttitle and abstract
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.