Evidence map›Paper›PMID 42890523›Full record

SynthesisFrontiers in endocrinology2026

CagriSema versus Semaglutide 2.4 mg monotherapy for weight management in adults with overweight or obesity, with or without type 2 diabetes: a systematic review, meta-analysis, and trial sequential analysis.

Zehra Khatoon Rasool, Rajvi Shah, Ansharah E Zinnia Batool, Rutvi Shah, Mariam Khachatryan, Sushant Bhardwaj, Ahmad Ali, Meeran Atta, Pugazhandhi Bakthavatchalam, Mirza Muhammad Hadeed Khawar and 1 more

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · 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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

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

5 · Who and what money

Authors and funding

11 authors.

Zehra Khatoon RasoolDePaul University, Chicago, IL, United States.
Rajvi ShahNarendra Modi Medical College, Ahmedabad, India.
Ansharah E Zinnia BatoolRashid Latif Medical College, Lahore, Pakistan.
Rutvi ShahNarendra Modi Medical College, Ahmedabad, India.
Mariam KhachatryanFanarjyan Clinic, Yerevan, Armenia.
Sushant BhardwajKathmandu University School of Medical Sciences, Dhulikhel, Nepal.
Ahmad AliServices Institute of Medical Sciences, Lahore, Pakistan.
Meeran AttaServices Institute of Medical Sciences, Lahore, Pakistan.
Pugazhandhi BakthavatchalamAmerican University of Antigua, St. John's, Antigua and Barbuda.
Mirza Muhammad Hadeed KhawarServices Institute of Medical Sciences, Lahore, Pakistan.
Muneeb KhawarKing Edward Medical University, Lahore, Pakistan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Semaglutide 2.4 mg is the reference pharmacotherapy for weight management, yet many patients do not reach ambitious weight-loss targets. CagriSema, a fixed-dose combination of cagrilintide and semaglutide, may offer additional benefit through complementary mechanisms. We quantified its incremental efficacy and safety against semaglutide 2.4 mg monotherapy in adults with overweight or obesity, with and without type 2 diabetes. Methods: This PRISMA 2020-compliant review (PROSPERO CRD420261380458) searched PubMed, Embase, Cochrane CENTRAL, ScienceDirect, ClinicalTrials.gov and WHO ICTRP to 30 June 2026 for randomised controlled trials comparing CagriSema with semaglutide 2.4 mg or placebo. Effects were pooled within two prespecified comparator strata using random-effects models with restricted maximum likelihood estimation of τ² and a Hartung-Knapp-Sidik-Jonkman small-sample adjustment, with prediction intervals, leave-one-out and phase-3a-restricted sensitivity analyses, trial sequential analysis. Results: Five trials (4,746 unique participants) were included. Versus semaglutide 2.4 mg, CagriSema produced greater weight loss (mean difference -6.89 percentage points, 95% CI -8.70 to -5.06; I² = 33%; prediction interval -8.91 to -4.86), a greater absolute reduction in body weight (-7.16 kg, 95% CI -9.15 to -5.17) and in body-mass index (-2.41 kg/m², 95% CI -2.83 to -1.99), and roughly twice the likelihood of reaching a 20% reduction (RR 2.10, 95% CI 1.78 to 2.47). Waist circumference fell further (-4.07 cm, 95% CI -5.10 to -3.04). No incremental glycaemic benefit was detected, with intervals for glycated haemoglobin (-0.07, 95% CI -0.14 to 0.01) and fasting plasma glucose lying entirely within prespecified minimal important differences. Injection-site reactions were more frequent (RR 3.14, 95% CI 1.42 to 6.96); gastrointestinal adverse events were not significantly increased under the primary model (RR 1.09, 95% CI 0.97 to 1.21). Conclusion: CagriSema produces clinically meaningful additional weight loss and modest improvements in surrogate cardiometabolic measures compared with semaglutide 2.4 mg alone, at the cost of more frequent injection-site reactions and, at most, modestly more frequent gastrointestinal events. The evidence is insufficient to determine whether serious adverse events or neoplasms differ between treatments, and long-term durability, cardiovascular outcomes and body composition remain undetermined. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD420261380458.

Indexed as

Anti-Obesity AgentsDiabetes Mellitus, Type 2Glucagon-Like PeptidesObesityOverweightHumansRandomized Controlled Trials as TopicSemaglutideWeight LossAnti-Obesity AgentsGlucagon-Like PeptidesSemaglutidecagrilintideCagriSemaobesitySemaglutideweight loss

Identifiers

PMID42890523
PMCPMC13673521

What OpenQuestion holds

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Read underepoch 390

Registered trials

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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.