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Literature ·

Amylin in Milan

CagriSema lowers HbA1c by 0.16 points and weight by 4 points more than semaglutide in type 2 diabetes (REIMAGINE 2), zenagamtide follows

Amylin day at EASD 2026 in Milan. REIMAGINE 2 (Lancet Diabetes and Endocrinology) randomised 2,713 adults with type 2 diabetes on metformin with or without an SGLT2 inhibitor (mean HbA1c 8.2 percent, BMI 25 or higher) to CagriSema 2.4/2.4 mg, semaglutide 2.4 mg, cagrilintide 2.4 mg, lower doses or placebo for 68 weeks. HbA1c fell by 1.91 versus 1.75 percentage points (difference -0.16, 95% CI -0.27 to -0.05, p=0.0035), body weight by 14.2 versus 10.2 percent; adverse events, mainly gastrointestinal, in 86.9 versus 81.2 percent. REIMAGINE 1 (189 treatment-naive people, 40 weeks: HbA1c -1.8 points, weight -13.8 percent versus placebo) and zenagamtide phase 2b (HbA1c -1.71 points, weight -14.6 percent at 36 weeks) were also presented. Amylin adds a small glycaemic gain and a clear weight gain over semaglutide alone; cardiovascular outcome data are pending. Sponsor-run trials.