Retatrutide vs cagrilintide: how they differ and what the trials show
Not yet medically reviewed. Fact-checked against the sources listed below on October 7, 2026.How we write and review
Last updated October 7, 2026
Retatrutide and cagrilintide are both investigational and unapproved in the sources checked, and no trial comparing them was found. Retatrutide (Eli Lilly) activates the GIP, GLP-1 and glucagon receptors. Cagrilintide (Novo Nordisk) is an amylin analogue, mostly tested as CagriSema, combined with semaglutide. Their weight results come from separate trials.
Key takeaways
- No head-to-head trial of retatrutide and cagrilintide (or CagriSema) was found. Their results come from separate trials with different people, lengths and ways of reporting.
- Retatrutide is a single peptide that activates three receptors: GIP, GLP-1 and glucagon. Cagrilintide is an amylin analogue. CagriSema combines it with semaglutide, a GLP-1 receptor agonist.
- In TRIUMPH-1 (80 weeks), mean weight change was -17.6% to -25.0% across three retatrutide dose groups versus -3.9% with placebo. In REDEFINE 1 (68 weeks), it was -20.4% with CagriSema versus -3.0% with placebo.
- Neither is approved by any regulator in the sources checked. Novo Nordisk has applied to the US FDA for CagriSema; Eli Lilly plans to apply for retatrutide in early 2027.
- The US FDA says neither can be used in compounding under US federal law. FDA Philippines has warned against two unregistered retatrutide products; no advisory naming cagrilintide was found.
Side by side
| Retatrutide | Cagrilintide | |
|---|---|---|
| Class | Triple GIP, GLP-1 and glucagon receptor agonist (investigational, not approved by any regulator found) | Long-acting amylin analogue (amylin and calcitonin receptor agonist), investigational, not approved by any regulator found |
| FDA Philippines registration | No record found in an FDA Philippines Verification Portal search on October 7, 2026 | No FDA Philippines registration record found for cagrilintide or CagriSema in a verification portal search on 2026-10-07 (portal returned No Record Found; a semaglutide control search returned records). No FDA Philippines advisory or statement on cagrilintide was found. Not approved by any regulator found (Novo Nordisk, 2025-12-18 and 2026-09-30) |
| Evidence | Phase 3 human trials | Phase 3 human trials |
| Prescription needed | Not confirmed | Not confirmed |
| Registration source date | Checked October 7, 2026 | Checked October 7, 2026 |
No head-to-head trial found
No trial comparing retatrutide with cagrilintide or CagriSema was found in the sources checked. Every number on this page comes from separate trials, run by different companies, in different people, for different lengths of time. Putting the numbers side by side does not show which one causes more weight loss or more side effects.
Both are investigational. Neither had been approved by any regulator in the sources checked on October 7, 2026.
How they work
They act on different hormone systems. Retatrutide is one molecule that hits three receptors. Cagrilintide copies a different hormone, amylin, and is mostly tested in combination with semaglutide.
| Retatrutide | Cagrilintide | CagriSema | |
|---|---|---|---|
| What it is | A single peptide that activates three receptors (a triple agonist) | A long-acting amylin analogue | A fixed-dose combination of cagrilintide with semaglutide |
| Receptors | GIP, GLP-1 and glucagon | Amylin receptors (AMY1R, AMY2R, AMY3R) and the calcitonin receptor | Those of cagrilintide, plus the GLP-1 receptor (semaglutide) |
| Developer | Eli Lilly | Novo Nordisk | Novo Nordisk |
| Research codes | LY3437943 | AM833, NN9833 | NN9838 |
| How it is given in trials | Once-weekly injection under the skin | Once-weekly injection under the skin | Once-weekly injection under the skin |
Retatrutide. It activates the glucose-dependent insulinotropic polypeptide (GIP) receptor, the glucagon-like peptide-1 (GLP-1) receptor and the glucagon receptor. The sources on this page do not describe what activating the glucagon receptor adds in people.
Cagrilintide. Natural amylin is a pancreatic hormone that induces satiety. In mice, cagrilintide lowered body weight and food intake, and the effect depended on amylin receptors 1 and 3 in the brain (an animal finding). Its half-life in a phase 1b study was 159 to 195 hours.
CagriSema. Novo Nordisk describes its two parts as targeting "complementary obesity-related pathways". Because it contains semaglutide, CagriSema results are not cagrilintide-alone results.
The trial programmes
Both have reached phase 3. Most of the large cagrilintide trials test CagriSema rather than cagrilintide alone.
| Retatrutide | Cagrilintide and CagriSema | |
|---|---|---|
| Weight trials (phase 3) | TRIUMPH-1, TRIUMPH-2, TRIUMPH-3, TRIUMPH-4 | REDEFINE 1, REDEFINE 2, REDEFINE 5, plus REDEFINE 4 against tirzepatide |
| Type 2 diabetes trials (phase 3) | TRANSCEND-T2D-1 | REIMAGINE 1, 2 and 3, plus REIMAGINE 4 and 5 against tirzepatide |
| Phase 2 | Obesity trial and type 2 diabetes trial (2023) | Cagrilintide alone (2021) and CagriSema in type 2 diabetes (2023) |
| Heart outcome trial | None recorded here. TRIUMPH-3, a weight trial in people with cardiovascular disease, reported heart event counts (company-reported) | REDEFINE 3 under way, results expected in the second half of 2027 |
| Alone, without a partner drug | Yes, retatrutide is tested on its own | Cagrilintide alone is in phase 3, per Novo Nordisk's pipeline |
| Funding of published trials | Eli Lilly | Novo Nordisk |
Weight results from separate trials
Both lowered weight more than placebo in their own trials. These are not head-to-head results. Retatrutide figures are listed by dose group, lowest to highest, without dose amounts.
| Trial | Medicine | Who took part | Length | Mean weight change | Placebo |
|---|---|---|---|---|---|
| Phase 2 obesity (NEJM 2023) | Retatrutide, four reported dose groups | 338 adults with a BMI of 30 or more, or 27 to under 30 with a weight-related condition | 48 weeks | -8.7%, -17.1%, -22.8%, -24.2% | -2.1% |
| TRIUMPH-1 (NEJM 2026) | Retatrutide, three dose groups | 2,339 adults with obesity, without diabetes | 80 weeks | -17.6%, -23.7%, -25.0% | -3.9% |
| TRIUMPH-4 (Lilly, company-reported, not peer reviewed in the sources checked) | Retatrutide, two dose groups | 445 adults with obesity or overweight and knee osteoarthritis, without diabetes | 68 weeks | -20.0%, -23.7% (treatment-regimen estimand) | -4.6% |
| TRIUMPH-3 (Lilly, company-reported, not peer reviewed in the sources checked) | Retatrutide, two dose groups | 1,949 adults with a BMI of 35 or more and established cardiovascular disease | 80 weeks | -21.6%, -22.6% (efficacy estimand) | -3.2% |
| Phase 2 (Lancet 2021) | Cagrilintide alone, five dose groups | 706 adults without diabetes with obesity, or overweight with high blood pressure or high blood fats | 26 weeks | -6.0% to -10.8% | -3.0% |
| REDEFINE 1, cagrilintide-alone group (Novo Nordisk, company-reported, not in the peer-reviewed abstract) | Cagrilintide alone | 302 adults | 68 weeks | -11.8% (trial product estimand) | Not given in this source |
| REDEFINE 1 (NEJM 2025) | CagriSema | 3,417 adults with obesity, or overweight with a complication, without diabetes | 68 weeks | -20.4% (treatment-policy estimand) | -3.0% |
| REDEFINE 5 (Lancet Diabetes Endocrinol 2026) | CagriSema | 331 adults in Japan and Taiwan with overweight or obesity and complications | 68 weeks | -18.4% (versus -11.9% with semaglutide alone) | Not applicable (compared with semaglutide alone) |
Type 2 diabetes results from separate trials
Both have been studied in adults with type 2 diabetes. Again, these trials were separate and used different comparators.
| Trial | Medicine | Who took part | Length | HbA1c change | Weight change | Comparator |
|---|---|---|---|---|---|---|
| TRIUMPH-2 (Lancet 2026) | Retatrutide, three dose groups | 1,152 adults with a BMI of 27 or more | 80 weeks | Not recorded here | -11.9%, -16.8%, -18.8% | -5.1% with placebo |
| TRANSCEND-T2D-1 (Lancet 2026) | Retatrutide, three dose groups | 537 adults not controlled by diet and exercise | 40 weeks | -1.69, -1.86, -1.94 points | -11.5%, -13.9%, -15.3% | HbA1c -0.81; weight -2.6% with placebo |
| REDEFINE 2 (NEJM 2025) | CagriSema | 1,206 adults with a BMI of 27 or more | 68 weeks | 73.5% reached HbA1c of 6.5% or less | -13.7% | 15.9% and -3.4% with placebo |
| REIMAGINE 1 (Lancet Diabetes Endocrinol 2026) | CagriSema, two dose groups | 189 adults not controlled by diet and exercise | 40 weeks | -1.8 and -1.5 points | -13.8% and -11.8% | HbA1c -0.1; weight -1.4% with placebo |
Low blood sugar. No severe hypoglycaemia was reported in TRANSCEND-T2D-1 or in the retatrutide phase 2 diabetes trial. No level 2 or 3 hypoglycaemia was reported in the CagriSema phase 2 diabetes trial.
Side effects as reported
Stomach and gut side effects were the most common with both. Neither has an approved label, so side effects come only from trial reports.
| Side effect | Retatrutide | Source | Cagrilintide or CagriSema | Source |
|---|---|---|---|---|
| Nausea | 28.6%, 38.4%, 42.4% vs 14.8% placebo | TRIUMPH-1, Lilly-reported | Cagrilintide alone: 20% to 47% vs 18% | Phase 2 |
| Nausea | 14% to 28% vs 8% | TRIUMPH-2 | CagriSema: 55% vs 12.6% | REDEFINE 1, as reported by Novo Nordisk |
| Vomiting | 10.6%, 22.8%, 25.3% vs 4.8% | TRIUMPH-1, Lilly-reported | CagriSema: 26.1% vs 4.1% | REDEFINE 1, as reported by Novo Nordisk |
| Diarrhoea | 27% to 34% vs 13% | TRIUMPH-2 | Cagrilintide alone: 15.6% vs 12.9% | REDEFINE 1, company-reported, not in the peer-reviewed abstract |
| Any gastrointestinal side effect | Mild to moderate gastrointestinal events in 35% | Retatrutide phase 2 diabetes trial | CagriSema: 79.6% vs 39.9%. Cagrilintide alone: 41% to 63% vs 32% | REDEFINE 1; phase 2 |
| Dysesthesia (abnormal skin sensations) | 5.1%, 12.3%, 12.5% vs 0.9% | TRIUMPH-1, Lilly-reported | Not recorded here | |
| Low blood pressure | 1%, 5%, 6% vs under 1% | TRIUMPH-2 | Not recorded here | |
| Heart rate and rhythm | Rose with dose, peaked at 24 weeks, then declined | Retatrutide phase 2 obesity trial | Cagrilintide did not cause clinically relevant QT prolongation in 105 healthy people | Thorough QT study |
| Stopped because of side effects | 4.1%, 6.9%, 11.3% vs 4.9% | TRIUMPH-1, Lilly-reported | CagriSema: 5.9% vs 3.5% | REDEFINE 1, as reported by Novo Nordisk |
Lilly-reported figures come from Eli Lilly press releases, and Novo Nordisk figures from its releases; the peer-reviewed abstracts checked do not give them. "Not recorded here" means the fact files behind this page do not record that figure, not that the side effect does not occur.
Injection sites. With cagrilintide alone, administration-site reactions were among the most frequent side effects in its phase 2 trial.
Approval status
Neither is approved. CagriSema has been submitted in the US and is under review in Canada; Eli Lilly plans to submit retatrutide in the US in early 2027.
| Regulator | Retatrutide | Cagrilintide and CagriSema |
|---|---|---|
| US FDA | Not approved. Eli Lilly said on September 29, 2026 that it "plans to submit a Biologics License Application (BLA) in Q1 2027" | CagriSema New Drug Application submitted December 18, 2025. Novo Nordisk said on September 30, 2026 that it expects a decision in the fourth quarter of 2026 |
| Health Canada | Not checked on the regulator's own website | CagriSema listed among new drug submissions under review, accepted March 2026 (page modified September 24, 2026) |
| European Union | Not checked on the regulator's own website | Novo Nordisk says its EU pathway is pending the REDEFINE 3 heart outcome trial, expected to read out in the second half of 2027 |
| Company description | Eli Lilly calls it "an investigational molecule that cannot be legally sold or marketed for human use." | On December 18, 2025, Novo Nordisk said "CagriSema is not approved in the US or EU." |
A submission is a request for review, not an approval.
"Research" products and compounding
The US FDA has found products of both, sold with "research" labels, to be unapproved new drugs because their marketing showed they were meant for people.
- Compounding: as of October 1, 2026, the US FDA says: "Retatrutide and cagrilintide cannot be used in compounding under federal law. Additionally, these are not components of FDA-approved drugs and have not been found safe and effective for any condition."
- Retatrutide: the US FDA says it has warned companies that illegally sold unapproved drugs containing retatrutide falsely labelled "for research purposes" or "not for human consumption", and urges consumers not to buy these products, "which are of unknown quality and may be harmful to their health."
- Cagrilintide: in December 2024 and March 2026, the US FDA found that cagrilintide products sold online as research chemicals were unapproved new drugs, because the sellers' websites showed they were meant for human use.
No regulator or peer-reviewed report testing the contents of "research" cagrilintide products was found.
Sport and anti-doping
Cagrilintide is not named on the WADA Prohibited List for 2026 or 2027, but it may be prohibited under class S0, non-approved substances. Retatrutide is not named on the 2026 or 2027 lists either, and WADA has not said whether it falls under S0.
- What S0 covers: substances with "no current approval by any governmental regulatory health authority for human therapeutic use", with "drugs under pre-clinical or clinical development" among WADA's examples. S0 is prohibited at all times. The 2027 list adds "peptides" to the examples.
- WADA's warning: "Even if a peptide is not specifically named on the List, utmost caution should be taken as it may still be prohibited and may be harmful to health."
- Not in the Monitoring Program: USADA lists semaglutide and tirzepatide in the WADA 2027 Monitoring Program. Cagrilintide is not listed in it. Retatrutide is not in the WADA 2026 Monitoring Program, which covers semaglutide and tirzepatide, and USADA's 2027 summary does not name it.
Neither retatrutide nor cagrilintide is approved anywhere in the sources checked. Athletes should check with their national anti-doping organisation before using any investigational substance.
Legal status in the Philippines
No FDA Philippines registration record was found for either in verification portal searches on October 7, 2026, and they have different advisory histories.
| Retatrutide | Cagrilintide and CagriSema | |
|---|---|---|
| Registration search | No registration record was found in an FDA Philippines Verification Portal search on October 7, 2026 | The verification portal returned "No Record Found" for both names on October 7, 2026, while a semaglutide control search returned records |
| FDA Philippines advisories | Two: No.2026-1265 (September 16, 2026) and No.2026-1392 (September 22, 2026), each on an unregistered retatrutide product with no Certificate of Product Registration | None found in searches of the FDA Philippines website on October 7, 2026 |
| Prescription classification | No Philippine source found | No Philippine source found |
FDA Philippines said the public has no assurance of the quality, safety and efficacy of the unregistered retatrutide products, and that using them may expose people to potential health risks, including possible injury or harm.
The Philippine FDA Act (RA 9711) prohibits the sale, distribution, promotion or advertising of any health product that requires registration but is not registered with FDA Philippines. A missing advisory does not mean a product is registered or approved.
To check any product, search the FDA Philippines verification portal at verification.fda.gov.ph. For more, see are peptides legal in the Philippines and the retatrutide page.
What can and cannot be compared
What can be compared.
- Mechanism. Retatrutide acts on GIP, GLP-1 and glucagon receptors. Cagrilintide acts on amylin and calcitonin receptors; CagriSema adds GLP-1 through semaglutide.
- Stage. Both have phase 3 results. Neither is approved. CagriSema has been submitted to the US FDA; retatrutide has not yet.
- Most common side effects. Gastrointestinal for both.
What cannot be compared directly.
- No head-to-head trial. No trial randomising people to retatrutide versus cagrilintide or CagriSema was found in the sources checked.
- Different lengths. TRIUMPH-1 ran for 80 weeks, REDEFINE 1 for 68 weeks and the cagrilintide phase 2 trial for 26 weeks.
- Different people and placebo results. Each trial had its own entry criteria. Placebo groups changed by -3.9% in TRIUMPH-1 and -3.0% in REDEFINE 1.
- Different ways of reporting. The trials used different estimands, and several results are company-reported and not peer reviewed in the sources checked.
- Combination versus single drug. CagriSema contains semaglutide, so its results are not cagrilintide-alone results.
Trial averages do not predict how any one person will respond, and neither medicine is approved in the sources checked. Questions about approved weight and diabetes medicines are for a licensed doctor; see GLP-1 medicines explained and tirzepatide vs retatrutide.
Frequently asked questions
What is the difference between retatrutide and cagrilintide?
Retatrutide is a single peptide that activates three hormone receptors: GIP, GLP-1 and glucagon. Cagrilintide is a long-acting amylin analogue, built to act like amylin, a pancreatic hormone that induces satiety, and acts on amylin and calcitonin receptors. Both are investigational and given as once-weekly injections in trials.
Has retatrutide been compared with cagrilintide or CagriSema?
No head-to-head trial was found in the sources checked. Each has been tested against placebo or other medicines in its own trials, so their results cannot be compared directly.
Which causes more weight loss, retatrutide or CagriSema?
The sources cannot answer that, because no trial comparing them was found. In separate trials, mean weight change was -17.6% to -25.0% with retatrutide over 80 weeks (TRIUMPH-1) and -20.4% with CagriSema over 68 weeks (REDEFINE 1). The trials enrolled different people for different lengths of time.
Is CagriSema the same as cagrilintide?
No. CagriSema is a fixed-dose combination of cagrilintide with semaglutide. Results for CagriSema reflect both ingredients. Cagrilintide alone has a phase 2 trial and a company-reported group in REDEFINE 1.
Are retatrutide and cagrilintide approved?
Neither was approved in the sources checked on October 7, 2026. Novo Nordisk submitted CagriSema to the US FDA in December 2025. Eli Lilly said in September 2026 that it plans to submit retatrutide to the US FDA in the first quarter of 2027. A submission is a request for review, not an approval.
What side effects were reported?
For both, stomach and gut side effects were the most common, such as nausea and vomiting. Retatrutide trials also reported more abnormal skin sensations (dysesthesia) and, in TRIUMPH-2, more low blood pressure than placebo. Neither has an approved label listing warnings.
Are retatrutide and cagrilintide legal in the Philippines?
No FDA Philippines registration record was found for retatrutide, cagrilintide or CagriSema in FDA Philippines Verification Portal searches on October 7, 2026. FDA Philippines warned the public against two unregistered retatrutide products in September 2026. For cagrilintide, no advisory naming it was found.
Can "research" retatrutide or cagrilintide be sold legally?
In the United States, the US FDA has found products sold as "research" retatrutide and cagrilintide to be unapproved new drugs when their marketing showed they were meant for people. It says neither can be used in compounding under US federal law.
Are retatrutide and cagrilintide banned in sport?
Cagrilintide is not named on the WADA list, but it may be prohibited under class S0, which covers substances with no approval for human use, including drugs in clinical development. Retatrutide is not named on the 2026 or 2027 lists, and WADA has not said whether it falls under S0. Athletes should check with their anti-doping organisation.
Sources
- Jastreboff et al., phase 2 retatrutide obesity trial, New England Journal of Medicine, 2023 (PMID 37366315)
- Rosenstock et al., phase 2 retatrutide type 2 diabetes trial, Lancet, 2023 (PMID 37385280)
- Jastreboff et al., TRIUMPH-1, New England Journal of Medicine, 2026 (PMID 42814954)
- Bellido et al., TRIUMPH-2, Lancet, 2026 (PMID 42810372)
- Bajaj et al., TRANSCEND-T2D-1, Lancet, 2026 (PMID 42250575)
- Eli Lilly press release, TRIUMPH-4 topline results, December 11, 2025
- Eli Lilly press release, TRIUMPH-1 results, May 21, 2026
- Eli Lilly press release, TRIUMPH-3 topline results, July 23, 2026
- Eli Lilly press release, retatrutide results and US submission plans, September 29, 2026
- Lau et al., cagrilintide phase 2 dose-finding trial, Lancet, 2021 (PMID 34798060)
- Structural study of cagrilintide at amylin and calcitonin receptors (PMID 40204768)
- Enebo et al., cagrilintide with semaglutide phase 1b trial, Lancet, 2021 (PMID 33894838)
- Mouse study of cagrilintide and brain amylin receptors (PMID 40609154)
- Thorough QT study of cagrilintide (PMID 39279639)
- Frias et al., CagriSema phase 2 trial in type 2 diabetes, Lancet, 2023 (PMID 37364590)
- Garvey et al., REDEFINE 1, New England Journal of Medicine, 2025 (PMID 40544433)
- Davies et al., REDEFINE 2, New England Journal of Medicine, 2025 (PMID 40544432)
- Yamauchi et al., REDEFINE 5, Lancet Diabetes and Endocrinology, 2026 (PMID 42009015)
- Aroda et al., REIMAGINE 1, Lancet Diabetes and Endocrinology, 2026 (PMID 42251860)
- Cavender et al., REDEFINE 3 trial design, American Heart Journal, 2026 (PMID 42838477)
- Novo Nordisk, CagriSema submitted to the US FDA, December 18, 2025
- Novo Nordisk, Q2 2026 investor presentation
- Novo Nordisk press release, CagriSema at EASD 2026, September 30, 2026
- Health Canada, new drug submissions under review (modified September 24, 2026)
- US FDA, FDA's Concerns with Unapproved GLP-1 Drugs Used for Weight Loss (current as of October 1, 2026)
- WADA, 2026 Prohibited List
- WADA, 2027 Prohibited List
- WADA, 2026 Monitoring Program
- WADA, 2027 Prohibited List explanatory note
- USADA, athlete advisory on the 2027 Prohibited List
- FDA Philippines, FDA Advisory No.2026-1265, September 16, 2026
- FDA Philippines, FDA Advisory No.2026-1392, September 22, 2026
- FDA Philippines, site search for retatrutide (opened October 7, 2026)
- FDA Philippines, site search for cagrilintide (opened October 7, 2026)
- FDA Philippines Verification Portal, search for retatrutide, October 7, 2026
- FDA Philippines, verification portal search for cagrilintide (October 7, 2026)
- FDA Philippines, verification portal search for CagriSema (October 7, 2026)
- Food and Drug Administration Act of 2009 (RA 9711), Lawphil
Related reading
This content is for education only and is not medical advice. Talk to a licensed doctor before starting any treatment.