Novo Nordisk's next-generation experimental drug, CagriSema, delivered an estimated average weight loss of 12.4% in a late-stage trial in patients with diabetes, outperforming Eli Lilly's rival drug, the company said.

The results mark a significant moment for Novo, who views CagriSema as a successor to its blockbuster weight-loss drug, Wegovy, which faces a looming patent expiration after 2030.¹ A win against Eli Lilly is expected to help the Danish drugmaker make up ground it’s lost to its rival in the fast-growing weight-loss market, particularly after CagriSema fell short of Lilly's Zepbound on weight loss in a head-to-head trial earlier this year.¹

What is CagriSema?

CagriSema is a weekly injection that combines cagrilintide, which mimics the pancreatic hormone amylin, and semaglutide, the active ingredient in Wegovy.¹ The company submitted an NDA to FDA for the treatment back in December 2025.

At Novo's capital markets day, the company detailed a multi-year rollout for its next-generation obesity injectables, targeting a launch of its CagriSema combination early next year.² A decision from FDA on the company's application for CagriSema for weight management is expected later in the fourth quarter.¹

What did the trial show?

In the late-stage study, a 1 mg dose of CagriSema showed superior results to Lilly's tirzepatide at 5 mg for weight loss, said Novo.¹ Tirzepatide, the active ingredient in Lilly's diabetes drug Mounjaro and obesity drug Zepbound, showed a weight loss of 9.1% in the comparison. In patients with diabetes, CagriSema also demonstrated non-inferior blood sugar reduction compared to Lilly's tirzepatide.¹

In another late-stage study, CagriSema displayed a 21% weight loss at a 1.0 mg dose compared to placebo in adults with obesity.¹

While the low-dose data is encouraging, the findings were less impactful given that tirzepatide has already been proven superior to higher doses of CagriSema in obesity, says Evan Seigerman, an analyst at BMO.¹

The data arrives as Novo works to reestablish its footing in the obesity market against Lilly, which has taken share with tirzepatide-based Mounjaro and Zepbound.¹

Novo's U.S.-listed shares were down more than 4% before the bell Monday morning as analysts questioned the drugmaker's pricing power and dealmaking strategy ahead of looming patent expirations on its existing obesity franchise.¹

What comes next?

With FDA's decision on CagriSema for weight management expected in the fourth quarter, and a launch targeted for early next year, the coming months will test whether the trial data is enough to shift momentum in the obesity drug race. Novo's broader multi-year rollout of next-generation obesity injectables suggests the company is betting on a pipeline of successors to Wegovy rather than a single product to defend its position, as Lilly continues to expand its own tirzepatide-based franchise ahead of Novo's approaching patent cliff.²

"If we can zoom in on individual patients and support individual patients in a better way with the help of data and AI, I think that will have a huge impact in the pharma industry,” former Novo Nordisk Chief Digital Information Officer and current Advisory Board Member at causaLens, Anders Romare told Pharmaceutical Executive in an interview.

Sources

1. Novo says CagriSema shows greater weight loss than Lilly rival in diabetes patients Reuters September 21, 2026, https://www.reuters.com/business/healthcare-pharmaceuticals/novo-says-its-next-gen-obesity-drug-tops-lilly-rival-late-stage-study-2026-09-21/
2. Novo Nordisk aims to launch more than five blockbuster drugs by 2030, CEO says Reuters September 21,2026, https://finance.yahoo.com/healthcare/articles/novo-nordisk-aims-launch-more-095031273.html?guccounter=1