Insights from the REIMAGINE Trial: Robust Glycaemic Control and Meaningful Weight Loss with Cagri Sema Across DiverseT2D Population

by Prateek Chopra | June 29, 2026 | Diabetes Conferences | ADA 2026

Therapy Overview

CagriSema is a fixed-dose combination of the amylin receptor agonist cagrilintide and the GLP-1 receptor agonist semaglutide.
The REIMAGINE clinical trial programme evaluated its efficacy and safety across different stages of type 2 diabetes (T2D).

REIMAGINE Trial Programme

REIMAGINE 1: Adults with early-stage T2D inadequately controlled with diet and exercise.
REIMAGINE 2: Individuals with T2D and overweight/obesity receiving metformin with or without an SGLT2 inhibitor.
REIMAGINE 3: Patients with long-standing T2D receiving basal insulin therapy.

Glycemic Outcomes

In REIMAGINE 1, CagriSema reduced HbA1c by up to 1.8% versus placebo.
In REIMAGINE 2, CagriSema 2.4 mg/2.4 mg achieved greater HbA1c reduction than semaglutide 2.4 mg alone (−1.9% vs −1.5%; p<0.0035).
In REIMAGINE 3, mean HbA1c decreased from 8.8% to 6.5%.

Weight Loss Outcomes

REIMAGINE 1:
- Body weight reduction of up to 13.8%.
REIMAGINE 3:
- Weight reduction of up to 12% in individuals receiving basal insulin.
Consistent and clinically meaningful weight loss was observed across all studies.

Benefits in Insulin-Treated T2D

Significant HbA1c and weight improvements were achieved without increasing insulin requirements.
No increase in severe hypoglycemia was observed.

Safety Profile

Gastrointestinal events were the most commonly reported adverse events.
No new safety signals were identified across the programme.

Clinical Implications

Combined amylin and GLP-1 receptor agonism provided greater glycemic improvement than GLP-1 receptor agonist therapy alone.
CagriSema demonstrated efficacy across a broad spectrum of T2D, from early disease to advanced insulin-treated diabetes.

The REIMAGINE programme showed that CagriSema delivers substantial improvements in glycemic control and body weight across diverse T2D populations. Its consistent efficacy and favorable safety profile support its potential as a comprehensive treatment option for type 2 diabetes management.