At EASD in Milan, Novo's CagriSema (semaglutide plus cagrilintide) showed 22.4% weight loss at one year, with an FDA decision expected by the end of 2026. Lilly's eloralintide plus tirzepatide reached 23% versus 14.8% on tirzepatide alone. Zealand's petrelintide, an amylin analogue on its own, gave 10% versus 1.7% on placebo (The Lancet, Sep 29). Separately, Lilly's oral Foundayo (orforglipron) matched insulin glargine on heart safety in the ACHIEVE-4 trial of more than 2,700 high-risk people with type 2 diabetes (MACE HR 0.84, 95% CI 0.59 to 1.2).
Why it matters
Weight loss in the low 20s is now a class effect, so the next question is what kind of weight is lost. Lean mass, tolerability and price will decide which patients get which drug. A pill with a clean cardiovascular record changes access for patients who will never inject.
Originally published in The Longevity Medicine Intelligence newsletter.
