Efficacy and Safety of Cagrilintide Alone and in Combination with Semaglutide (Cagrisema) as Anti-Obesity Medications: A Systematic Review and Meta-Analysis.

No meta-analysis has analysed role of cagrilintide as weight-loss medication in obese individuals. Electronic databases were searched for RCTs involving obese individuals receiving cagrilintide or cagrilintide-2.4 mg with semaglutide-2.4 mg combination (Cagrisema) compared to placebo/active comparator. Primary outcomes were changes in body weight; secondary outcomes were alterations in glycemia, lipids, and adverse events. From 678 articles, data from 3 RCTs involving 430 individuals were analysed. At 20-32 weeks, patients receiving Cagrisema weekly had significantly greater percentage [mean difference (MD)-9.07% (95%CI: -11.91, -6.23); P < 0.00001;I ² = 96%] and absolute [MD-9.11 kg (95%CI: -12.84, -5.39); P < 0.00001; I ² = 98%] weight-loss, compared to semaglutide 2.4 mg weekly. At 26-32 weeks, cagrilintide 2.4 mg had a similar percentage [MD - 1.83% (95%CI: -4.08, -0.42); P = 0.11; I ² = 98%] and absolute [MD - 1.88 kg (95%CI: -4.23,0.47); P = 0.12; I ² = 98%] weight-loss, compared to semaglutide/liraglutide. Treatment-emergent and serious adverse events were comparable between groups. Gastrointestinal adverse events and vomiting were significantly higher with Cagrisema compared to semaglutide. Vomiting was significantly lower with cagrilintide compared to semaglutide/liraglutide. Cagrisema outperforms semaglutide regarding weight loss. Cagrilintide shows comparable weight loss to semaglutide/liraglutide with significantly lower vomiting.