Cagrilintide
Long-acting analog of the pancreatic hormone amylin; engages both amylin and calcitonin receptors and reduces food intake via central amylin signaling, particularly in the area postrema and nucleus of the solitary tract.
Cagrilintide is a long-acting analog of human amylin (islet amyloid polypeptide), the 37-residue hormone co-secreted with insulin from pancreatic beta cells. Native amylin has a short circulating half-life and tends to aggregate; Cagrilintide carries amino-acid substitutions to abolish aggregation and a C20 fatty-acid modification to extend half-life into the weekly-dosing range.
The receptor pharmacology is more complex than a single-target peptide. Cagrilintide engages both the amylin receptors (heterodimers of the calcitonin receptor with RAMP1/2/3) and, at higher concentrations, the calcitonin receptor directly. The dominant in-vivo effects — reduction of food intake, slowing of gastric emptying, suppression of postprandial glucagon — appear to be driven through CNS amylin signaling in the area postrema and the nucleus of the solitary tract.
In clinical development, Cagrilintide is most prominent as part of the fixed-ratio combination CagriSema (Cagrilintide + Semaglutide), which has reported larger weight reductions than either monotherapy in trials. Cagrilintide alone is not currently approved as a standalone therapeutic.