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AMIRAVOResearch Library

Cagrilintide vs eloralintide

Cagrilintide and eloralintide are both long-acting, investigational amylin analogues being studied for obesity 1,2. Cagrilintide is described as a non-selective amylin and calcitonin receptor agonist, whereas eloralintide was designed to act preferentially at the amylin 1 receptor 3,4. Neither had a Drugs@FDA application record on 24 October 2026 5,6. The only direct comparison identified is preclinical (rats and monkeys) 4.

Unbranded reference vial illustrating Cagrilintide; not an actual product
Cagrilintide
Investigational
Unbranded reference vial illustrating Eloralintide; not an actual product
Eloralintide
Investigational

Side by side

FieldCagrilintideEloralintide
ClassLong-acting amylin analogue; amylin and calcitonin receptor agonist (investigational) 1,3Selective amylin receptor agonist (investigational) 2
Origin and structureStable, lipidated analogue of the pancreatic hormone amylin 737-amino-acid amidated polypeptide in which amylin's disulfide bridge is replaced by a methylene thioacetal bridge, with a C20 fatty diacid at lysine 26 4
Proposed mechanismAmylin-like binding at amylin receptors 1 to 3 and the calcitonin receptor 3; in mice, body-weight effects depended on amylin receptors 1 and 3 8In cell assays, activated the human amylin 1 receptor about 12-fold more potently than the calcitonin receptor and 11-fold more than the amylin 3 receptor 4
Half-life159 to 195 hours in a phase 1b trial with co-administered semaglutide 9310 to 366 hours (12.9 to 15.3 days) after single doses in a phase 1 trial in healthy participants 4
Highest human trial phasePhase 3 (comparator arm and combination trials; 22 phase 3 registry entries) 10,11Phase 3 trials registered and recruiting (e.g. ENLIGHTEN-1) 12; phase 2 published 2
FDA statusNot approved; no Drugs@FDA application record as of 24 October 2026 5Not approved; no Drugs@FDA application record as of 24 October 2026 6
Published human outcomesPhase 2: -6.0% to -10.8% vs -3.0% with placebo at 26 weeks 1Phase 2: -9% to -20% vs -0.4% with placebo at 48 weeks (efficacy estimand) 2
Safety signalsGastrointestinal events (nausea 20% to 47% vs 18%) and administration-site reactions 1Nausea and fatigue were most common (fatigue up to 46% vs 12% with placebo) 2; four phase 1 participants reported mood-related events 13
WADA statusNot named on the 2026 Prohibited List; class S0 covers drugs under clinical development with no current approval by any governmental health authority 14Not named on the 2026 Prohibited List; class S0 covers drugs under clinical development with no current approval by any governmental health authority 14
Who funded the evidenceNovo Nordisk 1,9Eli Lilly 2,4

Cagrilintide: what the data says

Cagrilintide has been studied alone and with semaglutide; the trials reviewed were funded by Novo Nordisk 1,10,15.

  • In a 26-week phase 2 trial (human data), mean body-weight change ranged from -6.0% to -10.8% across five doses vs -3.0% with placebo; gastrointestinal events affected 41% to 63% vs 32% 1.
  • In a 32-week phase 2 trial in type 2 diabetes (human data), cagrilintide alone changed body weight by -8.1% and HbA1c by -0.9 percentage points 15.
  • In mice lacking amylin receptors 1 and 3 (animal data), cagrilintide's body-weight effect was reduced 8.

Eloralintide: what the data says

Eloralintide is developed by Eli Lilly and has phase 3 trials recruiting 12.

  • In a 48-week phase 2 trial in 263 US adults with obesity or overweight (human data), mean body-weight change ranged from -9% to -20% across doses and escalation schemes vs -0.4% with placebo 2.
  • In a 12-week phase 1 study (100 participants; human data), gastrointestinal events were infrequent (diarrhoea 10%, nausea 8%), while decreased appetite, headache and fatigue were the most common adverse events 16.
  • In lean rats (animal data), eloralintide caused less conditioned taste avoidance than cagrilintide 4.

Key research differences

  • Receptor selectivity: eloralintide preferentially activates the amylin 1 receptor in cell assays, whereas cagrilintide acts at amylin receptors and the calcitonin receptor 3,4.
  • Half-life: 310 to 366 hours for eloralintide in phase 1 vs 159 to 195 hours for cagrilintide in phase 1b, measured in different study designs 4,9.
  • Preclinical head-to-head: in rats, eloralintide produced less conditioned taste avoidance than cagrilintide, and in rats and monkeys it showed longer half-life and flatter concentration curves (animal data) 4.
  • Development stage: cagrilintide has completed phase 3 trials mainly as part of the CagriSema combination, while eloralintide's phase 3 trials were recruiting in 2026 10,12.
  • Developers: cagrilintide is a Novo Nordisk compound and eloralintide an Eli Lilly compound 1,2.

Where the evidence is limited

No human head-to-head trial was identified; the only direct comparison is in rats and monkeys (animal data) 4. The phase 2 trials differ in length (26 vs 48 weeks), population and estimand, and the cagrilintide half-life was measured while it was given with semaglutide 1,2,9. Each programme was funded by its developer 1,2.

Frequently asked questions

What is the difference between cagrilintide and eloralintide?
Both are long-acting amylin analogues. Eloralintide was designed to act preferentially at the amylin 1 receptor, whereas cagrilintide also activates the calcitonin receptor 3,4.
Does eloralintide lead to more body-weight change than cagrilintide?
This has not been tested in humans. Their phase 2 trials differed in length and design, so their percentages cannot be compared directly 1,2.
Are cagrilintide or eloralintide approved?
No. Neither had a Drugs@FDA application record on 24 October 2026, and both are in phase 3 development 5,6,11,12.

References

  1. Once-weekly cagrilintide for weight management in people with overweight and obesity: a multicentre, randomised, double-blind, placebo-controlled and active-controlled, dose-finding phase 2 trial Lancet. 2021
  2. Eloralintide, a selective amylin receptor agonist for the treatment of obesity: a 48-week phase 2, multicentre, double-blind, randomised, placebo-controlled trial Lancet. 2025
  3. Structural and dynamic features of cagrilintide binding to calcitonin and amylin receptors Nat Commun. 2025
  4. Eloralintide (LY3841136), a novel amylin receptor agonist for the treatment of obesity: From discovery to clinical proof of concept (full text) Mol Metab. 2025
  5. Drugs@FDA application data queried through openFDA for cagrilintide (no matching application record returned on 24 October 2026) openFDA / Drugs@FDA. 2026
  6. Drugs@FDA application data queried through openFDA for eloralintide (no matching application record returned on 24 October 2026) openFDA / Drugs@FDA. 2026
  7. Development of Cagrilintide, a Long-Acting Amylin Analogue J Med Chem. 2021
  8. Cagrilintide lowers bodyweight through brain amylin receptors 1 and 3 EBioMedicine. 2025
  9. Safety, tolerability, pharmacokinetics, and pharmacodynamics of concomitant administration of multiple doses of cagrilintide with semaglutide 2.4 mg for weight management: a randomised, controlled, phase 1b trial Lancet. 2021
  10. Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity (REDEFINE 1) N Engl J Med. 2025
  11. ClinicalTrials.gov registry search for cagrilintide as intervention (44 records, 22 phase 3; retrieved 24 October 2026) ClinicalTrials.gov. 2026
  12. ENLIGHTEN-1: A Study of Eloralintide (LY3841136) in Participants With Obesity, or Overweight Without Type 2 Diabetes (NCT07321886), registry record ClinicalTrials.gov. 2026
  13. Eloralintide, a selective, long-acting amylin receptor agonist for treatment of obesity: Phase 1 proof of concept (full text) Diabetes Obes Metab. 2026
  14. The 2026 Prohibited List - World Anti-Doping Code, as published in the Netherlands Treaty Series (Tractatenblad 2026, 25; Council of Europe Anti-Doping Convention appendix, in force 1 January 2026) Tractatenblad (Official Publications of the Kingdom of the Netherlands). 2026
  15. Efficacy and safety of co-administered once-weekly cagrilintide 2.4 mg with once-weekly semaglutide 2.4 mg in type 2 diabetes: a multicentre, randomised, double-blind, active-controlled, phase 2 trial Lancet. 2023
  16. Eloralintide, a selective, long-acting amylin receptor agonist for treatment of obesity: Phase 1 proof of concept Diabetes Obes Metab. 2026

For research use only. Not for human or veterinary use. Not a drug, food, or dietary supplement. This page compares published research and is not medical advice or a recommendation.