The first detailed results of the REIMAGINE trials of cagrilintide and semaglutide for type 2 diabetes management will be unveiled in New Orleans during the 2026 Scientific Sessions of the American Diabetes® Association (ADA). The combination, termed CagriSema, was submitted to the U.S. Food and Drug Administration (FDA) for weight loss in late 2025.
“CagriSema is a play to increase the efficacy of semaglutide for weight loss and for A1C reduction in the setting of type 2 diabetes,” said John B. Buse, MD, PhD, the Verne S. Caviness Distinguished Professor of Medicine at the University of North Carolina School of Medicine. “The combination of cagrilintide, an amylin receptor agonist, and semaglutide, the well-known GLP-1 (glucagon-like peptide-1) receptor agonist, is using two different mechanisms of action that may be additive in a number of ways. These studies represent a dedicated program in type 2 diabetes where A1C was the primary outcome.”
Dr. Buse will chair a symposium exploring REIMAGINE 1, 2, 3: Leveraging Amylin and GLP-1 for Type 2 Diabetes Care with CagriSema on Sunday, June 7 from 4:30–6:00 p.m. in Great Hall A of the Ernest N. Morial Convention Center. This symposium will be the first detailed look at data and findings from the trials. On-demand access to recorded presentations will be available to registered participants following the conclusion of the 2026 Scientific Sessions, from June 10–August 10.
Cagrilintide is a long-acting analog of amylin, a peptide hormone co-secreted with insulin with broad effects on satiety, gastrointestinal motility, glucagon secretion, bone, muscle, fat, and the cardiovascular system.
“What started out as a peptide initially identified in islet amyloid deposits in type 2 diabetes, hence the name, has now come full circle from being a pathological entity to showing value in the treatment of people with type 2 diabetes,” said Steven Kahn, MB, ChB, the Leonard L. Wright and Marjorie C. Wright Chair and Director of the Diabetes Research Center at the University of Washington. “This is another great example of what science can do to improve health.”
REIMAGINE 1 evaluated CagriSema as monotherapy for individuals living with type 2 diabetes who are drug-naïve and have not responded adequately to lifestyle therapy.
“This trial gives us a very clean look and profile of what the medication can do in this very early treatment population,” said Vanita R. Aroda, MD, Director of Diabetes Clinical Research at Brigham and Women’s Hospital and Associate Professor of Medicine at Harvard Medical School. “The areas of interest are the effects on glycemia, body weight, and cardiovascular risk markers. Uniquely, it had a time period at the end of the study where study medication was discontinued for 12 weeks, then reassessed to see if the treatment effects persisted. That, in essence, is looking at the ADA criteria of diabetes remission.”
Amylin is not a novel hormone, Dr. Aroda added. One of the first incretin agents, exenatide, was approved by the FDA in 2005, as was the first synthetic analogue of amylin, pramlintide.
“We’ve known about amylin for a long time, but it’s time to revisit what its role might be in human pathology,” Dr. Aroda said. “The symposium will provide a broad understanding, from amylin biology to potential translation to clinical care via the phase 3 trials.”
REIMAGINE 2 compared CagriSema versus its individual components, cagrilintide and two semaglutide doses, and placebo in a population living with type 2 diabetes on metformin with or without a sodium-glucose cotransporter-2 (SGLT2) inhibitor. Topline results released earlier in 2026 showed reductions in A1C and body weight. CagriSema showed better glycemic management and weight loss than either of its components as single agents.
“We will be looking at some very interesting data on A1C and weight reduction [during the symposium],” said Akshay Jain, MD, FRCPC, FACE, CCD, ECNU, DABIM, DABOM, Clinical Instructor in Medicine at the University of British Columbia, Canada. “And we’ll be looking at cardiovascular risk markers as well, things like blood pressure, CRP (C-reactive protein) levels, and the highly anticipated safety data.”
Dr. Buse added that some data suggest adding cagrilintide could allow a lower dose of semaglutide with fewer unpleasant gastrointestinal side effects without sacrificing the benefits of glycemic management and weight loss.
REIMAGINE 3 explored CagriSema as an add-on to basal insulin for individuals living with type 2 diabetes with or without metformin.
“Glycemic control in people with long-standing type 2 diabetes on basal insulin therapy has been challenging due to insulin titration inertia, but many also need additional therapy,” said Julio Rosenstock, MD, Clinical Professor of Medicine at Texas Southwestern Medical Center. “It has been nicely demonstrated that adding a GLP-1 RA is highly effective in improving glucose control with some weight loss, but the combination of semaglutide and amylin in CagriSema shown in REIMAGINE 3 is taking the management to the next level in terms of demonstrating stronger A1C reductions to below target levels associated with very robust weight loss.”
Dr. Jain noted that semaglutide is one of the most talked about and most commonly used type 2 diabetes medications with multiple benefits at the moment.
“This symposium will further establish what additional benefits one can get on top of the old faithful, semaglutide, if we add an amylin component,” he said.
Register Today for the 2026 Scientific Sessions
Register to join us in New Orleans June 5–8 to learn about the latest advances in diabetes research, prevention, and care. After the meeting, registered participants will have on-demand access to recorded presentations.
