These are the next big shots from the two companies that dominate obesity medicine — and neither is approved yet. CagriSema (Novo Nordisk) combines two drugs in one weekly injection: semaglutide, the GLP-1 drug in Ozempic and Wegovy, plus cagrilintide, which mimics amylin, a fullness hormone. Retatrutide (Eli Lilly) is a single molecule that activates three receptors: GLP-1, GIP and glucagon. [2]
The numbers, side by side
Different trials, populations, durations and methods — not a head-to-head. Both "everyone who started" figures (treatment-policy / treatment-regimen estimands) and "if everyone stayed on treatment" figures are shown so you can compare like with like. REDEFINE 1 also used flexible dosing: only 57.3% of CagriSema participants were on the top 2.4/2.4 mg dose at week 68.
[3]| CagriSema 2.4/2.4 mg — REDEFINE 1 [1] | Retatrutide 12 mg — TRIUMPH-1 | |
|---|---|---|
| Status | Investigational — FDA decision expected Q4 2026 [5] | Investigational — submission planned Q1 2027 |
| Approach | Two drugs combined (GLP-1 + amylin) | One molecule, three receptors |
| Duration | 68 weeks | 80 weeks |
| Mean weight loss (everyone who started) | 20.4% (vs 3.0% placebo) | ~25.0% [8] |
| If everyone stayed on treatment | 22.7% (vs 2.3% placebo) [2] | 28.3% [7] |
The one head-to-head that does exist for CagriSema is against Lilly's tirzepatide, not retatrutide: in REDEFINE 4 (84 weeks), CagriSema did not meet its goal of being non-inferior to tirzepatide 15 mg — 20.2% vs 23.6% on the treatment-regimen estimand. [4] For how tirzepatide compares with retatrutide, see retatrutide vs tirzepatide.
Side effects
Both drugs show the incretin-class stomach effects, and both are dose-escalated slowly to manage them.
| % of participants | CagriSema — REDEFINE 1 [2] | Retatrutide 12 mg — TRIUMPH-1 [8] |
|---|---|---|
| Nausea | 55.0% (vs 12.6% placebo) | 42.4% |
| Vomiting | 26.1% (vs 4.1%) | 25.3% |
| Constipation | 30.7% (vs 11.6%) | 26.1% |
| Stopped because of side effects | 5.9% (vs 3.7%) | 11.3% (vs 4.9%) |
Retatrutide also carries a dysesthesia (skin sensation) signal — see retatrutide side effects.
Where each stands with the FDA
ConfirmedNovo Nordisk submitted CagriSema to the FDA on December 18, 2025. [6] ProjectedNovo says it expects a decision in Q4 2026; Lilly plans to submit retatrutide in Q1 2027 — company guidance, not commitments. [5] Track every confirmed retatrutide milestone on the FDA approval tracker.
Until either is approved, the GLP-1 medications you can actually be prescribed are semaglutide, tirzepatide and the two new pills — see retatrutide vs weight-loss pills, the RetaMaps provider directory, and every matchup on one page: retatrutide vs other weight-loss drugs. Or get an email when retatrutide's status changes.