Cagrilintide, explained: the amylin analogue beside the GLP-1s

Cagrilintide is a long-acting synthetic analogue of amylin, a pancreatic hormone, and it acts at amylin and calcitonin receptors rather than at the GLP-1 or GIP receptors. It appears in GLP-1 conversations because it has been developed in combination with semaglutide, but on its own it belongs to a different receptor family entirely. It is not a licensed medicine and Biovanta does not supply it.

What amylin is

Amylin is a 37-amino-acid peptide hormone made by the beta cells of the pancreas, the same cells that make insulin. The 2015 review by Hay and colleagues in Pharmacological Reviews covers its pharmacology and receptors in detail.

Natural amylin has a practical problem for anyone trying to make a stable analogue of it: it has a strong tendency to form amyloid fibrils, insoluble aggregates that make it a difficult starting point for drug design. An earlier amylin analogue, pramlintide, is an approved medicine but short-acting. Cagrilintide was developed from the pramlintide backbone as a stable, long-acting analogue.

What cagrilintide is, chemically

Kruse and colleagues described its development in the Journal of Medicinal Chemistry in 2021. The structural details that matter:

• Backbone. It is built on the pramlintide backbone, 37 residues, with a disulphide bridge between the cysteines at positions 2 and 7 and an amidated C-terminus, like the amylin family generally.
• Anti-fibril substitutions. Two helix-stabilising substitutions, N14E and V17R, were introduced to counteract amyloid fibril formation.
• Half-life extension. The lysine at position 1 carries a C20 fatty diacid through a gamma-glutamate linker. Lipidation is the same half-life strategy used in semaglutide and tirzepatide, where the fatty-acid chain binds albumin in the blood.

PubChem gives a molecular formula of C194H312N54O59S2 and a molecular weight of about 4,409 Da. That puts it in the same size range as the incretin analogues: a little heavier than semaglutide (about 4,114 Da) and lighter than retatrutide (about 4,731 Da).

The amylin receptor, and why it is unusual

This is the part most comparison pages skip, and it is the part that explains why cagrilintide is not "another GLP-1".

The GLP-1, GIP and glucagon receptors are each defined by one receptor protein. The amylin receptor is defined by two. According to the International Union of Basic and Clinical Pharmacology's review of this family (Hay et al., 2018), amylin receptors are complexes of two proteins:

RAMPs, receptor activity-modifying proteins, are small accessory proteins that change which peptides the calcitonin receptor responds to. The same core receptor, paired with a different RAMP, becomes a different receptor.

Cagrilintide activates all of these. Cryo-electron microscopy structures published by Cao and colleagues in Nature Communications in 2025 show it bound to all three amylin receptors and to the calcitonin receptor alone, with an amylin-like binding mode but distinct conformational dynamics. That is why the literature describes it as an amylin and calcitonin receptor agonist, not a selective amylin agonist.

Retatrutide vs cagrilintide

These two are often searched together because both sit at the front of the same field, but they do not overlap at the receptor level at all.

Retatrutide is one molecule engineered to reach three receptors that each respond to their own gut or pancreatic hormone. Cagrilintide reaches a different family of receptors, and its development pairs it with a separate GLP-1 molecule rather than building both activities into one chain. Retatrutide, explained. The GLP-1 side of the picture, one, two and three receptors, is in semaglutide vs tirzepatide vs retatrutide.

Where the evidence is published

The clinical programme is mostly the combination with semaglutide, sometimes called CagriSema. By design:

• REDEFINE 1 (Garvey et al., New England Journal of Medicine, 2025): phase 3a, 68 weeks, double-blind, in adults without diabetes with obesity or overweight plus a related condition. Four arms: the combination, semaglutide alone, cagrilintide alone and placebo. The co-primary end points were relative change in body weight and the share of participants reaching a 5% reduction.
• REDEFINE 2 (Davies et al., New England Journal of Medicine, 2025): phase 3a, 68 weeks, placebo-controlled, in adults with type 2 diabetes and a body-mass index of 27 or more, across 12 countries.

We cite these rather than quote their numbers. Figures from one trial set next to figures from another, with different populations and designs, are not a comparison.

Regulatory status

Cagrilintide on its own holds no marketing authorisation anywhere that we could find.

The cagrilintide–semaglutide combination was submitted to the FDA as a new drug application on 18 December 2025, according to the manufacturer's announcement, which said the FDA was expected to review it in 2026. As of 25 September 2026 we have not found a published FDA decision, and we have found no UK or EU authorisation. We will update this page when that changes. If you are reading this later, check the regulator, not us.

In the UK that makes cagrilintide an investigational compound, not a medicine. What "approved", "licensed" and "neither" each mean.

Where Biovanta stands

Biovanta does not supply cagrilintide, alone or in combination. What Biovanta supplies in the neighbouring incretin family is tirzepatide and retatrutide, for in-vitro laboratory research only. The other new name in that conversation, a GLP-1 receptor agonist that is not a peptide at all, is covered in orforglipron, explained.