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Both are investigational combinations that pair an amylin-pathway medicine with incretin drugs, but they are at different stages of development. CagriSema has reported Phase 3 results, and Novo Nordisk said it submitted a US FDA application for weight management in December 2025. EloraTZP has reported Phase 2b results, with Lilly planning to begin Phase 3 studies in the fourth quarter of 2026. Their reported weight-loss percentages come from different trials and cannot establish which combination works better.
What are CagriSema and EloraTZP?
Both candidates are designed to influence appetite- and metabolism-related hormone pathways, but they combine different medicines. The proposed logic is to pair amylin-pathway activity with incretin activity. The trial results may show whether that approach merits further study; they do not yet establish what either treatment’s eventual approved use, benefits, or risks would be.
CagriSema combines cagrilintide and semaglutide
CagriSema is Novo Nordisk’s once-weekly fixed-dose injectable combination. In the pivotal regimen described by the company, it contains cagrilintide 2.4 mg, a long-acting amylin analogue, and semaglutide 2.4 mg, a GLP-1 receptor agonist. Novo’s December 2025 US application sought weight-management use alongside reduced-calorie eating and increased physical activity.
EloraTZP combines eloralintide and tirzepatide
EloraTZP is Lilly’s investigational combination of eloralintide, a selective amylin receptor agonist, and tirzepatide, which activates GIP and GLP-1 receptors. Lilly describes the intended combination as acting on three nutrient-stimulated hormone pathways: amylin, GIP, and GLP-1. In the reported 48-week Phase 2b study, the drugs were given as separate injections; Lilly said a co-formulation would be advanced into Phase 3.
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What have the trials reported?
The table summarizes the principal results reported by the developers through October 3, 2026. It puts findings side by side for orientation only: these were not trials comparing CagriSema directly with EloraTZP.
| Measure | CagriSema | EloraTZP |
|---|---|---|
| Developer and ingredients | Novo Nordisk; cagrilintide plus semaglutide. | Eli Lilly and Company; eloralintide plus tirzepatide. |
| Hormone targets | Amylin pathway and GLP-1 receptor. | Amylin receptor, GIP receptor, and GLP-1 receptor. |
| Combination form | Once-weekly fixed-dose injectable combination in the pivotal regimen described by Novo. | Separate injections in the reported Phase 2b study; Lilly said it would advance a co-formulation into Phase 3. |
| Development stage | Phase 3 results reported; Novo said it submitted a US FDA weight-management application in December 2025. The review outcome was not established in the sources available by October 3, 2026. | Phase 2b combination results reported; Lilly said it planned to begin Phase 3 studies in Q4 2026. |
| Main trial population and duration | REDEFINE 1: 68 weeks in adults with obesity or overweight plus a weight-related complication, without diabetes. REDEFINE 4: 84 weeks in people with obesity and at least one comorbidity. | 48 weeks in 367 adults with obesity or overweight and type 2 diabetes. |
| Dose and comparator | REDEFINE 1: the cited pivotal combination regimen was cagrilintide 2.4 mg plus semaglutide 2.4 mg, compared with placebo. REDEFINE 4: CagriSema 2.4 mg/2.4 mg compared with tirzepatide 15 mg. | The highest-dose reported combination was eloralintide 9 mg plus tirzepatide 15 mg; the reported active comparator was tirzepatide 15 mg alone. |
| Weight outcome and analysis | REDEFINE 1: 22.7% at 68 weeks under the trial-product estimand, which assumes participants stayed on treatment and used no other weight-loss therapies; 20.4% under the treatment-policy estimand, which evaluates the effect regardless of whether participants remained on treatment. REDEFINE 4: 23.0% for CagriSema versus 25.5% for tirzepatide under the protocol efficacy estimand; 20.2% versus 23.6% under the treatment-regimen estimand. Novo said CagriSema did not meet REDEFINE 4’s primary non-inferiority endpoint. | 23.3% at 48 weeks in the highest-dose combination arm under Lilly’s reported efficacy estimand; tirzepatide 15 mg alone showed 14.8% in that study. |
| A1C outcome | Not stated for the cited REDEFINE 1 results (Novo Nordisk, 2025). | In the highest-dose combination arm, a 2.9 percentage-point reduction at 48 weeks; tirzepatide 15 mg alone showed a 2.4 percentage-point reduction (Eli Lilly and Company, 2026). |
| Gastrointestinal events and discontinuations | In REDEFINE 1, nausea occurred in 55.0% with CagriSema versus 12.6% with placebo; constipation in 30.7% versus 11.6%; vomiting in 26.1% versus 4.1%. Discontinuation due to adverse events was 5.9% versus 3.5%. | Gastrointestinal events were the most common adverse events, generally mild or moderate and primarily during dose escalation. Adverse-event discontinuation was 10.8%–27.0% across combination arms; the release reported 0%–10.8% for eloralintide, 2.9% for tirzepatide, and 16.7% for placebo. |
The REDEFINE 1, REDEFINE 4, and EloraTZP figures above are developer-reported trial results: Novo Nordisk’s 2025 and 2026 reports and Eli Lilly and Company’s 2026 report, respectively. Their different populations, durations, comparators, doses, and analysis methods mean the table is not a head-to-head efficacy or tolerability ranking.
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Why are the combinations attracting attention?
Each program tests whether adding an amylin-pathway medicine to incretin treatment can produce a useful combination effect. CagriSema pairs a long-acting amylin analogue with a GLP-1 receptor agonist; EloraTZP pairs a selective amylin receptor agonist with a medicine that activates both GIP and GLP-1 receptors. That distinction matters: these are not interchangeable versions of the same drug combination, and a result for one cannot establish the effect of the other.
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1Scan for outdated or missing drivers - takes under a minute2Clear out junk files and repair common Windows errors3Fix the driver behind crashes, sound loss and screen glitchesThe reported results give both programs a reason to continue clinical development, while leaving important questions open. For CagriSema, Novo’s Phase 3 program includes both a placebo-controlled result and a direct comparison with tirzepatide. The latter is especially informative about how CagriSema performed against that specific comparator and regimen, but it did not meet its stated primary non-inferiority endpoint. In September 2026, Novo also announced topline findings from REIMAGINE 5 and REDEFINE 9, describing superior weight loss for CagriSema 1.0 mg/1.0 mg versus tirzepatide 5 mg. The announcement excerpt available here does not provide enough detail on populations, estimands, or statistics to extend that finding beyond those lower-dose comparisons.
EloraTZP’s reported combination evidence is earlier-stage and comes from participants with type 2 diabetes. Its weight and A1C findings address outcomes in that study population, but they are not a completed Phase 3 result and cannot be compared directly with CagriSema’s separate obesity trial.
What do the results say about safety and tolerability?
Both developers reported gastrointestinal adverse events, but trial-specific rates should not be used to rank the candidates against each other. Differences in trial design, participants, dosing, and reporting can affect the observed rates.
For EloraTZP, Lilly said gastrointestinal events were more frequent in combination arms than with either medicine alone, and occurred primarily during dose escalation. The company described them as generally mild or moderate. The reported discontinuation ranges are relevant to tolerability in those particular study arms, but do not predict what would happen in a larger Phase 3 population or in routine use.
Are either CagriSema or EloraTZP approved or available?
No approval or routine availability for either combination is established by the reports summarized here. Novo said it submitted a US FDA application for CagriSema weight management in December 2025 and stated then that the medicine was not approved in the US or EU. The FDA review outcome was not established in the cited sources by October 3, 2026. Lilly described EloraTZP as investigational and said its combination would proceed to planned Phase 3 studies; it is not an approved treatment on the evidence covered here.
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Eloralintide alone is also being studied in Phase 3, but that monotherapy program is separate from EloraTZP’s combination development stage. Neither program’s trial announcements determine a final label, eventual availability, price, or place in treatment.
What would establish which combination works better?
A meaningful comparison would require a randomized head-to-head study with comparable participants, doses, treatment duration, outcome definitions, and analysis methods. It would also need to report enough information about benefits and harms to judge both weight outcomes and tolerability. Until such evidence is available, the reported percentages answer different trial questions, not the question of which candidate is superior.
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