Danish drugmaker Novo Nordisk unveiled back-to-back real-world data supporting the competitiveness of its flagship product Wegovy (semaglutide) and clinical results for next-generation obesity and diabetes treatments at the American Diabetes Association Scientific Sessions (ADA 2026) held in New Orleans, U.S., from the 5th to the 8th (local time).
In particular, by disclosing development results for next-generation therapies aimed at stronger weight loss and blood sugar control, analysts said the company is fleshing out its "post-Wegovy" strategy.
At the meeting, Novo Nordisk presented: ▲ a real-world study (COMPETE SWITCH) comparing increasing Wegovy (semaglutide) to 2 mg versus switching to Eli Lilly and Company's diabetes and obesity drugs Mounjaro and zepbound (tirzepatide); ▲ phase 3 trials (REIMAGINE 1–3) of CagriSema, which combines an amylin analog with a GLP-1 receptor agonist; and ▲ phase 2 results for the next-generation dual-acting investigational drug Zenagamtide.
First, in a study comparing the effects of increasing the dose for patients on Wegovy versus switching to the rival product Mounjaro, the blood sugar target achievement rate after one year was similar at 74.7% and 75.1%, respectively.
The proportion achieving at least 5% weight loss was higher in the Wegovy dose-escalation group (60.5%) than in the Mounjaro switch group (55.3%). The researchers said the results show the validity of a strategy that maximizes the dose of the existing therapy.
Novo Nordisk also released phase 3 results for CagriSema, a next-generation obesity and diabetes treatment candidate. CagriSema is a once-weekly injection that adds the action of the appetite-regulating hormone amylin to semaglutide, the active ingredient in Wegovy. The industry views it as a next-generation flagship candidate to succeed Wegovy.
In the study of 2,713 patients with type 2 diabetes, CagriSema showed superior blood sugar control and weight loss compared with semaglutide monotherapy.
After 68 weeks, hemoglobin A1c (HbA1c) decreased by 1.91 percentage points, outperforming the semaglutide-only group (down 1.75 percentage points), and weight fell 14.2%, a larger drop than the semaglutide-only group (10.2%).
In other phase 3 studies involving patients who struggled to control blood sugar with diet and exercise alone and those using insulin, CagriSema also met key endpoints. In particular, in the study of patients on insulin therapy, HbA1c fell by 2.33 percentage points and weight dropped 12.0%, confirming consistent effects.
However, gastrointestinal adverse events such as nausea and vomiting occurred more frequently than in the semaglutide monotherapy group. Accordingly, the proportion of patients who discontinued treatment was somewhat higher in the CagriSema group. The results were published simultaneously in the medical journals "The Lancet" and "The Lancet Diabetes & Endocrinology."
Another next-generation candidate, Zenagamtide, also drew attention.
Zenagamtide is a next-generation therapeutic candidate that combines in a single drug two mechanisms used to treat obesity and diabetes. While CagriSema is a combination product of two components, Zenagamtide is characterized by delivering the same effect with a single molecule.
In a phase 2 trial of 262 patients with type 2 diabetes, the highest-dose group saw HbA1c decrease by 1.71 percentage points after 36 weeks and weight fall by 14.6%. The rate of achieving the blood sugar target (HbA1c below 7%) reached 89.1%.
Notably, the weight-loss effect did not taper off by the end of the study, earning reviews that it suggested the possibility of further reduction. Novo Nordisk plans to begin phase 3 trials in the second half of this year in patients with type 2 diabetes.