{
  "abstract": "Background: Once-weekly cagrilintide-semaglutide (CagriSema) has been evaluated at two maintenance doses, 2.4/2.4 mg and 1.0/1.0 mg, in type 2 diabetes (T2DM), but they have not been directly compared. We compared their efficacy and safety. Methods: We searched PubMed, Embase, and Cochrane CENTRAL for randomized controlled trials (RCTs) comparing both doses. Contrasts derived from arm-level estimates were pooled using random-effects models. Primary outcomes were interpreted against prespecified minimally important differences (MIDs) of 3 percentage points (pp) for body weight and 0.3 pp (3.3 mmol/mol) for glycated hemoglobin (HbA1c). Results: Three trials (1,506 participants) were included. CagriSema 2.4/2.4 mg produced a greater reduction in body weight (mean difference [MD] -2.07 pp; 95% confidence interval [CI] -2.91 to -1.24), with the entire CI below the MID, and higher proportions achieving reductions of [≥]10% (64.9% vs. 55.1%) and [≥]15% (41.9% vs. 30.9%). The difference in HbA1c was not statistically significant (MD -0.16 pp [-1.7 mmol/mol]; 95% CI -0.43 to 0.10 [-4.7 to 1.1 mmol/mol]). The higher dose increased gastrointestinal disorders (64.8% vs. 53.2%; risk ratio 1.22; 95% CI 1.12 to 1.32), without differences in serious adverse events or adverse events leading to treatment discontinuation. Certainty of evidence was high for body weight and moderate for HbA1c. Conclusions: CagriSema 2.4/2.4 mg provided additional weight loss smaller than the MID, no clear HbA1c benefit, and more gastrointestinal adverse events than 1.0/1.0 mg, supporting individualized dose selection.",
  "abstract_shown": true,
  "affiliations": [
    "Universidade Federal do Rio Grande do Sul"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "B. M. Diefenthaeler"
    },
    {
      "name": "L. E. d. Canto"
    },
    {
      "name": "G. M. Pretto"
    },
    {
      "name": "H. C. Malta"
    },
    {
      "name": "G. L. Noll"
    },
    {
      "name": "L. d. O. Magalhaes"
    },
    {
      "name": "G. G. d. Santos"
    },
    {
      "name": "F. Gerchman"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/cds3v95dm66yn.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.10.30.26366916",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.10.30.26366916v1.full",
  "id": "cds3v95dm66yn",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.10.30.26366916v1",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "endocrinology"
    ]
  ],
  "openalex": null,
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.10.30.26366916v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-30",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/cds3v95dm66yn.ris",
  "sources": [
    {
      "first_seen": "2026-11-02T12:20:44Z",
      "native_id": "10.64898/2026.10.30.26366916",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.10.30.26366916v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:endocrinology",
      "subfield": "endocrinology-metabolism"
    }
  ],
  "title": "CagriSema 2.4/2.4 mg versus CagriSema 1.0/1.0 mg in adults with type 2 diabetes: a dose-comparison systematic review and meta-analysis of randomized controlled trials",
  "title_text": "CagriSema 2.4/2.4 mg versus CagriSema 1.0/1.0 mg in adults with type 2 diabetes: a dose-comparison systematic review and meta-analysis of randomized controlled trials",
  "type": "preprint",
  "updated_at": "2026-11-03T00:20:22Z",
  "url": "https://research.draconitic.com/paper/cds3v95dm66yn",
  "venue": "medRxiv",
  "versions": []
}