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Cagrilintide and semaglutide work through different mechanisms and have different dosing schedules: Cagrilintide: Amylin receptor agonist Escalation: 0.6 mg 1.2 mg 2.4 mg weekly Three-step titration over 8 weeks Semaglutide: GLP-1 receptor agonist Escalation: 0.25 mg 0.5 mg 1.0 mg 1.7 mg 2.4 mg weekly Five-step titration over 16-20 weeks When combined in CagriSema, both peptides are dosed at 2.4 mg weekly, representing the maximum studied dose for each component

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This temporal dissociation suggests that early microglial activation, acting in a neuroprotective fashion, may serve a compensatory or protective role, potentially delaying the onset of clinical symptoms [468]

Jacob 2007