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CagriSema produced unprecedented mean weight loss of 20.4% at 68 weeks on an intent-to-treat basis, significantly exceeding semaglutide alone (14.9%), cagrilintide alone (11.5%), and placebo (3.0%)

This is the pharmacological basis for the safety discussion that follows and the reason copper balance, not peptide kinetics, is the parameter that ought to anchor any thinking about systemic exposure

Its also associated with pulmonary disease

Proposed Mechanisms Preventing GABA receptor downregulation Counteracting compensatory NMDA glutamate receptor sensitization Stabilizing benzodiazepine receptor configuration (preventing shift to inverse agonist state) Upregulating GABAergic neurotransmission through pathways distinct from benzodiazepine action itself This tolerance prevention has profound clinical implications