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Multidiscipline review for NDA 210557

Long-Term Maintenance of Weight Loss

Yes, pregnancy increases sensitivity to iron

Lower cagrilintide doses in combinations When combining, can reduce cagrilintide: 1.8mg cagrilintide + 2.4mg semaglutide: Still very effective (14-18% weight loss estimated) Better tolerated than both at 2.4mg Cost savings on cagrilintide Consider if GI-sensitive 1.2mg cagrilintide + 2.4mg semaglutide: Modest benefit from cagrilintide addition Minimal GI side effects from cagrilintide Semaglutide does heavy lifting May still achieve 12-15% total weight loss Testing approach: Start with standard doses (both 2.4mg) If intolerable, reduce cagrilintide first Maintain semaglutide at 2.4mg (well-tolerated, established) Find optimal cagrilintide dose for your tolerance Maintenance dosing after weight loss Strategies to sustain results long-term

Studies on combination anti-pain therapy have been around for a long time