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Cagrilintide, the second generation (2020s) Novo Nordisk took the Pramlintide concept and applied the same half-life extension strategy that they used with Semaglutide: Kept the proline substitutions (anti-amyloid) Added a C20 fatty diacid via a -Glu linker to a lysine residue, albumin binding Additionally stabilized the N- and C-terminal positions Result: Cagrilintide with a half-life of 6.6 days (vs 50 minutes for Pramlintide)

Carnitine enhances metabolism by converting fat cells into energy and prevent them to store as extra fat deposits