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Cagrilintide vs tirzepatide (Mounjaro/Zepbound) Mechanism: Cagrilintide: Amylin agonist Tirzepatide: Dual GIP/GLP-1 agonist Both novel approaches Weight loss: Cagrilintide: 10-12% monotherapy Tirzepatide: 15-22% monotherapy Tirzepatide superior as single agent Administration: Both: Weekly subcutaneous injection Both: Similar convenience Side effects: Cagrilintide: Strong GI effects Tirzepatide: Moderate GI effects Similar overall profile Approval status: Cagrilintide: Investigational Tirzepatide: FDA approved Tirzepatide available now Cost (when both available): Likely similar ($1,000-1,500/month) Both premium weight loss options Verdict: Currently, tirzepatide better choice (approved, superior weight loss)

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doi: 10.1016/s1050-1738(00)00066-9

These observations imply that MSTN most likely emerged from the ancestral gene to allow more specific control of skeletal muscle growth in vertebrates, although the relatively small amount of information available on the function of invertebrate MSTN/GDF11 limits further interpretation