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TNX-102 SL

Phase 3

Primary Fibromyalgia | Small molecule | Musculoskeletal |Tonix Pharmaceuticals Holding Corp.|Last Updated: Jun 2, 2026

Target and mechanism

ModalitySmall molecule

Also known as TNX-102 SL Tablet

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLED
Total Trials3
Total Enrollment738

FDA Designations

No designations recorded

Clinical trial landscape

TNX-102 SL · 16 trials · 21 indications

Phase 3 7Phase 2 5Phase 1 4
NCT05273749A Phase 3 Study to Evaluate the Efficacy and Safety of TNX-102 SL Taken Daily in Patients With FibromyalgiaFibromyalgia
COMPLETED457 Analytics
NCT04508621A Phase 3 Study To Evaluate The Efficacy And Safety Of TNX-102 SL In Patients With FibromyalgiaFibromyalgia
COMPLETED514 Analytics
NCT04172831A Study To Evaluate The Efficacy And Safety Of TNX-102 SL In Patients With FibromyalgiaFibromyalgia
COMPLETED503 Analytics
NCT03508700A 40-week Study to Evaluate TNX-102 SL 5.6 mg Taken Daily at Bedtime in Patients With PTSDPTSD
COMPLETED93 Analytics
NCT02589275A 3-Month Open-Label Safety and Efficacy Study of TNX-102 SL Tablets in Fibromyalgia PatientsPrimary Fibromyalgia
COMPLETED375 Analytics
NCT02436096A Study to Evaluate eFFIcacy and Safety of Sublingual TNX-102 SL Tablet Taken at Bedtime in Patients With fibRoMyalgiaFibromyalgia
COMPLETED519 Analytics
NCT0201523412-Month Open-Label Long-term Safety Study of TNX-102 SL Tablets in Fibromyalgia PatientsPrimary Fibromyalgia
COMPLETED158 Analytics
PHASE3COMPLETED
A Phase 3 Study to Evaluate the Efficacy and Safety of TNX-102 SL Taken Daily in Patients With Fibromyalgia
FibromyalgiaUnlock trial analytics
PHASE3COMPLETED
A Phase 3 Study To Evaluate The Efficacy And Safety Of TNX-102 SL In Patients With Fibromyalgia
FibromyalgiaUnlock trial analytics
PHASE3COMPLETED
A Study To Evaluate The Efficacy And Safety Of TNX-102 SL In Patients With Fibromyalgia
FibromyalgiaUnlock trial analytics
PHASE3COMPLETED
A 40-week Study to Evaluate TNX-102 SL 5.6 mg Taken Daily at Bedtime in Patients With PTSD
PTSDUnlock trial analytics
PHASE3COMPLETED
A 3-Month Open-Label Safety and Efficacy Study of TNX-102 SL Tablets in Fibromyalgia Patients
Primary FibromyalgiaUnlock trial analytics
PHASE3COMPLETED
A Study to Evaluate eFFIcacy and Safety of Sublingual TNX-102 SL Tablet Taken at Bedtime in Patients With fibRoMyalgia
FibromyalgiaUnlock trial analytics
PHASE3COMPLETED
12-Month Open-Label Long-term Safety Study of TNX-102 SL Tablets in Fibromyalgia Patients
Primary FibromyalgiaUnlock trial analytics

Study Endpoints

Primary Endpoints

Change From Baseline to the Week 14 Endpoint in the Diary NRS Weekly Average of Daily Self Reported Average Pain Severity Scores.
Baseline (Day -7 to Day -1), Week 14

Change from Baseline to the Week 14 endpoint in the diary Numerical Rating Scale (NRS) weekly average of daily self-reported average pain severity scores. Scores range from 0 to 10 where a higher score means worse outcome.

Change From Baseline to Week 14 in the Numerical Rating Scale (NRS) Weekly Average of Daily Self-reported Average Pain Severity Scores.
14 weeks

Patients provide a daily numeric assessment of their average pain (24-hour recall), via an electronic diary, using an 11-point NRS. Scores range from 0 (no pain) to 10 (worst possible pain).

Incidence of Newly Emergent Adverse Events
40 weeks

Evaluate the incidence of newly emergent adverse events over an additional 40 weeks of treatment with TNX-102 SL 5.6 mg in patients with PTSD who have participated in a double-blinded lead-in study. Adverse events will be coded using the latest version of the Medical Dictionary for Regulatory Activities (MedDRA) and will be summarized overall and by preferred term and system organ class. Serious AEs and AEs leading to discontinuation of study drug will also be summarized.

Newly Emergent Adverse Events
Up to 3 months from first dose

The number of patients with at least one adverse event which began after the first dose of TNX-102 SL in this open-label extension study.

Proportion of Patients With ≥30% Pain Improvement
Day 1, Week 12

The primary efficacy endpoint is the proportion of patients with a ≥30% improvement (responder criteria) from baseline to Week 12 in the weekly mean of the daily self-reported 24-hour recall average pain intensity score using an 11-point (0-10) NRS. Scores range from 0 (no pain) to 10 (worst possible pain).

Newly-emergent Adverse Events (NEAEs) During Treatment With TNX-102 SL Tablets Taken Daily at Bedtime Over 12 Months in Patients With Fibromyalgia.
Up to 12 months

NEAEs and Serious Adverse events (SAEs) were collected and are coded using the latest version of the Medical Dictionary for Regulatory Activities (MedDRA).

Change from Baseline (Visit 2) in the MADRS total score at Week 6.
From Day 1 to Week 6

Change from Baseline (Visit 2) in the MADRS total score at Week 6. Scores range from 0 to 60. Lower scores indicate less depression.

Daily Diary Pain NRS
Week 14

Change from Baseline in the diary Numeric Rating Scale (NRS) weekly average of daily self-reported worst Long COVID pain intensity scores at the Week 14 endpoint. Scores range from 0 to 10 where a higher score means worse outcome.

Newly Treatment Emergent Adverse Events
Week 12

Number of patients with new treatment emergent AEs since completing lead-in study

The Mean Change From Baseline (Visit 2) in the Total CAPS-5 Score After 12 Weeks of Treatment Evaluated at Visit 9 (Week 12).
Day 1, Week 12

The mean change from baseline (Visit 2) in the Total CAPS-5 score after 12 weeks of treatment evaluated at Visit 9 (Week 12). The primary efficacy comparison will be the change from baseline in total CAPS-5 score for the 2.8 mg treatment arm compared to placebo. CAPS-5 score ranges from 0-80 with lower scores indicating less severe PTSD symptoms.

Mean Change From Baseline in Weekly Average of Daily Pain Scores at Week 12
Baseline, Week 12

Daily pain scores were assessed using a 24-hour recall response provided by each patient via an interactive voice response system (IVRS) daily telephone diary. Average daily pain was measured using an 11-point (0-10) numerical rating scale (NRS), with higher scores representing worse pain. Jump to control was used to replace missing data in each treatment arm.

AUC0-inf: Area Under the curve from time zero to infinity
From dosing day to end of treatment at 16 days
AUC0-t: Area Under the Curve from time zero to the last measurable concentration
From dosing day to end of treatment at 16 days
Cmax: Maximum Plasma Concentration
From dosing day to end of treatment at 16 days
AUC0-∞: Area Under the curve from time zero to infinity
Total study duration for a participant is up to 72 days, which includes the screening period
AUC0-t: Area under the concentration-time zero to the last measurable concentration
Total study duration for a participant is up to 72 days, which includes the screening period
Cmax: Maximum concentration
Total study duration for a participant is up to 72 days, which includes the screening period
Tmax: Time to maximum concentration
Total study duration for a participant is up to 72 days, which includes the screening period
t1/2: Half - life
Total study duration for a participant is up to 72 days, which includes the screening period
λz: Elimination Rate Constant
Total study duration for a participant is up to 72 days, which includes the screening period
Area Under the Plasma Concentration Versus Time Curve (AUC) of TNX-102 SL 5.6 mg versus TNX-102 SL 2.8 mg under fasting conditions
Day 1 to Day 6

Blood samples are collected from pre-dose on Day 1 up until Day 6 (144 hours post-dose)

Area Under the Plasma Concentration Versus Time Curve (AUC) of TNX-102 SL 5.6 mg versus TNX-102 SL 5.6 mg under fed conditions
Day 1 to Day 6

Blood samples are collected from pre-dose on Day 1 up until Day 6 (144 hours post-dose)

Number of Subjects With Treatment-Emergent Adverse Events (TEAEs) of TNX-102 SL 2.8 mg versus TNX-102 SL 5.6 mg under fasting conditions
Day 1 to Day 15

Blood samples are collected from pre-dose on Day 1 up until Day 15 (360 hours post-dose)

Number of Subjects With Treatment-Emergent Adverse Events (TEAEs) of TNX-102 SL 5.6 mg under fasted and fed conditions
Day 1 to Day 15

Blood samples are collected from pre-dose on Day 1 up until Day 15 (360 hours post-dose)

Steady-State Area Under the Plasma Concentration Versus Time Curve (AUC-ss) of TNX-102 SL 5.6 mg versus AMRIX 30 mg
Day 1 to Day 27

Blood samples are collected from pre-dose on Day 1 up until Day 27 (168 hours post-last dose).

Peak Steady-State Plasma Concentration (Cmax-ss) of TNX-102 SL 5.6 mg versus AMRIX 30 mg
Day 1 to Day 27

Blood samples are collected from pre-dose on Day 1 up until Day 27 (168 hours post-dose).

Number of Subjects With Treatment-Emergent Adverse Events (TEAEs) of TNX-102 SL 5.6 mg versus AMRIX 30 mg
Day 1 to Day 47

TEAEs will be collected throughout the study and are summarized descriptively by treatment, relationship, and severity for all subjects dosed.

Peak Steady-State Plasma Concentration (Cmax-ss) of norcyclobenzaprine from TNX-102 SL 5.6 mg versus AMRIX 30 mg
Day 1 to Day 47

Blood samples are collected from pre-dose on Day 1 up until Day 47 (648 hours post-last dose).

Secondary Endpoints

Proportion of Patients With a Patient's Global Impression of Change (PGIC) Rating of "Very Much Improved" or "Much Improved" at the Week 14 Endpoint
Week 14
Change From Baseline in the Fibromyalgia Impact Questionnaire - Revised (FIQ-R) Symptoms Domain Score at the Week 14 Endpoint
Day 1, Week 14
Change From Baseline in the FIQ-R Function Domain Score at the Week 14 Endpoint
Day 1, Week 14
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Study Design & Arms

AllocationRANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
TNX-102 SL Tablet, 5.6 mgEXPERIMENTAL1 x TNX-102 SL 2.8 mg Tablet taken sublingually each day at bedtime for 2 weeks, then 2 x TNX-102 SL 2.8 mg (5.6 mg) Tablet taken sublingually each day at bedtime for 12 weeks.
Placebo SL TabletPLACEBO_COMPARATOR1 x Placebo Tablet taken sublingually each day at bedtime for 2 weeks, then 2 x Placebo Tablet taken sublingually each day at bedtime for 12 weeks.
TNX-102 SL Tablets, 5.6 mgEXPERIMENTAL1 x TNX-102 SL 2.8 mg Tablet taken sublingually each day at bedtime for 2 weeks then 2 x TNX-102 SL 2.8 mg (5.6 mg) Tablet taken sublingually each day at bedtime for 12 weeks.
TNX-102 SL 5.6 mgEXPERIMENTAL2 tablets of TNX-102 SL 2.8 mg taken simultaneously and sublingually (under the tongue) each day at bedtime starting on Day 0 for 40 weeks
TNX-102 SL Tablet 2.8 mgEXPERIMENTAL1x TNX-102 SL 2.8 mg sublingual tablet taken daily at bedtime for 3 months
TNX-102 SL Tablet, 2.8 mgEXPERIMENTAL1 x TNX-102 SL 2.8mg Tablet taken sublingually each day at bedtime for 12 weeks
TNX-102 SLEXPERIMENTAL1x TNX-102 SL 2.8 mg sublingual tablet taken daily at bedtime for 12 months
Placebo sublingual tabletsPLACEBO_COMPARATORParticipants will take placebo ( 2 x placebo sublingual tablets) daily at bedtime.
PlaceboPLACEBO_COMPARATOR2 x placebo tablet ("placebo") to be taken sublingually once daily at bedtime.
TNX-102 SL, 2.8 mgACTIVE_COMPARATOR1 x TNX-102 SL 2.8mg tablet ("TNX-102 SL") and 1 x placebo tablet ("placebo") to be taken sublingually once daily at bedtime.
TNX-102 SL, 5.6 mgACTIVE_COMPARATOR2 x TNX-102 SL 2.8mg tablets ("TNX-102 SL") to be taken sublingually once daily at bedtime.
TNX-102 SL 2.8 mgEXPERIMENTALPatients will take 1 tablet of TNX-102 SL sublingually each day at bedtime for 12 weeks.
A single 2.8 mg dose of TNX-102 SL, administered as one 2.8 mg sublingual tabletEXPERIMENTAL -
A single 5.6 mg dose of TNX-102 SL, administered as two 2.8 mg sublingual tabletsEXPERIMENTAL -
Treatment AEXPERIMENTALTNX-102 SL 2.8 mg, under fasting conditions
Treatment BEXPERIMENTALTNX-102 SL 5.6 mg (2 x 2.8 mg sublingual tablets), under fasting conditions
Treatment CEXPERIMENTALTNX-102 SL 5.6 mg (2 x 2.8 mg sublingual tablets), under fed conditions
Treatment A (TNX-102 SL)EXPERIMENTAL2 x TNX-102 SL (cyclobenzaprine HCl sublingual tablets) 2.8 mg once daily for 20 consecutive days
Treatment B (AMRIX)ACTIVE_COMPARATOR1 x AMRIX ER capsule 30 mg once daily for 20 consecutive days

Interventions

NameTypeDescription
TNX-102 SL Tablet, 5.6 mgDRUGPatients will take 1 tablet of randomly assigned study drug sublingually starting on Day 1 for 2 weeks. At the Week 2 visit, all patients will have the dose increased to 2 tablets for 12 weeks.
Placebo SL TabletDRUGPatients will take 1 tablet of randomly assigned study drug sublingually starting on Day 1 for 2 weeks. At the Week 2 visit, all patients will have the dose increased to 2 tablets for 12 weeks.
TNX-102 SLDRUGPatients will take 1 tablet of randomly assigned study drug sublingually starting on Day 1 for 2 weeks. At the Week 2 visit, all patient will have the dose increased to 2 tablets for 12 weeks.
TNX-102 SL 5.6 mgDRUGcyclobenzaprine HCl sublingual tablets
TNX-102 SL Tablet 2.8 mgDRUGTNX-102 SL 2.8 mg tablet taken daily at bedtime
TNX-102 SL Tablet, 2.8mgDRUGPatients will take 1 tablet of randomly assigned study drug sublingually each day at bedtime starting on Day 1 for 12 weeks.
Placebo sublingual tabletDRUGParticipants will take placebo ( 2 x placebo sublingual tablets) daily at bedtime.
PlaceboDRUG -
TNX-102 SL 2.8mgDRUGPatients will take 1 tablet of randomly assigned study drug sublingually each day at bedtime starting on Day 0 for 12 weeks.
TNX-102 SL TabletDRUGCYCLOBENZAPRINE HYDROCHLORIDE SUBLINGUAL TABLET
Amrix 30 mgDRUGSubjects randomly assigned to this treatment will swallow 1 capsules with a cup of water, and not to crush or chew it.
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Eligibility Criteria

Age Range18 Years to 65 Years
SexALL
Healthy VolunteersNo
Study Sites33

Inclusion Criteria: * The patient is male or female 18 to 65 years of age, inclusive. * The patient has a diagnosis of primary FM as defined by the 2016 Revisions to the 2010/2011 fibromyalgia diagnostic criteria (American College of Rheumatology Preliminary Diagnostic Criteria) Exclusion Criteria...

Countries:United StatesCanada
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Recent Changes (Last 90 Days)

LOWJun 2, 2026NCT07621237NEW_TRIAL: changed
LOWJun 2, 2026NCT07621237NEW_TRIAL: changed
LOWJun 2, 2026NCT07621237NEW_TRIAL: changed

Frequently asked questions about TNX-102 SL

What is TNX-102 SL used for?

TNX-102 SL is an investigational small molecule being developed for primary fibromyalgia, a chronic musculoskeletal condition. It is also being studied for post-acute sequelae of SARS-CoV-2 infection (PASC), major depressive episodes, and post-traumatic stress disorder (PTSD). The drug is administered as a sublingual tablet.

Who makes TNX-102 SL?

TNX-102 SL is being developed by Tonix Pharmaceuticals Holding Corp., a biopharmaceutical company traded on NASDAQ under the ticker TNXP. The company is conducting clinical trials to evaluate the drug's safety and efficacy in several patient populations.

What phase is TNX-102 SL in?

TNX-102 SL is in Phase 3 clinical development. It has completed Phase 2 and Phase 3 trials, including a Phase 2 study in fibromyalgia and a Phase 3 long-term safety study. The drug remains investigational and has not been approved by regulatory authorities.

What clinical trials is TNX-102 SL in?

TNX-102 SL has been studied in four clinical trials. These include NCT01903265, a Phase 2 study in fibromyalgia; NCT02015234, a Phase 3 open-label safety study; NCT02277704, a Phase 2 study in PTSD; and NCT02589275, a Phase 3 open-label study in fibromyalgia. All trials have been completed.

Is TNX-102 SL the same as TNX-102 SL Tablet?

Yes, TNX-102 SL is also known as TNX-102 SL Tablet. The drug is formulated as a sublingual tablet, which is placed under the tongue for absorption. This alternative name is used in clinical trial documentation and regulatory filings.

What does TNX-102 SL target?

TNX-102 SL is a small molecule, but its specific molecular target is not disclosed in the available information. The drug is being evaluated for its effects on fibromyalgia, PTSD, and other conditions, suggesting it may act on pathways relevant to these disorders.