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Tonix Pharmaceuticals Presents Positive Efficacy and Safety Data from Phase 3 RELIEF Study of TNX-102 SL for the Management of Fibromyalgia at the 5th International Congress on Controversies in Fibromyalgia Interim An

Key Takeaway: Tonix Pharmaceuticals presented favorable efficacy and safety data from the Phase 3 RELIEF Study of TNX-102 SL for fibromyalgia management at a recent congress. The interim analysis indicated that TNX-102 SL met its primary endpoint, showing significant reductions in daily pain compared to placebo. Additionally, the treatment was well-tolerated by participants, with minimal adverse effects noted. The company anticipates further results from the RESILIENT study, which may bolster the drug's development pathway.

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POSITIVE FACTORS

  • TNX-102 SL significantly reduced daily pain compared to placebo.
  • Participants reported higher rates of pain improvement with TNX-102 SL.
  • TNX-102 SL demonstrated well-tolerated safety profile during the trial.
  • Upcoming interim analysis for RESILIENT study may confirm effectiveness.

Full Press Release Details

Tonix Pharmaceuticals Holding Corp. 8-K
Tonix Pharmaceuticals Presents Positive Efficacy
and Safety Data from Phase 3 RELIEF Study of TNX-102 SL for the Management of Fibromyalgia at the 5th International Congress on Controversies
Interim Analysis of RESILIENT, a Potentially
Confirmatory Registration-Enabling Phase 3 Fibromyalgia Trial of TNX-102 SL Expected Second Quarter 2023; Topline Data Expected Fourth
CHATHAM, N.J., March 30, 2023 (GLOBE NEWSWIRE)
- Tonix Pharmaceuticals Holding Corp. (Nasdaq: TNXP) (Tonix or the Company), a clinical-stage biopharmaceutical company, announced
that Seth Lederman, M.D., Chief Executive Officer of Tonix Pharmaceuticals, will present an oral presentation and poster at the 5th
International Congress on Controversies in Fibromyalgia being held March 30-31, 2023 at the Austria Trend Hotel Savoyen
Vienna in Vienna, Austria. The presentation will take place today, Thursday, March 30, 2023 at 5:10-5:20 p.m. CET.
The presentation, titled, "Efficacy and
Safety of TNX-102 SL (Sublingual Cyclobenzaprine) for the Treatment of Fibromyalgia: Results from the Randomized, Placebo Controlled RELIEF
Trial" reports that TNX-102 SL met its pre-specified primary endpoint in the Phase 3 RELIEF trial, significantly reducing daily
pain compared to placebo (p=0.01) in participants with fibromyalgia. Also, when the primary endpoint was analyzed as a 30% pain
responder analysis, there was a higher rate of responders to TNX-102 SL (47%) than to placebo (35%; p=0.006). TNX-102 SL at 5.6 mg also
showed activity in key secondary endpoints demonstrating improvements in sleep quality, mitigation of fatigue, and fibromyalgia-specific
global symptomatic and functional recovery.
Early discontinuation rates were similar for
TNX-102 SL and placebo (17.7% and 16.5%, respectively). In addition, TNX-102 SL was well tolerated with the most common adverse event
from active treatment being oral numbness or hypoaesthesia, an administration site reaction that is typically transient, was never rated
as severe, and only lead to one discontinuation.
"There continues to be a pressing need
for new, safe and more tolerable drugs to treat patients with fibromyalgia," said Dr. Lederman. "We are looking forward to
the results of a planned interim analysis due next quarter for our RESILIENT study, a potentially pivotal confirmatory Phase 3 study of
TNX-102 SL for the management of fibromyalgia."
Copies of the presentation and poster are
available under the Scientific Presentations tab of the Tonix website at www.tonixpharma.com.
In addition to the presentation, the Company's submitted abstract will be published in an online supplement to the journal Clinical
and Experimental Rheumatology in a special issue on Fibromyalgia.
Fibromyalgia is a chronic pain disorder that
is understood to result from amplified sensory and pain signaling within the central nervous system. Fibromyalgia afflicts an estimated
6-12 million adults in the U.S., approximately 90% of whom are women. Symptoms of fibromyalgia include chronic widespread pain, nonrestorative
sleep, fatigue, and morning stiffness. Other associated symptoms include cognitive dysfunction and mood disturbances, including anxiety
and depression. Individuals suffering from fibromyalgia struggle with their daily activities, have impaired quality of life, and frequently
are disabled. Physicians and patients report common dissatisfaction with currently marketed products.
TNX-102 SL is a patented sublingual tablet
formulation of cyclobenzaprine hydrochloride which provides rapid transmucosal absorption and reduced production of a long half-life active
metabolite, norcyclobenzaprine, due to bypass of first-pass hepatic metabolism. As a multifunctional agent with potent binding and antagonist
activities at the 5-HT2A-serotonergic, 1-adrenergic, H1-histaminergic, and M1-muscarinic receptors, TNX-102 SL is in development
as a daily bedtime treatment for fibromyalgia, Long COVID (formally known as post-acute sequelae of COVID-19 [PASC]), alcohol use disorder
and agitation in Alzheimer's disease. The United States Patent and Trademark Office (USPTO) issued United States Patent No. 9636408
in May 2017, Patent No. 9956188 in May 2018, Patent No. 10117936 in November 2018, Patent No. 10,357,465 in July 2019, and Patent No.
10736859 in August 2020. The Protectic protective eutectic and Angstro-Technology formulation claimed in the patent are
important elements of Tonix's proprietary TNX-102 SL composition. These patents are expected to provide TNX-102 SL, upon NDA approval,
with U.S. market exclusivity until 2034/2035.
About the Phase 3 RELIEF Study
The RELIEF study has been completed and TNX-102
SL achieved a statistically significant benefit as measured by the primary, prespecified endpoint of improvement over placebo in daily
pain. The RELIEF study was a double-blind, randomized, placebo-controlled Phase 3 trial designed to evaluate the efficacy and safety of
TNX-102 SL (cyclobenzaprine HCl sublingual tablets) for the management of fibromyalgia. The two-arm trial targeted enrollment of 470 participants,
at approximately 40 U.S. sites. RELIEF completed final enrollment of 503 participants. The first two weeks of treatment were a run-in
period in which participants start on TNX-102 SL 2.8 mg (1 tablet) or placebo. After the first two weeks, all participants had the dose
increased to TNX-102 SL 5.6 mg (2 x 2.8 mg tablets) or two placebo tablets for 12 weeks. The primary endpoint was daily diary pain severity
score change (TNX-102 SL 5.6 mg vs. placebo) from baseline (using the weekly averages of the daily numerical rating scale scores), analyzed
by mixed model repeated measures with multiple imputation.
Additional details about the completed RELIEF
study are available at clinicaltrials.gov (NCT04172831).
Tonix Pharmaceuticals Holding Corp.*
clinical-stage biopharmaceutical company focused on discovering, licensing, acquiring and developing therapeutics to treat and
prevent human disease and alleviate suffering. Tonix's portfolio is composed of central nervous system (CNS), rare disease,
immunology and infectious disease product candidates. Tonix's CNS portfolio includes both small molecules and biologics to
treat pain, neurologic, psychiatric and addiction conditions. Tonix's lead CNS candidate, TNX-102 SL (cyclobenzaprine HCl
sublingual tablet), is in mid-Phase 3 development for the management of fibromyalgia with interim data expected in the second
quarter of 2023. TNX-102 SL is also being developed to treat Long COVID, a chronic post-acute COVID-19 condition, for which a Phase
2 study was initiated in the third quarter of 2022. TNX-1900 (intranasal potentiated oxytocin), a small molecule in development for
chronic migraine, is currently enrolling with interim data expected in the fourth quarter of 2023. TNX-601 ER (tianeptine
hemioxalate extended-release tablets), a once-daily formulation of tianeptine being developed as a treatment for major depressive
disorder (MDD), is also currently enrolling with interim data expected in the fourth quarter of 2023. TNX-1300 (cocaine esterase) is
a biologic designed to treat cocaine intoxication and has been granted Breakthrough Therapy designation by the FDA. A Phase 2 study
of TNX-1300 is expected to be initiated in the second quarter of 2023. Tonix's rare disease portfolio includes TNX-2900
(intranasal potentiated oxytocin) for the treatment of Prader-Willi syndrome. TNX-2900 has been granted Orphan Drug designation by
the FDA. Tonix's immunology portfolio includes biologics to address organ transplant rejection, autoimmunity and cancer,
including TNX-1500, which is a humanized monoclonal antibody targeting CD40-ligand (CD40L or CD154) being developed for the
prevention of allograft and xenograft rejection and for the treatment of autoimmune diseases. A Phase 1 study of TNX-1500 is
expected to be initiated in the second quarter of 2023. Tonix's infectious disease pipeline includes TNX-801, a vaccine in
development to prevent smallpox and mpox, for which a Phase 1 study is expected to be initiated in the second half of 2023. TNX-801
also serves as the live virus vaccine platform or recombinant pox vaccine platform for other infectious diseases. The infectious
disease portfolio also includes TNX-3900, a class of broad-spectrum small molecule oral antivirals.
This press release and further information
about Tonix can be found at www.tonixpharma.com.
Forward Looking Statements
Certain statements in this press release are
forward-looking within the meaning of the Private Securities Litigation Reform Act of 1995. These statements may be identified by the
use of forward-looking words such as "anticipate," "believe," "forecast," "estimate,"
"expect," and "intend," among others. These forward-looking statements are based on Tonix's current expectations
and actual results could differ materially. There are a number of factors that could cause actual events to differ materially from those
indicated by such forward-looking statements. These factors include, but are not limited to, risks related to the failure to obtain FDA
clearances or approvals and noncompliance with FDA regulations; delays and uncertainties caused by the global COVID-19 pandemic; risks
related to the timing and progress of clinical development of our product candidates; our need for additional financing; uncertainties
of patent protection and litigation; uncertainties of government or third party payor reimbursement; limited research and development
efforts and dependence upon third parties; and substantial competition. As with any pharmaceutical under development, there are significant
risks in the development, regulatory approval and commercialization of new products. Tonix does not undertake an obligation to update
or revise any forward-looking statement. Investors should read the risk factors set forth in the Annual Report on Form 10-K for the year
ended December 31, 2022, as filed with the Securities and Exchange Commission (the "SEC") on March 13, 2023, and periodic
reports filed with the SEC on or after the date thereof. All of Tonix's forward-looking statements are expressly qualified by all such
risk factors and other cautionary statements. The information set forth herein speaks only as of the date thereof.
Jessica Morris (corporate)
Tonix Pharmaceuticals
Olipriya Das, Ph.D. (media)

Frequently Asked Questions

What were the results of the Phase 3 RELIEF Study?

TNX-102 SL significantly reduced daily pain in fibromyalgia patients compared to placebo.

When is the interim analysis of the RESILIENT trial expected?

The interim analysis of the RESILIENT trial is expected in the second quarter of 2023.

What are the common side effects of TNX-102 SL?

The most common side effect is oral numbness, which is typically transient.

What is TNX-102 SL used for?

TNX-102 SL is developed for fibromyalgia, Long COVID, and other conditions.

How many participants were in the RELIEF study?

The RELIEF study enrolled 503 participants across approximately 40 U.S. sites.

Last updated: Mar 30, 2023