Tenax Therapeutics Reports Third Quarter 2026 Financial Results and Provides Corporate Update
Revised LEVEL-2 eligibility targets patients identified in a post hoc analysis, while enrollment remains temporarily paused.
Sentiment and the balance of points
Rhea-AI Sentiment reads the wording of the document, how positive or negative its language is on a 1 to 5 scale. The balance of points shown with the takes weighs what the document actually discloses, so the two can disagree, for example when a trial that missed its main goal is described in upbeat language.
Rhea-AI Summary
Tenax Therapeutics (Nasdaq: TENX) reported third-quarter financial results and is amending its LEVEL-2 trial after analyzing the failed LEVEL trial. LEVEL missed its primary and key secondary objectives in pulmonary hypertension associated with heart failure with preserved ejection fraction. A post hoc analysis identified patients with a 34-meter improvement in six-minute walk distance versus placebo at Week 12; LEVEL-2 enrollment is temporarily paused while sites implement revised eligibility criteria.
Tenax has been granted an FDA Type C meeting to discuss levosimendan development. Quarterly net loss widened to $16.704 million from $15.804 million a year earlier. Cash totaled $113.729 million at September 30, 2026, versus $97.565 million at year-end 2025. Tenax expects funding through fiscal 2028, although its operating plan may change following the FDA meeting. Protocol publication and development updates are expected in the first quarter of 2027.
How this balance works
Rhea-AI gives every point it takes from this document a weight. Minor counts 1, Moderate 3 and Major 9, so one Major point outweighs several Minor ones. The bar adds up the weights on each side, and when neither side holds more than 65% of the total the balance reads Mixed.
It reads the document as published, with the same rules for every company, and it does not look at what the market expected or at how the stock traded, so a point can be objectively good on a day the stock falls.
Rhea-AI Sentiment measures something else, the tone of the wording.
Hollow bars mark forward-looking points. How the balance works
Positive
- Moderate pointFDA granted a Type C meeting to discuss levosimendan development in the targeted heart-failure population.
- Moderate pointCash increased to $113.729 million at September 30, 2026, from $97.565 million at December 31, 2025.
- Moderate point. Forward-looking: it has not happened yet and may not happen.Tenax expects its cash to fund operations through fiscal 2028.
- Minor pointPrespecified LEVEL subgroup below 333 meters at baseline improved walking distance 26.3 meters versus placebo; nominal p=0.0112.
- Minor pointExploratory LEVEL results showed 49% greater NT-proBNP reduction, a cardiac-stress marker, versus placebo; nominal p<0.0001.
10 minor points
- Minor pointOverall LEVEL right ventricular systolic pressure fell 3.5 mmHg versus placebo; nominal p=0.0045.
- Minor pointMore exercise-impaired LEVEL subgroup showed a 4.9 mmHg pressure reduction; nominal p=0.009.
- Minor pointPost hoc LEVEL subgroup matching revised eligibility improved walking distance 34 meters versus placebo at Week 12; nominal p=0.001.
- Minor pointLEVEL safety findings showed balanced serious adverse events and clinical worsening across treatment groups, with no significant arrhythmias observed.
- Minor pointLEVEL results showed approximately 20 echocardiographic parameters improved with TNX-103 compared with placebo.
- Minor point. Forward-looking: it has not happened yet and may not happen.Tenax expects LEVEL-2 protocol publication and development updates in the first quarter of 2027.
- Minor pointThird-quarter selling, general and administrative expenses fell to $5.660 million from $6.478 million a year earlier.
- Minor pointNine-month selling, general and administrative expenses fell to $16.628 million from $17.804 million a year earlier.
- Minor pointThird-quarter loss per share narrowed to $0.31 from $0.40 a year earlier.
- Minor pointThird-quarter interest income increased to $1.036 million from $1.017 million a year earlier.
Negative
- Major pointPhase 3 LEVEL missed its primary and key secondary objectives.
- Major pointCommon shares outstanding increased to 45,536,448 at September 30, 2026, from 9,314,130 at year-end 2025.
- Moderate pointLEVEL-2 enrollment is temporarily paused while sites implement the protocol amendment.
- Moderate pointNine-month net loss widened to $50.223 million from $37.059 million a year earlier.
- Moderate pointNine-month research and development expenses rose to $36.457 million from $22.132 million a year earlier.
7 minor points
- Minor pointRevised LEVEL-2 enrichment criteria derive from post hoc, hypothesis-generating analyses of LEVEL.
- Minor point. Forward-looking: it has not happened yet and may not happen.Current operating plan is subject to change pending the FDA Type C meeting outcome.
- Minor pointThird-quarter net loss widened to $16.704 million from $15.804 million a year earlier.
- Minor pointThird-quarter research and development expenses rose to $12.068 million from $10.328 million a year earlier.
- Minor pointNine-month loss per share widened to $1.01 from $0.96 a year earlier.
- Minor pointThird-quarter cash utilization totaled $4.3 million.
- Minor pointNine-month interest income decreased to $2.878 million from $2.901 million a year earlier.
News Explained
The balance sheet lists 45,536,448 common shares issued and outstanding at
Details
Market move: TENX -10.22% vs previous close. 3Q26 earnings report
On Nov 5, the day this news came out, the latest delayed price for TENX is 10.22% below the previous close. Our momentum scanner has recorded 24 alerts for this stock so far that day. The latest delayed price is $1.63. Relative volume is above average at 1.5x what this stock usually trades by this time of day.
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Key Figures
- Cash and equivalents
- $113.7 million
- As of September 30, 2026
- Quarterly cash utilization
- $4.3 million
- Third quarter of 2026
- Cash runway
- Through fiscal 2028
- Current operating plan; subject to change pending the FDA Type C meeting outcome
- R&D expenses
- $12.1 million
- Third quarter 2026, compared with $10.3 million in third quarter 2025
- SG&A expenses
- $5.7 million
- Third quarter 2026, compared with $6.5 million in third quarter 2025
- Net loss
- $16.7 million
- Third quarter 2026, compared with $15.8 million in third quarter 2025
- 6MWD improvement
- 26.3 meters
- Prespecified analysis of patients with baseline 6MWD below the trial median, compared with placebo
- 6MWD improvement
- 34 meters
- At Week 12 in LEVEL patients meeting the stated enrichment criteria, compared with placebo
Previous Earnings Reports
-
Q2 cash runway and operating expenses provide a direct prior-quarter baseline for this report.
24h Move is the share-price change in the day after each event; other market factors may also have contributed.
Key Terms
nt-probnp medical
right ventricular systolic pressure (rvsp) medical
6-minute walk distance (6mwd) medical
pulmonary capillary wedge pressure (pcwp) medical
post hoc predictive enrichment analysis technical
AI-generated analysis. How Rhea-AI works. Not financial advice.
Completed Statistical Analyses of LEVEL Yielded a Predictive Enrichment Strategy Being Applied in Amended LEVEL-2 Protocol
Company Has Been Granted a Type C Meeting with the FDA
CHAPEL HILL, N.C., Nov. 05, 2026 (GLOBE NEWSWIRE) -- Tenax Therapeutics, Inc. (Nasdaq: TENX) (“Tenax” or “Tenax Therapeutics” or the “Company”) today reported financial results for the quarter ended September 30, 2026 and provided an update on recent corporate progress.
On August 10, 2026, Tenax announced that LEVEL, the first Phase 3 clinical trial of oral levosimendan in patients with pulmonary hypertension associated with heart failure with preserved ejection fraction (PH-HFpEF), did not achieve its primary or key secondary objectives, but did demonstrate evidence of beneficial biological effects on predefined cardiac biomarker and pulmonary hemodynamic measures in the overall population. Clinically meaningful improvements were observed in cardiac wall stress as measured by NT-proBNP (
According to Stuart Rich, Chief Medical Officer of Tenax Therapeutics, “NT-proBNP and measures of PAP such as RVSP are independent biomarkers used in everyday diagnosis and treatment of patients with all forms of heart failure and pulmonary hypertension. Decades of research link improvements in both markers to reductions in mortality in patients suffering from these diseases. We believe the combination of robust reductions in both NT-proBNP and PAP in the patients treated with levosimendan support the hypothesis that levosimendan will provide meaningful chronic clinical effectiveness.”
On August 29, 2026, in a Late-Breaking Clinical Science session at the European Society of Cardiology (ESC) Congress, Professor Sanjiv Shah of Northwestern University Feinberg School of Medicine, who serves as LEVEL’s Principal Investigator, reviewed in more detail a prespecified analysis of the LEVEL population: in patients who walked less than the trial median of 333 meters at baseline, the levosimendan group demonstrated a 26.3 meter improvement in 6MWD as compared to the placebo group, a strong drug-treatment benefit in a more characteristic PH-HFpEF population. In this group of more symptomatic patients who demonstrated impressive exercise improvement, the observed RVSP reduction was greater than in the overall trial population (4.9 mmHg reduction, nominal p=0.009).
On October 8, 2026, the Company disclosed the completion of a multivariable analysis of LEVEL results that identified baseline characteristics as predictors of enhanced treatment response, described a predictive enrichment strategy for LEVEL-2 resulting from this analysis, and announced a temporary pause on LEVEL-2 enrollment while a protocol amendment is implemented at each site to ensure the population recruited for the trial meets these requirements. The enrichment criteria for LEVEL-2 were derived from a post hoc predictive enrichment analysis of the LEVEL data using a statistical methodology that estimates individual-level treatment effects using arm-specific regression models and then applies classification trees to identify baseline characteristics that distinguish treatment-responsive from non-responsive patients.
“Analysis of the results of the LEVEL trial provides insights into those patients who exhibit a significant improvement in exercise tolerance. With treatment continuing for those randomized prior to October, we believe we have now taken the steps necessary to ensure our LEVEL-2 protocol population will be enriched with these more symptomatic patients,” said Chris Giordano, President and Chief Executive Officer of Tenax Therapeutics. “In a LEVEL population with greater exercise limitation at baseline (i.e., lower 6MWD) and more pronounced echocardiographic evidence of volume overload causing their left heart disease, an improvement of 34 meters in 6MWD was observed after 12 weeks in this clinical trial. Our objective in LEVEL-2 is to enroll a population that conforms to this LEVEL subpopulation demonstrating significant treatment benefit on levosimendan, which made up more than
Mr. Giordano added, “We shared the topline LEVEL data with the Food and Drug Administration (“FDA” or the “Agency”) in mid-August, have updated the Agency on these hypothesis-generating observations from LEVEL and have been granted a Type C meeting to discuss the overall development of levosimendan in PH-HFpEF. We remain focused on our mission to bring the first approved therapy to these patients.”
Recent Corporate and Clinical Highlights
- In August 2026, Tenax announced topline results from the Phase 3 LEVEL clinical trial of TNX-103 (oral levosimendan) in patients with PH-HFpEF. LEVEL did not meet its primary endpoint of improvement in 6MWD versus placebo. However, in a prespecified analysis, patients with a baseline 6MWD below the trial median of 333 meters showed a 26.3-meter improvement compared to placebo (
95% CI 6.0, 46.7; nominal p=0.0112).- In prespecified exploratory analyses in the overall trial population, treatment with TNX-103 resulted in a
49% greater reduction in NT-proBNP compared to placebo (nominal p<0.0001) and a 3.5 mmHg reduction in RVSP compared to placebo (nominal p=0.0045). - TNX-103 was generally safe and well tolerated, with serious adverse events and adjudicated clinical worsening events balanced across treatment groups.
- In prespecified exploratory analyses in the overall trial population, treatment with TNX-103 resulted in a
- In August 2026, LEVEL results were presented by Sanjiv Shah, MD, Director of the HFpEF Program at Northwestern University Feinberg School of Medicine and LEVEL’s Principal Investigator, in a Late-Breaking Clinical Science session at the ESC Congress 2026 in Munich, Germany.
- Approximately 20 echocardiographic parameters improved with TNX-103 compared to placebo, and no significant arrhythmias were observed across the overall trial population.
- With full statistical analysis now complete, the Company confirms TNX-103’s biological effects include marked reductions in PAP and NT-proBNP, a biomarker reflecting increased cardiac wall stress.
- Based on multivariable analyses of LEVEL, Tenax has temporarily paused enrollment and is amending the protocol for LEVEL-2, its ongoing global Phase 3 clinical trial, to enrich for patients with either a baseline 6MWD of 100 to 300 meters, or a baseline 6MWD of 301 to 400 meters and a right atrial volume index (RAVI) of at least 25 mL/m².
- In LEVEL patients meeting these criteria, TNX-103 showed a 34-meter improvement in 6MWD compared to placebo at Week 12 (
95% CI 15, 53; nominal p=0.001). - Enrollment in LEVEL-2 has been temporarily paused while the amendment is implemented.
- Tenax shared the topline LEVEL results with the FDA in mid-August and has been granted a Type C meeting to discuss the overall development of levosimendan in PH-HFpEF.
- Tenax expects to publish the LEVEL-2 protocol design paper and to provide further updates on the development of levosimendan in the first quarter of 2027.
- In LEVEL patients meeting these criteria, TNX-103 showed a 34-meter improvement in 6MWD compared to placebo at Week 12 (
Third Quarter 2026 Financial Results
Cash position: Tenax Therapeutics reported cash and cash equivalents of
Research and development (R&D): R&D expenses for the third quarter of 2026 were
Selling, General and administrative (SG&A): SG&A expenses for the third quarter of 2026 were
Net loss: Tenax Therapeutics reported a net loss of
About Levosimendan (TNX-101, TNX-102, TNX-103)
Levosimendan is a novel, first-in-class K-ATP channel activator/calcium sensitizer currently being evaluated to treat pulmonary hypertension (PH) associated with heart failure with preserved ejection fraction (PH-HFpEF). Levosimendan was first developed for intravenous use in hospitalized patients with acutely decompensated heart failure, and it has received market authorization in 60 countries in this indication, although it is not available in the United States or Canada. TNX-103 (oral levosimendan) is being evaluated in LEVEL-2, a Phase 3, double-blind, randomized, placebo-controlled clinical trial in patients with PH-HFpEF.
About Tenax Therapeutics
Tenax Therapeutics, Inc. is a Phase 3, development-stage pharmaceutical company using clinical insights to develop novel cardiopulmonary therapies. The Company owns global rights to develop and commercialize levosimendan, which it is developing for the treatment of PH-HFpEF, the most prevalent form of pulmonary hypertension globally, for which no product has been approved to date. For more information, visit www.tenaxthera.com. Tenax Therapeutics’ common stock is listed on The Nasdaq Stock Market LLC under the symbol “TENX”.
Caution Regarding Forward-Looking Statements
Except for historical information, all of the statements, expectations and assumptions contained in this press release are forward-looking statements. These forward-looking statements may include information concerning our clinical trials and our possible or projected future business operations. Actual results might differ materially from those explicit or implicit in the forward-looking statements. Important factors that could cause actual results to differ materially include: risks of our clinical trials, including, but not limited to, the timing, delays, costs, design, location, initiation, enrollment, and results of such trials, including that the Phase 3 LEVEL trial did not meet its primary endpoint of change in 6-minute walk distance (6MWD) in the overall enrolled population; the risk that, if LEVEL-2 fails or regulators require additional trials, we may be unable to continue development of TNX-103 and may need to pursue strategic alternatives; the risk that subgroup and post hoc analyses of LEVEL may not be confirmed in LEVEL-2 or accepted by regulators, physicians or investors, and that enriching enrollment in LEVEL-2 may slow enrollment, reduce the commercial opportunity for TNX-103 or result in narrower labeling; the pause in LEVEL-2 enrollment and the implementation of the LEVEL-2 protocol amendment; the outcome of our Type C meeting with the FDA, including the risk that the FDA may disagree with our revised development plan or the amended LEVEL-2 design or require additional trials or a larger or longer safety database; any delays in regulatory review and approval of product candidates in development; our estimates regarding the potential market opportunity for our product candidates; reliance on third parties, including Orion Corporation, our manufacturers and CROs; risks regarding the formulation, production, marketing, customer acceptance and clinical utility of our product candidates; the potential advantages of our product candidates; risks related to our business strategy, including the prioritization and development of product candidates; our competitive position; our ability to maintain our culture and recruit, integrate and retain qualified personnel and advisors, including our executives and on our Board of Directors, including following the LEVEL results and the decline in our stock price; risks associated with our cash needs, including the assumptions underlying our expected cash runway, and our ability to raise additional capital on acceptable terms, and the potential for any such financing to be highly dilutive; the outcome of securities litigation, derivative claims, or regulatory inquiries arising from the LEVEL results; intellectual property risks; volatility and uncertainty in the global economy and financial markets in light of unexpected changes in tariffs and the possibility of pandemics, global financial and geopolitical uncertainties, including in the Middle East and the Russian invasion of and war against the country of Ukraine; changes in legal, regulatory and legislative environments in the markets in which we operate, and the impact of these changes on our ability to obtain regulatory approval for our products; and other risks and uncertainties set forth from time to time in our SEC filings, including those described under “Risk Factors” in our Annual Report on Form 10-K for the year ended December 31, 2025 and our Quarterly Report on Form 10-Q for the quarter ended September 30, 2026. Tenax Therapeutics assumes no obligation and does not intend to update these forward-looking statements except as required by law.
Contact:
Investor and Media:
Argot Partners
tenax@argotpartners.com
| Tenax Therapeutics, Inc. Condensed Consolidated Balance Sheets (Amounts in thousands, except share and per share data) | |||||||||
| September 30, 2026 | December 31, 2025 | ||||||||
| ASSETS | (unaudited) | ||||||||
| Current assets: | |||||||||
| Cash and cash equivalents | $ | 113,729 | $ | 97,565 | |||||
| Prepaid expenses | 3,177 | 5,643 | |||||||
| Other current assets | 108 | 1,019 | |||||||
| Total current assets | 117,014 | 104,227 | |||||||
| Total assets | $ | 117,014 | $ | 104,227 | |||||
| LIABILITIES AND STOCKHOLDERS’ EQUITY | |||||||||
| Current liabilities: | |||||||||
| Accounts payable | $ | 6,570 | $ | 6,041 | |||||
| Accrued liabilities | 1,785 | 1,115 | |||||||
| Total current liabilities | 8,355 | 7,156 | |||||||
| Total liabilities | 8,355 | 7,156 | |||||||
| Stockholders' equity: | |||||||||
| Preferred stock, undesignated, authorized 4,818,654 shares | |||||||||
| Series A Preferred stock, par value | - | - | |||||||
| Common stock, par value | 5 | 1 | |||||||
| Additional paid-in capital | 526,331 | 464,524 | |||||||
| Accumulated deficit | (417,677 | ) | (367,454 | ) | |||||
| Total stockholders’ equity | 108,659 | 97,071 | |||||||
| Total liabilities and stockholders' equity | $ | 117,014 | $ | 104,227 | |||||
| Tenax Therapeutics, Inc. Condensed Consolidated Statements of Operations (unaudited) | ||||||||||||||||
| (Amounts in thousands, except share and per share data) | ||||||||||||||||
| For the three months ended September 30, | For the nine months ended September 30, | |||||||||||||||
| 2026 | 2025 | 2026 | 2025 | |||||||||||||
| Operating expenses | ||||||||||||||||
| Research and development | $ | 12,068 | $ | 10,328 | $ | 36,457 | $ | 22,132 | ||||||||
| Selling, general and administrative | 5,660 | 6,478 | 16,628 | 17,804 | ||||||||||||
| Total operating expenses | 17,728 | 16,806 | 53,085 | 39,936 | ||||||||||||
| Net operating loss | (17,728 | ) | (16,806 | ) | (53,085 | ) | (39,936 | ) | ||||||||
| Interest income | 1,036 | 1,017 | 2,878 | 2,901 | ||||||||||||
| Other income (expense), net | (12 | ) | (15 | ) | (16 | ) | (24 | ) | ||||||||
| Net loss | $ | (16,704 | ) | $ | (15,804 | ) | $ | (50,223 | ) | $ | (37,059 | ) | ||||
| Net loss per share, basic and diluted | $ | (0.31 | ) | $ | (0.40 | ) | $ | (1.01 | ) | $ | (0.96 | ) | ||||
| Weighted average number of common shares and prefunded warrants outstanding, basic and diluted | 53,452,869 | 39,741,404 | 49,880,130 | 38,644,395 | ||||||||||||
FAQ
AI-generated questions and answers. How Rhea-AI works. Not financial advice.
What did Tenax's LEVEL trial show for oral levosimendan?
LEVEL did not meet its primary or key secondary objectives, although subgroup and exploratory analyses showed treatment effects. The prespecified group walking below 333 meters at baseline improved six-minute walk distance by 26.3 meters versus placebo, with a 95% confidence interval of 6.0 to 46.7 meters and nominal p=0.0112.
How much cash does Tenax have, and how long is it expected to last?
Tenax held $113.729 million in cash and cash equivalents at September 30, 2026, and expects funding through fiscal 2028. Its current operating plan is subject to change pending the outcome of the FDA Type C meeting.
What are Tenax's revised eligibility criteria for LEVEL-2?
The revised criteria require a baseline six-minute walk distance of 100 to 300 meters, or 301 to 400 meters together with a right atrial volume index, a heart-chamber size measure, of at least 25 mL/m². Treatment continues for patients randomized before October while enrollment is paused for implementation.
How did Tenax identify the patients targeted by the LEVEL-2 amendment?
Tenax used a post hoc predictive enrichment analysis of LEVEL data to identify baseline characteristics associated with treatment response. The method estimated individual treatment effects using separate regression models for each treatment arm, then used classification trees to distinguish treatment-responsive from non-responsive patients.