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Tonix Pharmaceuticals Announces In-licensing Phase 2/3-Ready Monoclonal Antibody Designed for Seasonal Prevention of Lyme Disease (TNX-4800)

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Tonix Pharmaceuticals (Nasdaq: TNXP) has announced the in-licensing of worldwide rights to TNX-4800, a long-acting human monoclonal antibody designed for seasonal prevention of Lyme disease. The antibody targets the outer surface protein A (OspA) of Borrelia burgdorferi, the bacteria causing Lyme disease.

The treatment, developed by UMass Chan Medical School researchers, requires just one subcutaneous dose in Spring to provide protection through Fall. TNX-4800 has shown positive Phase 1 results with safety, tolerability, and linear pharmacokinetic relationships. The potential market includes approximately 70 million people living in Lyme disease endemic areas in the U.S.

TNX-4800 works by blocking Borrelia maturation in infected tick midguts, offering immediate immunity without requiring the recipient's immune system to generate antibodies. The company plans to advance the treatment through additional clinical trials toward a Biologics Licensing Application (BLA).

Tonix Pharmaceuticals (Nasdaq: TNXP) ha annunciato l'acquisizione/licenza dei diritti a livello mondiale su TNX-4800, un anticorpo monoclonale umano a lunga durata d’azione pensato per la prevenzione stagionale della malattia di Lyme. L’anticorpo punta sulla proteina di superficie esterna A (OspA) di Borrelia burgdorferi, il batterio che causa la malattia di Lyme.

Il trattamento, sviluppato dai ricercatori della UMass Chan Medical School, richiede appena una dose sottocutanea in primavera per offrire protezione fino all’autunno. TNX-4800 ha mostrato risultati positivi nella fase 1, con sicurezza, tollerabilità e relazioni farmacocinetiche lineari. Il mercato potenziale comprende circa 70 milioni di persone che vivono nelle aree endemiche della malattia di Lyme negli Stati Uniti.

TNX-4800 agisce bloccando la maturazione di Borrelia nei midgutt dei vettori infetti, offrendo un’immunità immediata senza che il sistema immunitario del destinatario debba generare anticorpi. L’azienda intende avanzare il trattamento in ulteriori studi clinici verso una Biologics Licensing Application (BLA).

Tonix Pharmaceuticals (Nasdaq: TNXP) ha anunciado la licencia mundial de derechos para TNX-4800, un anticuerpo monoclonal humano de acción prolongada diseñado para la prevención estacional de la enfermedad de Lyme. El anticuerpo apunta a la proteína de superficie externa A (OspA) de Borrelia burgdorferi, la bacteria que causa la enfermedad de Lyme.

El tratamiento, desarrollado por investigadores de la UMass Chan Medical School, requiere tan solo una dosis subcutánea en primavera para proporcionar protección hasta el otoño. TNX-4800 ha mostrado resultados positivos en la fase 1 con seguridad, tolerabilidad y relaciones farmacocinéticas lineales. El mercado potencial incluye aproximadamente 70 millones de personas que viven en zonas endémicas de Lyme en Estados Unidos.

TNX-4800 funciona bloqueando la maduración de Borrelia en los midgut de las garrapatas infectadas, proporcionando inmunidad inmediata sin que el sistema inmune del receptor tenga que generar anticuerpos. La empresa planea avanzar con más ensayos clínicos hacia una Biologics Licensing Application (BLA).

Tonix Pharmaceuticals (Nasdaq: TNXP)가 전 세계적으로 TNX-4800의 권리를 라이선스 취득했다고 발표했습니다. TNX-4800은 라임병의 계절적 예방을 위해 설계된 장기간 작용하는 인간 단일클론 항체입니다. 이 항체는 라임병의 원인 박테리아인 Borrelia burgdorferi의 외부 표면 단백질 A(OspA)를 겨냥합니다.

UMass Chan Medical School 연구진이 개발한 이 치료제는 봄에 하나의 피하 주사만으로 가을까지 보호 효과를 제공해야 합니다. TNX-4800은 안전성, 내약성 및 선형 약동학 관계를 보여준 1상 양성 결과를 보였습니다. 잠재적 시장은 미국 내 라임병 내전 지역에 거주하는 대략 7000만 명의 사람들을 포함합니다.

TNX-4800은 감염된 진드기 중장( mids gut)에서 Borrelia의 성숙을 차단함으로써 즉시 면역을 제공하며, 수혜자의 면역 체계가 항체를 생성할 필요가 없도록 합니다. 회사는 이 치료제를 추가 임상 시험을 거쳐 생물학적 제재 승인을 위한 BLA(Biologics Licensing Application)로 진행할 계획입니다.

Tonix Pharmaceuticals (Nasdaq: TNXP) a annoncé la cession de droits mondiaux pour TNX-4800, un anticorps monoclonal humain à action longue conçu pour la prévention saisonnière de la maladie de Lyme. L’anticorps cible la protéine de surface externe A (OspA) de Borrelia burgdorferi, la bactérie à l’origine de la maladie de Lyme.

Le traitement, développé par des chercheurs de la UMass Chan Medical School, nécessite une dose unique sous-cutanée au printemps pour assurer une protection jusqu’à l’automne. TNX-4800 a montré des résultats positifs en phase 1 en matière de sécurité, de tolérance et de relations pharmacocinétiques linéaires. Le marché potentiel comprend environ 10 millions de personnes vivant dans les zones endémiques de la Lyme aux États-Unis.

TNX-4800 agit en bloquant la maturation de Borrelia dans les midguts des tiques infectées, offrant une immunité immédiate sans que le système immunitaire du receveur ait à générer des anticorps. L’entreprise prévoit de poursuivre le traitement dans d’autres essais cliniques en vue d’une Biologics Licensing Application (BLA).

Tonix Pharmaceuticals (Nasdaq: TNXP) hat die weltweiten Rechte an TNX-4800, einem lang wirkenden humanen Monoklonalen Antikörper zur saisonalen Vorbeugung gegen Lyme-Borreliose, lizenziert. Der Antikörper zielt auf das äußere Oberflächenprotein A (OspA) von Borrelia burgdorferi, dem Erreger der Lyme-Borreliose.

Die Behandlung, entwickelt von Forschern der UMass Chan Medical School, erfordert lediglich eine subkutane Dosis im Frühjahr, um Schutz bis zum Herbst zu gewährleisten. TNX-4800 zeigte in Phase-1-Studien positive Ergebnisse in Bezug auf Sicherheit, Verträglichkeit und lineare Pharmakokinetik. Das potenzielle Marktsegment umfasst rund 70 Millionen Menschen in den in Lyme-Borreliose-endem Gebieten der USA.

TNX-4800 wirkt, indem es die Reifung von Borrelia in den Midgut-Strukturen infizierter Zecken blockiert und so eine sofortige Immunität bietet, ohne dass das Immunsystem des Empfängers Antikörper bilden muss. Das Unternehmen plant, die Behandlung durch weitere klinische Studien vor einer Biologics Licensing Application (BLA) weiterzuentwickeln.

Tonix Pharmaceuticals (Nasdaq: TNXP) قد أعلنت عن ترخيص الحقوق العالمية لـ TNX-4800، وهو جسم مضاد أحادي النسيلة بشري ذو تأثير طويل مصمم للوقاية الموسمية من مرض لايم. ي targeting الغشاء البروتيني Outer Surface Protein A (OspA) لـ Borrelia burgdorferi، البكتيريا المسببة لمرض لايم.

العلاج، الذي طوره باحثو كلية UMass Chan Medical School، يتطلب جرعة تحت الجلد واحد فقط في الربيع لتوفير حماية حتى الخريف. أظهرت TNX-4800 نتائج إيجابية في المرحلة 1 فيما يتعلق بالسلامة والتحمل والعلاقات الدوائية الحركية الخطية. السوق المحتمل يشمل نحو قرابة 70 مليون شخص يعيشون في مناطق تكون Lyme مرضاً وبائياً فيها في الولايات المتحدة.

يعمل TNX-4800 عن طريق حجب نضوج BORRELIA في midguts النملة المصابة، موفراً مناعة فورية دون حاجة جهاز المناعة للمستفيد لتوليد أجسام مضادَة. تخطط الشركة لتطوير العلاج من خلال تجارب سريرية إضافية باتجاه طلب ترخيص بيولوجي (BLA).

Tonix Pharmaceuticals (纳斯达克: TNXP) 宣布全球范围内对 TNX-4800 权利的许可转让,这是一种为季节性预防莱姆病而设计的长效人源单克隆抗体。该抗体靶向莱姆病致病菌 Borrelia burgdorferi 的外表面蛋白 A(OspA)。

该治疗由马萨诸塞大学圣克兰医学院研究人员开发,只需在春季进行一次皮下注射即可提供直至秋季的保护。TNX-4800 在1期研究中显示出安全性、耐受性和线性药代动力学关系的积极结果。潜在市场包括居住在美国莱姆病流行区的约 7000万 人。

TNX-4800 的作用机制是阻断感染蚤虫的中肠道中 Borrelia 的成熟,从而提供立即的免疫力,而无需受试者的免疫系统产生抗体。公司计划通过更多临床试验推进该治疗,直至提交生物制品许可申请(BLA)。

Positive
  • Positive Phase 1 study results demonstrating safety and tolerability
  • Single-dose administration provides protection for entire tick season
  • Large potential market of 70 million people in endemic areas
  • Novel mechanism of action avoiding autoimmunity risks
  • Immediate immunity without requiring multiple doses
Negative
  • Currently in early clinical development phase
  • Will require extensive clinical trials before potential approval
  • No FDA-approved vaccines or prophylactics exist as benchmarks

Insights

Tonix's in-licensing of TNX-4800 targets a significant unmet need with potentially disruptive single-dose Lyme disease prevention technology.

Tonix Pharmaceuticals has made a strategic move by in-licensing TNX-4800, a long-acting human monoclonal antibody targeting the OspA protein of Borrelia burgdorferi, the bacteria causing Lyme disease. This represents a significant pipeline expansion addressing an unmet medical need, as there are currently no FDA-approved preventatives for Lyme disease despite approximately 70 million eligible patients living in endemic areas.

The scientific approach here is particularly innovative. Unlike vaccine approaches that require multiple doses and depend on the patient's immune response, TNX-4800 works through direct antibody administration, providing immediate protection within two days of a single seasonal dose. The mechanism - blocking bacterial maturation in infected ticks - effectively prevents transmission to humans without triggering the potential autoimmune concerns that plagued previous Lyme vaccines.

The positive Phase 1 results showing a linear 1:1:1 relationship between pharmacokinetics, pharmacodynamics, and efficacy is particularly promising from a development perspective. This data pattern suggests predictable dosing and efficacy relationships, potentially streamlining the planned adaptive Phase 2/3 trial design.

This acquisition significantly strengthens Tonix's infectious disease portfolio with a potentially differentiated product addressing a growing public health concern - Lyme disease remains the most common vector-borne infection in the US with increasing incidence. The collaboration with UMass Chan Medical School also brings valuable institutional expertise, as the antibody was developed by researchers with deep knowledge in this therapeutic area.

The market opportunity appears substantial, with seasonal prevention targeting the millions who live, work, or vacation in Lyme-endemic regions. The convenience of a single spring dose providing protection through the entire tick season represents a potentially compelling value proposition compared to vaccine approaches requiring multiple administrations.

Positive Phase 1 study showed safety, tolerability and a linear pharmacokinetic: pharmacodynamic: efficacy relationship (1: 1: 1)

Planning adaptive Phase 2/3 study

Approximately 70 million people that are eligible for treatment live in areas of the U.S. in which Lyme Disease is endemic

CHATHAM, N.J., Sept. 17, 2025 (GLOBE NEWSWIRE) -- Tonix Pharmaceuticals Holding Corp. (Nasdaq: TNXP) (“Tonix” or the “Company”), a fully-integrated biopharmaceutical company with marketed products and a pipeline of development candidates, today announced the in-licensing of worldwide rights to TNX-4800 (formerly known as mAb 2217LS)1, which is a long-acting human monoclonal antibody that targets the outer surface protein A (OspA) of Borrelia burgdorferi, the causative agent of Lyme disease in humans. TNX-4800 is being developed for annual seasonal use, as one subcutaneous dose administered in the Spring to protect against Lyme disease through Fall, or the entire tick season in the U.S. TNX-4800 was developed by researchers at UMass Chan Medical School, which is licensing the technology to Tonix. There are currently no FDA-approved vaccines or prophylactics to protect against Lyme Disease.

“Lyme disease remains the most common vector-borne infection in the United States and its incidence is climbing each year,”2 said Seth Lederman, M.D., Chief Executive Officer of Tonix Pharmaceuticals. “Licensing TNX-4800 expands our infectious disease pipeline with a potentially differentiated, single-dose approach that can be given each Spring to provide protection within two days and protect through Fall, which is the entire tick season in the U.S. We believe TNX-4800’s long-acting monoclonal antibody prophylaxis could play an important role for preventing Lyme for millions of people who live, work, and vacation in regions endemic for Lyme disease. TNX-4800’s novel mechanism of blocking the maturation of Borrelia in the midgut of infected ticks is consistent with Tonix’s focus on innovation. We look forward to advancing the TNX-4800 program.”

“Preventing Lyme disease is an urgent public health priority, and more than thirty years of clinical experience confirm that monoclonal antibodies can be delivered safely and can be effective in preventing infections,” said Mark Klempner, M.D., Professor of Medicine at UMass Chan Medical School and leader of the research team that discovered and developed mAb 2217LS. “We are delighted to be collaborating with Tonix on the development of this program. TNX-4800 is a single dose and provides immediate immunity to the bacteria that causes Lyme disease, which is very different from Lyme disease vaccine programs currently in development.”

Terence R. Flotte, MD, Provost, Dean and Executive Deputy Vice Chancellor of UMass Chan Medical School, said, “We are proud to partner with Tonix Pharmaceuticals to advance the development of our novel monoclonal antibody as a prophylactic for Lyme disease, which is an urgent and growing public health challenge in the United States and around the world. This collaboration reflects UMass Chan’s enduring commitment to translational research that addresses unmet medical needs, and we are excited to work with Tonix to bring forward science-driven solutions that have the potential to prevent infection and protect vulnerable populations.”

TNX-4800 is a fully human monoclonal antibody with an engineered extended half-life that targets the outer-surface protein A (OspA) on Lyme-causing Borrelia bacteria. By binding OspA, TNX-4800 blocks the maturation of Borrelia burgdorferi in the mid-gut of infected deer ticks. The mAb 2217LS1 was derived from mAb 2217 by amino acid substitutions that crystallizable fragment (Fc) domain to prolong the serum half-life. A single administration in the Spring is designed to maintain protective antibody titers for the entire tick season, providing pre-exposure prophylaxis against Lyme disease without relying on the recipient’s immune system to generate antibodies. By delivering a well-characterized antibody directly, TNX-4800 has been shown to block transmission of the major Borrelia genospecies from ticks to animals. TNX-4800 sidesteps the multidose schedules required for OspA vaccines in development3 and FDA-approved vaccines that have been withdrawn from the market due to concerns about increased risk of autoimmunity. 4 Tonix intends to advance TNX-4800 through additional clinical trials with the goal of submitting a Biologics Licensing Application (BLA).

About Lyme Disease 
In the United States, Lyme disease is caused by the bacterium Borrelia burgdorferi. It occurs most commonly in the Northeast, mid-Atlantic, and upper-Midwest regions. Lyme disease bacteria are transmitted through the bite of infected Ixodes ticks. Typical symptoms include fever, headache, fatigue, and a characteristic skin rash called erythema migrans. If left untreated, infection can spread to joints, the heart, and the nervous system. Laboratory testing is helpful if used correctly and performed with FDA-cleared tests. Although many cases of Lyme disease can be treated successfully with antibiotics, diagnosis and treatment are often delayed or missed, and even with treatment, up to 20% of cases may progress to a Post-Treatment Lyme Disease Syndrome (PTLDS) called “Chronic Lyme” or “Long Lyme”. Chronic Lyme is considered an Infection Associated Chronic Illness (IACI), and is a chronic, debilitating disease state characterized by joint and muscle pain, fatigue and other symptoms.5

About Borrelia Burgdorferi
In infected deer ticks, Borrelia’s OspA binds to tick-gut receptor TROSPA and helps it adhere to the midgut lining. During a tick bite Borrelia downregulates OspA, upregulates OspC, and activates motility genes. Borrelia undergoes a metamorphic-like transformation becoming highly flagellated and mobile, which facilitates migration to the salivary glands and invasion of human host tissues. The mAb 2217LS blocks the metamorphic-like transformation of Borrelia in the tick’s midgut preventing transmission of the bacteria. Lyme-causing Borrelia exposed or infected individuals, rarely make antibodies against OspA which allows for people to be reinfected despite having immunity to OspC. Consequently we expect that protection against Borrelia would require annual prophylaxis.

About Monoclonal Antibody Prophylaxis
Two long-acting monoclonal antibody products6,7 have won FDA approval for prophylaxis against respiratory syncytial virus (RSV). AstraZeneca (in partnership with Sanofi) markets Beyfortus™ (nirsevimab) and Merck markets Enflonsia™ (clesrovimab).

Tonix Pharmaceuticals Holding Corp.*

Tonix Pharmaceuticals is a fully-integrated biotechnology company with marketed products and a pipeline of development candidates. Tonix recently received FDA approval for TonmyaTM, a first-in-class, non-opioid analgesic medicine for the treatment of fibromyalgia, a chronic pain condition that affects millions of adults. This marks the first approval for a new prescription medicine for fibromyalgia in more than 15 years. Tonix also markets two treatments for acute migraine in adults. Tonix’s development portfolio is focused on central nervous system (CNS) disorders, immunology, immuno-oncology and infectious diseases. TNX-102 SL is being developed to treat acute stress reaction and acute stress disorder under a Physician-Initiated IND at the University of North Carolina in the OASIS study funded by the U.S. Department of Defense (DoD). Tonix’s immunology development portfolio consists of biologics to address organ transplant rejection, autoimmunity and cancer, including TNX-1500, which is an Fc-modified humanized monoclonal antibody targeting CD40-ligand (CD40L or CD154) being developed for the prevention of allograft rejection and for the treatment of autoimmune diseases. Tonix’s infectious disease portfolio includes TNX-801, a vaccine in development for mpox and smallpox, as well as TNX-4200 for which Tonix has a contract with the U.S. DoD’s Defense Threat Reduction Agency (DTRA) for up to $34 million over five years. TNX-4200 is a small molecule broad-spectrum antiviral agent targeting CD45 for the prevention or treatment of infections to improve the medical readiness of military personnel in biological threat environments. Tonix owns and operates a state-of-the art infectious disease research facility in Frederick, Md.

* Tonix’s product development candidates are investigational new drugs or biologics; their efficacy and safety have not been established and have not been approved for any indication.

This press release and further information about Tonix can be found at www.tonixpharma.com.

UMass Chan Medical School
UMass Chan Medical School, one of five campuses of the University of Massachusetts system, comprises the T.H. Chan School of Medicine, the Morningside Graduate School of Biomedical Sciences, the Tan Chingfen Graduate School of Nursing, ForHealth Consulting at UMass Chan Medical School, MassBiologics, and a thriving Nobel-Prize-winning biomedical research enterprise. UMass Chan is advancing together to improve the health and wellness of our diverse communities throughout Massachusetts and across the world by leading and innovating in education, research, health care delivery and public service. It is ranked among the best medical schools in the nation for primary care education and biomedical research by U.S. News & World Report. Learn more at www.umassmed.edu.  

1Schiller ZA, et al. J Clin Invest. 2021 131(11):e144843. doi: 10.1172/JCI144843. PMID: 33914704; PMCID: PMC8159683.

2Gomes-Solecki M, et. al.. Clin Infect Dis. 2020 70(8):1768-1773. doi: 10.1093/cid/ciz872. PMID: 31620776; PMCID: PMC7155782.

3Connaught’s (ImuLyme™) and SmithKline Beecham’s (LYMErix™) Lyme disease vaccines were withdrawn over concerns about an increased risk of autoimmune arthritis triggered by molecular mimicry, particularly in HLADRB1*0401 ("DR4+") individuals. Nigrovic LE, et al. Epidemiol Infect. 2007 135(1):1-8. doi: 10.1017/S0950268806007096. Epub 2006 Aug 8. PMID: 16893489; PMCID: PMC2870557.

4Pfizer and Valneva's VLA15 vaccine candidate has been specifically engineered and clinically evaluated to mitigate the autoimmune concerns that contributed to the withdrawal of earlier OspA-based vaccines. Comstedt P, et al. Vaccine. 2015 33(44):5982-8. doi: 10.1016/j.vaccine.2015.07.095. Epub 2015 Aug 13. PMID: 26277070.

5National Academies of Sciences, Engineering, and Medicine. 2025. Charting a Path Toward New Treatments for Lyme Infection-Associated Chronic Illnesses. Washington, DC: The National Academies Press. https://doi.org/10.17226/28578.

6Sanofi Press Release. “May 29, 2025. Press Release: Beyfortus public health advantage bolstered by first real-world comparison of infant vs maternal RSV immunization programs.“ https://bit.ly/40DeJGf

7June 9, 2025. Merck Press Release. “U.S. FDA Approves Merck’s ENFLONSIA™ (clesrovimab-cfor) for Prevention of Respiratory Syncytial Virus (RSV) Lower Respiratory Tract Disease in Infants Born During or Entering Their First RSV Season” https://bit.ly/4kkXDE8.

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 successfully launch and commercialize Tonmya and any of our approved products; risks related to the failure to obtain FDA clearances or approvals and noncompliance with FDA regulations; 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, 2024, as filed with the Securities and Exchange Commission (the “SEC”) on March 18, 2025, 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.

Investor Contacts
Jessica Morris 
Tonix Pharmaceuticals 
investor.relations@tonixpharma.com  
(862) 799-8599 

Brian Korb 
astr partners 
(917) 653-5122 
brian.korb@astrpartners.com 

Media Contact 
Ray Jordan 
Putnam Insights 
ray@putnaminsights.com  
 

INDICATION

TONMYA is indicated for the treatment of fibromyalgia in adults.

CONTRAINDICATIONS

TONMYA is contraindicated:

In patients with hypersensitivity to cyclobenzaprine or any inactive ingredient in TONMYA. Hypersensitivity reactions may manifest as an anaphylactic reaction, urticaria, facial and/or tongue swelling, or pruritus. Discontinue TONMYA if a hypersensitivity reaction is suspected.

With concomitant use of monoamine oxidase (MAO) inhibitors or within 14 days after discontinuation of an MAO inhibitor. Hyperpyretic crisis seizures and deaths have occurred in patients who received cyclobenzaprine (or structurally similar tricyclic antidepressants) concomitantly with MAO inhibitors drugs.

During the acute recovery phase of myocardial infarction, and in patients with arrhythmias, heart block or conduction disturbances, or congestive heart failure.

In patients with hyperthyroidism.

WARNINGS AND PRECAUTIONS

Embryofetal toxicity: Based on animal data, TONMYA may cause neural tube defects when used two weeks prior to conception and during the first trimester of pregnancy. Advise females of reproductive potential of the potential risk and to use effective contraception during treatment and for two weeks after the final dose. Perform a pregnancy test prior to initiation of treatment with TONMYA to exclude use of TONMYA during the first trimester of pregnancy.

Serotonin syndrome: Concomitant use of TONMYA with selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants, tramadol, bupropion, meperidine, verapamil, or MAO inhibitors increases the risk of serotonin syndrome, a potentially life-threatening condition. Serotonin syndrome symptoms may include mental status changes, autonomic instability, neuromuscular abnormalities, and/or gastrointestinal symptoms. Treatment with TONMYA and any concomitant serotonergic agent should be discontinued immediately if serotonin syndrome symptoms occur and supportive symptomatic treatment should be initiated. If concomitant treatment with TONMYA and other serotonergic drugs is clinically warranted, careful observation is advised, particularly during treatment initiation or dosage increases.

Tricyclic antidepressant-like adverse reactions: Cyclobenzaprine is structurally related to TCAs. TCAs have been reported to produce arrhythmias, sinus tachycardia, prolongation of the conduction time leading to myocardial infarction and stroke. If clinically significant central nervous system (CNS) symptoms develop, consider discontinuation of TONMYA. Caution should be used when TCAs are given to patients with a history of seizure disorder, because TCAs may lower the seizure threshold. Patients with a history of seizures should be monitored during TCA use to identify recurrence of seizures or an increase in the frequency of seizures.

Atropine-like effects: Use with caution in patients with a history of urinary retention, angle-closure glaucoma, increased intraocular pressure, and in patients taking anticholinergic drugs.

CNS depression and risk of operating a motor vehicle or hazardous machinery: TONMYA monotherapy may cause CNS depression. Concomitant use of TONMYA with alcohol, barbiturates, or other CNS depressants may increase the risk of CNS depression. Advise patients not to operate a motor vehicle or dangerous machinery until they are reasonably certain that TONMYA therapy will not adversely affect their ability to engage in such activities.

Oral mucosal adverse reactions: In clinical studies with TONMYA, oral mucosal adverse reactions occurred more frequently in patients treated with TONMYA compared to placebo. Advise patients to moisten the mouth with sips of water before administration of TONMYA to reduce the risk of oral sensory changes (hypoesthesia). Consider discontinuation of TONMYA if severe reactions occur.

ADVERSE REACTIONS

The most common adverse reactions (incidence ≥2% and at a higher incidence in TONMYA-treated patients compared to placebo-treated patients) were oral hypoesthesia, oral discomfort, abnormal product taste, somnolence, oral paresthesia, oral pain, fatigue, dry mouth, and aphthous ulcer.

DRUG INTERACTIONS

MAO inhibitors: Life-threatening interactions may occur.

Other serotonergic drugs: Serotonin syndrome has been reported.

CNS depressants: CNS depressant effects of alcohol, barbiturates, and other CNS depressants may be enhanced.

Tramadol: Seizure risk may be enhanced.

Guanethidine or other similar acting drugs: The antihypertensive action of these drugs may be blocked.

USE IN SPECIFIC POPULATIONS

Pregnancy: Based on animal data, TONMYA may cause fetal harm when administered to a pregnant woman. The limited amount of available observational data on oral cyclobenzaprine use in pregnancy is of insufficient quality to inform a TONMYA-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. Advise pregnant women about the potential risk to the fetus with maternal exposure to TONMYA and to avoid use of TONMYA two weeks prior to conception and through the first trimester of pregnancy. Report pregnancies to the Tonix Medicines, Inc., adverse-event reporting line at 1-888-869-7633 (1-888-TNXPMED).

Lactation: A small number of published cases report the transfer of cyclobenzaprine into human milk in low amounts, but these data cannot be confirmed. There are no data on the effects of cyclobenzaprine on a breastfed infant, or the effects on milk production. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for TONMYA and any potential adverse effects on the breastfed child from TONMYA or from the underlying maternal condition.

Pediatric use: The safety and effectiveness of TONMYA have not been established.

Geriatric patients: Of the total number of TONMYA-treated patients in the clinical trials in adult patients with fibromyalgia, none were 65 years of age and older. Clinical trials of TONMYA did not include sufficient numbers of patients 65 years of age and older to determine whether they respond differently from younger adult patients.

Hepatic impairment: The recommended dosage of TONMYA in patients with mild hepatic impairment (HI) (Child Pugh A) is 2.8 mg once daily at bedtime, lower than the recommended dosage in patients with normal hepatic function. The use of TONMYA is not recommended in patients with moderate HI (Child Pugh B) or severe HI (Child Pugh C). Cyclobenzaprine exposure (AUC) was increased in patients with mild HI and moderate HI compared to subjects with normal hepatic function, which may increase the risk of TONMYA-associated adverse reactions.

Please see additional safety information in the full Prescribing Information.

To report suspected adverse reactions, contact Tonix Medicines, Inc. at 1-888-869-7633, or the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.


FAQ

What is TNX-4800 and how does it work to prevent Lyme disease?

TNX-4800 is a long-acting human monoclonal antibody that targets the outer surface protein A (OspA) of Borrelia burgdorferi. It works by blocking bacterial maturation in infected tick midguts, providing immediate immunity against Lyme disease.

How is TNXP's TNX-4800 different from other Lyme disease treatments?

TNX-4800 requires just one subcutaneous dose per year in Spring for protection through Fall, unlike other treatments requiring multiple doses. It provides immediate immunity without relying on the body's immune response.

What are the Phase 1 clinical trial results for TNX-4800?

The Phase 1 study showed positive results for safety and tolerability with a linear pharmacokinetic:pharmacodynamic:efficacy relationship (1:1:1).

How many people could potentially benefit from TNXP's Lyme disease treatment?

Approximately 70 million people living in Lyme disease endemic areas of the U.S. are eligible for treatment.

What is the current development status of TNXP's TNX-4800?

After successful Phase 1 trials, Tonix Pharmaceuticals is planning an adaptive Phase 2/3 study and aims to submit a Biologics Licensing Application (BLA) following additional clinical trials.
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