Company Description
Tenax Therapeutics, Inc. (NASDAQ: TENX) is a Phase 3, development-stage pharmaceutical company focused on cardiopulmonary therapies. According to the company’s disclosures, Tenax uses clinical insights to develop drug candidates for serious cardiovascular and pulmonary conditions. The company is developing levosimendan for the treatment of pulmonary hypertension associated with heart failure with preserved ejection fraction (PH-HFpEF), a form of pulmonary hypertension for which the company states no product has been approved to date.
Core focus on levosimendan and PH-HFpEF
Tenax reports that it owns global rights to develop and commercialize levosimendan. Levosimendan is described as a novel, first-in-class K-ATP channel activator and calcium sensitizer that is being evaluated to treat pulmonary hypertension (PH) associated with HFpEF. The company highlights PH-HFpEF as the most prevalent form of pulmonary hypertension and characterizes it as a debilitating, often fatal disease without approved drug treatments for this specific indication.
Levosimendan was first developed for intravenous use in hospitalized patients with acutely decompensated heart failure and, according to Tenax, has received market authorization in multiple countries for that use, though it is not available in the United States or Canada in that indication. Tenax’s development work is focused on PH-HFpEF, where it is studying several formulations of levosimendan, including TNX-101 (IV levosimendan), TNX-102 (subcutaneous levosimendan), and TNX-103 (oral levosimendan).
Clinical development program
The company describes itself as a Phase 3, development-stage organization. Its lead program centers on TNX-103 in PH-HFpEF. Tenax reports that its Phase 2 HELP study, including an open-label extension, demonstrated the potential of IV and oral levosimendan to bring durable improvements in exercise capacity, quality of life, and other clinical assessments in patients with PH-HFpEF. Building on this, Tenax is conducting late-stage clinical trials designed as registrational studies.
The LEVEL study is an ongoing, registrational Phase 3, double-blind, randomized, placebo-controlled clinical trial evaluating TNX-103 in patients with PH-HFpEF in the United States and Canada. Tenax has disclosed that LEVEL uses change in 6‑minute walk distance (6MWD) as its primary endpoint. A prespecified blinded sample size re-estimation (BSSR) based on the first portion of randomized patients indicated that the trial is powered to detect a change in 6MWD, and the company confirmed its previously announced enrollment targets and timelines based on this analysis.
In addition to LEVEL, Tenax has initiated LEVEL‑2, which it describes as a global, Phase 3, double-blind, randomized, placebo-controlled study of TNX-103 in PH-HFpEF. The company has indicated that LEVEL‑2 plans to enroll hundreds of patients across multiple countries, with a primary endpoint of change from baseline in 6MWD at Week 26 and secondary endpoints that include the Kansas City Cardiomyopathy Questionnaire (KCCQ) and New York Heart Association (NYHA) Functional Class. LEVEL‑2 also includes a cohort of patients who will undergo a six‑month, blinded, placebo-controlled safety observation to build a safety database for regulatory review.
Intellectual property and licensing
Tenax emphasizes the importance of intellectual property around levosimendan in PH-HFpEF. The company has reported that the European Patent Office (EPO) issued an Intention to Grant a patent covering TNX‑103 (oral levosimendan), other formulations of levosimendan (including oral, intravenous, inhaled, transdermal, and subcutaneous routes), and its active metabolites OR1896 and OR1855 for use in PH-HFpEF. Once granted, this patent is expected to provide protection in Europe through at least 2040 and may qualify for supplementary protection certificates that could extend the term.
Tenax has also disclosed that the Canadian Intellectual Property Office (CIPO) allowed claims in a patent application covering TNX‑103, TNX‑102, TNX‑101, the active metabolites of levosimendan, and combinations of levosimendan with various cardiovascular drugs for improving exercise performance in PH-HFpEF patients, with protections extending to 2040 once granted.
On the licensing side, an amendment to the company’s license agreement with Orion Corporation expanded Tenax’s licenses to include exclusive worldwide rights to develop, commercialize, manufacture, and have manufactured any orally administered pharmaceutical product containing levosimendan. The amendment also confirms rights related to subcutaneously administered products and sets out supply terms under which Orion will provide levosimendan to Tenax for the manufacture of orally administered products.
Geographic footprint and trial reach
Tenax is headquartered in Chapel Hill, North Carolina, and its common stock trades on the Nasdaq under the ticker symbol TENX. The company’s clinical activities, as described in its communications, span North America and multiple other countries. The LEVEL study is being conducted in the United States and Canada, while LEVEL‑2 is described as a global study with investigative sites across numerous countries. Tenax has indicated that it has qualified sites in more than a dozen countries for LEVEL‑2, reflecting a broad international clinical footprint for its PH-HFpEF program.
Development-stage business model
Based on its public statements, Tenax’s business model is that of a development-stage biopharmaceutical company. The company focuses on identifying and advancing a specific drug candidate—levosimendan—through clinical development for a defined cardiopulmonary indication (PH-HFpEF). Tenax highlights its use of clinical insights and engagement with key opinion leaders in cardiovascular medicine to inform trial design, such as the rationale and design of the LEVEL trial and the selection of endpoints like 6MWD and patient-reported outcomes.
Tenax has also communicated that it is planning or conducting an open-label extension (OLE) study to provide patients who participate in levosimendan clinical trials continued access to TNX‑103 after completion of blinded studies and until potential availability of a commercialized product. This approach is consistent with its stated goal of building a robust safety and efficacy dataset to support regulatory submissions in PH-HFpEF.
Regulatory and reporting profile
As a Nasdaq-listed issuer, Tenax files periodic and current reports with the U.S. Securities and Exchange Commission (SEC). Recent Form 8‑K filings have covered clinical and corporate milestones, including the EPO Intention to Grant patent protection for levosimendan in PH-HFpEF, the blinded sample size re-estimation results in LEVEL, initiation of the LEVEL‑2 study, and quarterly financial results. These filings provide additional detail on the company’s trial progress, intellectual property, and financial position.
Position within biotechnology and cardiopulmonary research
Within the broader category of research and development in biotechnology, Tenax positions itself specifically in cardiopulmonary drug development, with a narrow focus on PH-HFpEF. The company’s materials emphasize that PH-HFpEF is a common form of pulmonary hypertension and that, according to Tenax, no drugs have been approved for this indication. Its work on levosimendan formulations, global Phase 3 trial program, and patent portfolio are presented as the foundation of its strategy in this therapeutic area.
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Short Interest History
Short interest in Tenax Therapeutics (TENX) currently stands at 93.1 thousand shares, down 82.5% from the previous reporting period, representing 1.6% of the float. Over the past 12 months, short interest has decreased by 75.6%. This relatively low short interest suggests limited bearish sentiment.
Days to Cover History
Days to cover for Tenax Therapeutics (TENX) currently stands at 1.0 days, down 64.8% from the previous period. This low days-to-cover ratio indicates high liquidity, allowing short sellers to quickly exit positions if needed. The days to cover has decreased 92.8% over the past year, suggesting improved liquidity for short covering. The ratio has shown significant volatility over the period, ranging from 1.0 to 39.3 days.