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Tenax Therapeutics temporarily pauses LEVEL-2 enrollment

The LEVEL-2 target population is intended to match a more symptomatic LEVEL subgroup that comprised more than 50% of participants.

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(High)

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.

Form Type
8-K

Rhea-AI Filing Summary

Tenax Therapeutics reported third-quarter 2026 results and an update on levosimendan. Its Phase 3 LEVEL trial in PH-HFpEF did not meet its primary or key secondary objectives. Tenax reported overall-population reductions of 49% in NT-proBNP and 3.5 mmHg in right ventricular systolic pressure (RVSP). Among patients below the 333-meter baseline 6-minute walk median, the levosimendan group showed a 26.3-meter improvement in 6-minute walk distance versus placebo, with a 4.9 mmHg RVSP reduction.

Post hoc LEVEL analyses informed a predictive enrichment strategy for LEVEL-2. Enrollment was temporarily paused while a protocol amendment was being implemented at each site. Tenax has been granted an FDA Type C meeting to discuss levosimendan development in PH-HFpEF. Cash and cash equivalents were $113.7 million as of September 30, 2026. Tenax expects its cash runway to fund operations through fiscal 2028, subject to change pending the meeting outcome.

Third-quarter research and development expense was $12.1 million, versus $10.3 million; selling, general and administrative expense was $5.7 million, versus $6.5 million. Net loss was $16.7 million, compared with $15.8 million; nine-month net loss was $50.2 million, versus $37.1 million.

0 points · 0 major

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.

1 major · 3 points

How the balance works

Positive

  • None.

Negative

  • Major pointLEVEL did not meet its primary or key secondary objectives, as reported on August 10, 2026.
  • Moderate pointNine-month net loss rose to $50.2 million from $37.1 million.
  • Minor pointQuarterly net loss rose to $16.7 million from $15.8 million.

Filing Explained

Tenax reports 45,536,448 common shares issued and outstanding at September 30, 2026, versus 9,314,130 at December 31, 2025; for holders whose share counts did not change, that larger base means a smaller ownership fraction.

Item 2.02 Results of Operations and Financial Condition Financial
Disclosure of earnings results, typically an earnings press release or preliminary financials.
Item 9.01 Financial Statements and Exhibits Exhibits
Financial statements, pro forma financial information, or exhibit attachments filed with this report.
Cash and cash equivalents $113.7 million As of September 30, 2026
Third-quarter net loss $16.7 million Compared with $15.8 million for the third quarter of 2025
Nine-month net loss $50.2 million Compared with $37.1 million for the nine months ended September 30, 2025
Research and development expense $12.1 million Third quarter of 2026; compared with $10.3 million in 2025
Selling, general and administrative expense $5.7 million Third quarter of 2026; compared with $6.5 million in 2025
Expected cash runway Through fiscal 2028 Company expectation; current operating plan is subject to change pending the Type C meeting outcome
PH-HFpEF medical
"pulmonary hypertension associated with heart failure with preserved ejection fraction (PH-HFpEF)"
Pulmonary hypertension associated with heart failure with preserved ejection fraction (PH‑HFpEF) is a condition where high blood pressure builds up in the lungs because the heart’s left side is stiff and doesn’t fill properly, even though its pumping strength looks normal. For investors, it matters because it defines a specific patient group and treatment need that shapes clinical trial design, drug approval chances, market size, and potential revenue for companies developing therapies; think of it as a distinct customer segment with a clear unmet need.
NT-proBNP medical
"reductions in NT-proBNP"
A blood test marker released when the heart is under strain; higher NT‑proBNP levels indicate the heart is working harder or may be failing, similar to a dashboard warning light that signals engine stress. Investors watch NT‑proBNP because changes in the marker can drive clinical trial results, treatment approvals, hospital use, and insurance decisions for heart drugs and devices, all of which affect revenue, adoption and valuation in healthcare companies.
right ventricular systolic pressure (RVSP) medical
"right ventricular systolic pressure (RVSP)"
Right ventricular systolic pressure (RVSP) is an echocardiographic estimate of the pressure generated by the right ventricle during contraction, commonly used as a noninvasive surrogate for pulmonary artery systolic pressure. It is calculated from the velocity of the tricuspid regurgitation jet using the Bernoulli equation and adding an estimate of right atrial pressure; consequently RVSP is an indirect measure that can be inaccurate when the regurgitation signal is poor, right atrial pressure is misestimated, or when measured by modalities other than Doppler echocardiography.
predictive enrichment strategy medical
"a predictive enrichment strategy for LEVEL-2"
Type C meeting regulatory
"granted an FDA Type C meeting"
Net loss $16.7 million Compared with $15.8 million in the three months ended September 30, 2025
Research and development expense $12.1 million Compared with $10.3 million in the three months ended September 30, 2025
Selling, general and administrative expense $5.7 million Compared with $6.5 million in the three months ended September 30, 2025
Cash and cash equivalents $113.7 million As of September 30, 2026
Guidance

Tenax expects its cash runway to fund operations through fiscal 2028; its current operating plan is subject to change pending the Type C meeting outcome.

AI-generated analysis. How Rhea-AI works. Not financial advice.

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false 0000034956 0000034956 2026-11-05 2026-11-05
 
 

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

 

 

FORM 8-K

 

 

CURRENT REPORT

Pursuant to Section 13 OR 15(d)

of The Securities Exchange Act of 1934

Date of Report (Date of earliest event reported): November 5, 2026

 

 

Tenax Therapeutics, Inc.

(Exact name of registrant as specified in its charter)

 

 

 

Delaware   001-34600   26-2593535
(State or other jurisdiction
of incorporation)
  (Commission
File Number)
  (IRS Employer
Identification No.)

101 Glen Lennox Drive, Suite 300

Chapel Hill, North Carolina 27517

(Address of principal executive offices) (Zip Code)

919-855-2100

(Registrant’s telephone number, including area code)

 

 

Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions:

 

☐

Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)

 

☐

Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)

 

☐

Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))

 

☐

Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))

Securities registered pursuant to Section 12(b) of the Act:

 

Title of each class

 

Trading
Symbol(s)

 

Name of each exchange
on which registered

Common Stock, $0.0001 par value per share   TENX   The Nasdaq Stock Market LLC

Indicate by check mark whether the registrant is an emerging growth company as defined in Rule 405 of the Securities Act of 1933 (17 CFR 230.405) or Rule 12b-2 of the Securities Exchange Act of 1934 (17 CFR 240.12b-2).

Emerging growth company ☐

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐

 

 
 


Item 2.02

Results of Operations and Financial Condition.

On November 5, 2026, Tenax Therapeutics, Inc. (the “Company”) issued a press release announcing its financial results for the third quarter ended September 30, 2026. A copy of the press release is attached hereto as Exhibit 99.1 and is incorporated herein in its entirety by reference.

The information in this Item 2.02 (including Exhibit 99.1) shall not be deemed “filed” for purposes of Section 18 of the Securities Exchange Act of 1934, as amended (the “Exchange Act”) or otherwise subject to the liabilities of that section, nor shall it be deemed incorporated by reference in any filing under the Securities Act of 1933, as amended or the Exchange Act, except as expressly set forth by specific reference in such a filing.

 

Item 9.01

Financial Statements and Exhibits.

(d) Exhibits

 

Exhibit
No.

  

Description

99.1    Press release dated November 5, 2026.
104    Cover Page Interactive Data File (embedded within the Inline XBRL document).

 


SIGNATURES

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.

 

Date: November 5, 2026   Tenax Therapeutics, Inc.
    By:  

/s/ Christopher T. Giordano

      Christopher T. Giordano
      President and Chief Executive Officer

Exhibit 99.1

 

LOGO

Tenax Therapeutics Reports Third Quarter 2026 Financial Results and Provides Corporate Update

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., November 5, 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 (49% reduction, nominal p<0.0001) and in right ventricular systolic pressure (RVSP), an echocardiographic measure of pulmonary arterial pressure (reduction of 3.5 mmHg, nominal p=0.0045). Subgroup analyses identified a meaningful beneficial treatment effect in patients with the most advanced disease, defined by their limitation in exercise capacity, hemodynamic elevation in central venous pressure (CVP), pulmonary arterial pressure (PAP), and pulmonary capillary wedge pressure (PCWP), and elevated NT-proBNP levels. The treatment effect in the half of the LEVEL population with greater exercise impairment was manifested not only by clinically meaningful changes in 6-minute walk distance (6MWD), but also by greater improvement in pulmonary hemodynamic measures than was observed overall.

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).


LOGO

 

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 50% of patients in LEVEL, following the protocol amendment we are in the process of implementing.”

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.


LOGO

 

  •  

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.

Third Quarter 2026 Financial Results

Cash position: Tenax Therapeutics reported cash and cash equivalents of $113.7 million as of September 30, 2026. The Company utilized $4.3 million in the third quarter of 2026 but has $16.2 million more cash and cash equivalents than on December 31, 2025. Tenax now expects its cash runway to fund operations through fiscal 2028, but its current operating plan is subject to change pending the outcome of its Type C meeting with the FDA.

Research and development (R&D): R&D expenses for the third quarter of 2026 were $12.1 million, compared to $10.3 million for the third quarter of 2025. The increase is primarily attributable to increased preclinical development costs and clinical costs associated with the Company’s LEVEL and LEVEL-2 clinical trials.

Selling, General and administrative (SG&A): SG&A expenses for the third quarter of 2026 were $5.7 million, compared to $6.5 million for the third quarter of 2025. The decrease is primarily attributable to a decrease in stock-based compensation expense, partially offset by an increase in professional fees as well as salary and benefit costs.

Net loss: Tenax Therapeutics reported a net loss of $16.7 million for the third quarter of 2026, compared to a net loss of $15.8 million for the third quarter of 2025.


LOGO

 

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


LOGO

 

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


LOGO

 

Tenax Therapeutics, Inc.

Condensed Consolidated Balance Sheets

(Amounts in thousands, except share and per share data)

 

     September 30,
2026
    December 31,
2025
 
     (unaudited)        

ASSETS

    

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 $0.0001, authorized 5,181,346 shares; issued and outstanding 210 as of September 30, 2026 and December 31, 2025

     —        —   

Common stock, par value $0.0001 per share; authorized 400,000,000 shares; issued and outstanding 45,536,448 as of September 30, 2026 and 9,314,130 as of December 31, 2025, respectively

     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  

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