• Think of it as a focused, early-stage Amgen, dedicated to creating medicines for cardiovascular and pulmonary diseases still in clinical trials.
• It's like the R&D arm of a major pharmaceutical company like Pfizer, but operating independently to develop new heart and lung drugs.
• Essentially a specialty biotech company aiming to be the next Vertex Pharmaceuticals, but focused on treatments for heart and lung conditions.

• TNX-103 and TNX-102 (levosimendan): These are drug candidates for the treatment of pulmonary hypertension associated with heart failure with preserved ejection fraction and associated pulmonary hypertension.
• TNX-201 (imatinib): This is a tyrosine kinase inhibitor drug candidate for the treatment of pulmonary arterial hypertension.

Tenax Therapeutics (TENX) is a development-stage pharmaceutical company focused on identifying, developing, and commercializing products for cardiovascular and pulmonary diseases. Their current drug candidates are still in clinical trials (Phase II for TNX-103, TNX-102, and TNX-201) and have not yet received regulatory approval for commercial sale. As such, Tenax Therapeutics does not currently have major customers for its products as it is not actively selling commercial products to other companies or individuals.

• Orion Corporation (ORNBV)

Chris Giordano
President and Chief Executive Officer

Christopher Giordano has served as President and Chief Executive Officer of Tenax Therapeutics since July 2021. From early 2018 to 2021, he was President of IQVIA Biotech and IQVIA MedTech, two full-service clinical research business units of IQVIA (formerly Quintiles), where his team executed a clinical trial portfolio that grew from 250 to 400 active projects and produced double-digit annual sales growth. Mr. Giordano joined Quintiles in 2008 as Vice President, overseeing various consulting, regulatory, commercial, and clinical development services. He led over a dozen global cardiovascular outcomes trials during this period. Prior to Quintiles, from 2001 to 2008, he held sales and operational management roles at PPD, focusing on biotechnology companies.

Thomas McGauley
Chief Financial Officer

Thomas McGauley has served as the Interim Chief Financial Officer of Tenax Therapeutics since December 2024. Since July 2021, Mr. McGauley has been a member of Danforth Advisors, LLC, providing executive financial services to several public and private companies. From 2018 to 2022, he was a director at CBIZ in their accounting advisory practice, advising public and private clients and serving as interim chief financial officer for a private life sciences company. From 2009 to 2018, he was CFO and a consultant to various public and private life science companies, including Galectin Therapeutics Inc. His career began in public accounting, with his most recent position as a manager at PricewaterhouseCoopers LLP, specializing in life sciences and technology companies.

Stuart Rich, MD
Chief Medical Officer

Dr. Stuart Rich joined Tenax Therapeutics as Chief Medical Officer in 2021. He was a co-founder, Chief Executive Officer, and Director of PHPrecisionMed (PHPM) from October 2018 until January 2021. Dr. Rich previously served as Chief Medical Officer (part-time) of United Therapeutics from October 2003 until December 2004. He is also a Professor Emeritus of Medicine at Northwestern University Feinberg School of Medicine. Dr. Rich was a co-founder of the Pulmonary Vascular Research Institute. His extensive academic career includes serving as Professor of Medicine and Chief of the Section of Cardiology at the University of Illinois College of Medicine in Chicago, Professor of Medicine at the Rush Heart Institute of the Rush University School of Medicine, and Professor of Medicine at the Section of Cardiology of the University of Chicago Pritzker School of Medicine.

Key Risks to Tenax Therapeutics (TENX)

1. Clinical Trial and Regulatory Approval Risk: The primary risk to Tenax Therapeutics stems from the inherent uncertainties associated with the success of its ongoing Phase 3 clinical trials for levosimendan (TNX-103), particularly the LEVEL and LEVEL-2 studies, and the subsequent ability to obtain regulatory approval. Despite positive early indications, there is a substantial risk that these trials may fail to demonstrate sufficient efficacy or safety, or that the company may not receive necessary regulatory approvals (e.g., FDA approval) for its drug candidates. This risk is highlighted by the fact that Phase 3 clinical trial failures are a principal risk, with one source estimating a 60-70% chance of success for the lead asset.
2. Funding and Dilution Risk: Developing pharmaceutical products is a capital-intensive process. While Tenax Therapeutics has reported sufficient cash and cash equivalents to fund operations through 2027, the company has incurred ongoing operating losses, which widened in 2025. Future funding requirements for advanced clinical trials, potential commercialization, or unexpected delays could necessitate additional equity raises. Such capital raises may lead to significant dilution for existing shareholders, potentially pressuring the stock price.
3. Pipeline Dependency: Tenax Therapeutics' business prospects are largely dependent on the success of a limited number of product candidates, primarily TNX-103 for pulmonary hypertension associated with heart failure with preserved ejection fraction (PH-HFpEF). Any setbacks, such as clinical trial failures or prolonged regulatory delays concerning this lead candidate, would significantly impact the company's future value and viability, given the lack of diversification in its product pipeline.

Tenax Therapeutics (TENX) focuses on developing products for cardiovascular and pulmonary diseases. The addressable markets for its main products are as follows:

TNX-103 and TNX-102 (Levosimendan) for Pulmonary Hypertension associated with Heart Failure with Preserved Ejection Fraction (PH-HFpEF) and Associated Pulmonary Hypertension

While a specific standalone market size for PH-HFpEF is not readily available, the broader market for heart failure, which includes heart failure with preserved ejection fraction (HFpEF), provides context. The global congestive heart failure market is estimated to be valued at approximately USD 24.95 billion in 2025 and is projected to reach USD 40.85 billion by 2032. North America is expected to hold the largest share of this market, at 41.3% in 2025. Similarly, the global heart failure drugs market, encompassing both heart failure with reduced ejection fraction (HFrEF) and HFpEF, was valued at approximately USD 25 billion in 2025 and is projected to exceed USD 45 billion by 2033. North America dominates the heart failure drugs market. Pulmonary hypertension is a common complication in patients with heart failure, with prevalence estimates in HFpEF ranging from 30% to 88% depending on diagnostic methods and study design. A meta-analysis reported an overall pulmonary hypertension prevalence in individuals with heart failure of 46.6%, with a higher prevalence (47.2%) in those with preserved ejection fraction.

The global market for Levosimendan injection, which has expanded its clinical applications to include pulmonary hypertension, was estimated at USD 445.27 million in 2025 and is expected to grow to USD 760.27 million by 2032. This market includes regions such as Europe, the Middle East, and Asia-Pacific.

TNX-201 (Imatinib) for Pulmonary Arterial Hypertension (PAH)

The global addressable market for Pulmonary Arterial Hypertension (PAH) is substantial. In 2024, the global pulmonary arterial hypertension market size was estimated at USD 8.02 billion and is projected to reach USD 13.34 billion by 2033, demonstrating a compound annual growth rate (CAGR) of 5.9% from 2025 to 2033. Other estimates place the global market at USD 8.3 billion in 2024, with a forecast to grow to USD 13.9 billion by 2034. North America consistently represents the largest regional share of this market, holding approximately 41% to 52.9% of the global market. Specifically, the U.S. pulmonary arterial hypertension market was valued at USD 4 billion in 2024. The seven major markets (7MM), which include the U.S., France, Germany, Italy, Spain, UK, and Japan, are forecast to see the PAH market reach USD 9.35 billion by 2034.

Tenax Therapeutics (TENX) is poised for potential future revenue growth primarily driven by the advancement and eventual commercialization of its lead product candidate, TNX-103 (oral levosimendan), for the treatment of pulmonary hypertension associated with heart failure with preserved ejection fraction (PH-HFpEF). The company's strategy involves a multi-pronged approach to bring this potential first-in-class therapy to market.

Here are 3-5 expected drivers of future revenue growth for Tenax Therapeutics over the next 2-3 years:

1. Commercialization of TNX-103 (oral levosimendan) in North America: The most immediate and significant driver of future revenue growth is the successful completion of the Phase 3 LEVEL study, followed by regulatory approval and subsequent commercial launch of TNX-103 in the United States and Canada. The company achieved its randomization target of 230 patients in the LEVEL study in March 2026, with topline data anticipated in the third quarter of 2026. This milestone is critical for progressing towards potential regulatory approval and addressing a large, underserved patient population with no currently approved treatments for PH-HFpEF.
2. Global Market Expansion of TNX-103 through LEVEL-2 Study: Beyond the initial North American market, Tenax Therapeutics is pursuing a global commercialization strategy for TNX-103 through the ongoing Phase 3 LEVEL-2 study. This second global registrational trial was initiated in December 2025, with enrollment expected to conclude by the end of 2027. The successful completion of LEVEL-2 and subsequent regulatory approvals in additional territories would significantly expand the addressable market and contribute to long-term revenue growth.
3. Strategic Partnerships and Licensing Agreements for TNX-103: As a development-stage pharmaceutical company, Tenax Therapeutics' business model relies heavily on successful Phase 3 outcomes, regulatory approvals, and future commercialization or partnerships under its exclusive levosimendan license from Orion. Successful clinical trial results for TNX-103 could make it an attractive asset for larger pharmaceutical companies, leading to strategic partnerships or licensing agreements that could provide significant upfront payments, milestone payments, and royalties, thereby driving future revenue.

Share Issuance

• Tenax Therapeutics completed financing in August 2024 and a private placement in March 2025, raising approximately $125 million in total to fund the completion of two Phase 3 levosimendan clinical trials.
• In March 2025, the company completed a private placement resulting in gross proceeds of approximately $25 million from the issuance of common stock and pre-funded warrants.
• Net cash provided by financing activities was $99.9 million in 2024 and $38.5 million in 2025, which included $23.2 million from the March 2025 offering and $15.3 million from warrant exercises.

Inbound Investments

• RTW Investments participated in a private placement financing with Tenax Therapeutics in March 2025, providing approximately $25 million in gross proceeds.
• Institutional ownership of Tenax Therapeutics increased by 109.94% to 4,753,000 shares in the three months leading up to December 2025.
• As of December 2025, key institutional holders included Ikarian Capital, VR Adviser, RTW Investments, Siren, L.L.C., and Boothbay Fund Management, collectively holding significant ownership percentages.

Capital Expenditures

• The net proceeds from the March 2025 private placement are intended to be used for capital expenditures, working capital, and other general corporate purposes, primarily to advance ongoing and planned Phase 3 clinical trials.
• Research and development expenses, which support the company's clinical trials, increased significantly from $12.7 million in 2024 to $32.7 million in 2025.
• Tenax Therapeutics reported minimal capital expenditures of $2,000 in the third quarter of 2023.