Tonix Pharmaceuticals Holding
Corp. TNXP ("Tonix"), a clinical-stage company developing
next-generation medicines for fibromyalgia, post-traumatic stress disorder,
and episodic tension-type headache, announced that it presented non-clinical
data from its TNX-201 (dexisometheptene mucate) program in two posters at
the 57(th) Annual Scientific Meeting of the American Headache Society in
Washington, DC. Tonix is currently evaluating TNX-201 in a Phase 2
proof-of-concept (POC) study in episodic tension-type headache. To learn
more, please visit www.clinicaltrials.gov (NCT02423408).
The active ingredient in TNX-201, dexisometheptene mucate, contains
(R)-isometheptene, or (R)-IMH, a single optical isomer of isometheptene.
Racemic IMH, a mixture of both the (R) and (S) isomers, had been widely used
as a single-agent prescription medicine and as a component of combination
drug products (e.g., Midrin(R) ) for many decades in the U.S. for various
indications including tension-type headache. IMH was introduced as a
pharmaceutical prior to 1962, and no products containing IMH are currently
approved by the U.S. Food and Drug Administration (FDA) for any indication.
TNX-201 is being developed as a new chemical entity for the treatment of
episodic tension-type headache, based on current FDA drug registration
requirements.
The two posters are summarized below, and are available on Tonix's website
at www.tonixpharma.com.
Abstract PS29. "(R)-Isometheptene (IMH) Binds to the Imidazoline-1 Receptor
and (S)-IMH Increases Blood Pressure: Potentially Superior Benefit-to-Risk
Ratio for (R)-IMH as an Analgesic for Headache"(1)
Key points:
-- Data from receptor binding studies, taken together with the recent
description of a decreased pain threshold in imidazoline-1 receptor
(I1R)
knock-out mice(2), suggest that I1R may be the primary site of action
for
racemic IMH's analgesic effects. Since (R)-IMH, the active ingredient in
TNX-201, binds I1R with approximately 60-fold greater affinity than
(S)-IMH, TNX-201 may be responsible for the therapeutic effect of
racemic
IMH.
-- In anesthetized rats, treatment with (S)-IMH resulted in dose-dependent
and statistically-significant blood pressure increases that were higher
relative to those produced by the (R)-isomer.
Abstract PS58. "The (R)-isomer of isometheptene, decreases trigeminal
sensitivity in the Inflammatory Soup and Spontaneous Trigeminal Allodynia
rat models"(3)
Key points:
-- The effects of (R)-IMH and (S)-IMH were evaluated in two rat models of
trigeminal pain which feature aspects of chronic migraine: the
Inflammatory Soup (IS) model and the Spontaneous Trigeminal Allodynia
(STA) model.(4,5) These models had been developed to allow for the
testing of therapeutic compounds for migraine. Both of these models
experience similar symptoms to human migraine patients such as episodic
or chronic trigeminal hypersensitivity, phonophobia, responsiveness to
abortive and prophylactic headache treatments, and sensitivity to
migraine triggers.
-- In the IS model, treatment with 30 mg/kg of (R)-IMH mucate significantly
increased trigeminal thresholds at each of the 0.5 hour (hr) (2.3-fold,
p<0.01), 1.5 hr (3.0-fold, p<0.01), 2.5 hr (2.9-fold, p<0.001), and 3.5
hr (1.7-fold, p<0.05) time points.
-- In the STA model, treatment with 30 mg/kg of (R)-IMH mucate
significantly
increased trigeminal thresholds at the 0.5 hr (7.8-fold, p<0.01), 1.5 hr
(4.3-fold, p<0.05), 2.5 hr (4.5-fold, p<0.01), 3.5 hr (8.5-fold,
p<0.01),
and 24 hr (8.2-fold, p<0.01) time points.
-- Treatment with 30 mg/kg of (S)-IMH mucate had no effect on trigeminal
sensitivity in either the IS or STA models.
"Our findings that TNX-201 selectively modulates a receptor in the central
nervous system that appears to regulate pain perception and responses,
together with positive data in two rodent models representative of migraine,
support the development of TNX-201 as a therapeutic for headache and
potentially other pain indications and one that may be differentiated from
currently-approved products," said Bruce Daugherty, Ph.D., Tonix's chief
scientific officer. "We look forward to reporting the results of our Phase 2
POC study in episodic tension-type headache in the fourth quarter of this
year."
References
(1) Daugherty BL, Gershell L, and Lederman S. (R)-isometheptene (IMH) binds
to the imidazoline-1 receptor and (S)-isometheptene increases blood
pressure: potentially superior benefit to risk ratio for (R)-IMH as an
analgesic for headache. Headache 2015;June 55(53):Abstract PS29. 172.
(2) Zhang L et al. CNS Neurosci Ther 2013;19:978-81.
(3) Fried NT, Oshinsky MI, Daugherty BL, Lederman S and Elliott MB. The (R)
isomer of isometheptene decreases trigeminal sensitivity in a rat model of
primary headache. Headache 2015;June 55(53):Abstract PS58. 184.
(4) Oshinsky ML and Gomonchareonsiri S. Headache 2007;47:1026-36.
(5) Oshinsky ML et al. Headache 2012;52:1336-1349.
About Episodic Tension-Type Headache
Episodic tension-type headache is the most common type of headache. It is
estimated that approximately 30% of U.S. adults experience frequent episodic
tension-type headaches (one to 15 headaches per month over a three-month
period). Tension-type headache pain is often described as a constant
pressure on both sides of the head, and typically lasts for several hours.
All of the FDA-approved prescription options for tension-type headache
contain barbiturates.
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