Tonix Pharmaceuticals Holding Corp. 8-K
Exhibit 99.03
TNX - 801: A Novel Mpox Vaccine: Live, Replicating, Attenuated Orthopoxvirus (Horsepox) Vaccine Zeil Rosenberg MD Executive Vice President, Medical World Vaccine Congress Washington DC, April 5, 2023 © 2023 Tonix Pharmaceuticals Holding Corp.
2 © 2023 Tonix Pharmaceuticals Holding Corp. Cautionary Note on Forward - Looking Statements Certain statements in this presentation regarding strategic plans, expectations and objectives for future operations or results are “forward - looking statements” as defined by 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” 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, the risks related to failure to obtain FDA clearances or approvals and noncompliance with FDA regulations; delays and uncertainties caused by the global COVID - 19 pandemic; 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. The forward - looking statements in this presentation are made as of the date of this presentation, even if subsequently made available by Tonix on its website or otherwise. Tonix does not undertake an obligation to update or revise any forward - looking statement, except as required by law. Investors should read the risk factors set forth in the Annual Report on Form 10 - K for the year ended December 31, 2022, as filed with the Securities and Exchange Commission (the “SEC”) on March 13, 2023, and periodic reports and current 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.
3 In 1796 Edward Jenner Successfully Used Vaccination to Protect Against Smallpox • Jenner reasoned infection with illness similar to smallpox, but less deadly, could protect against smallpox ‒ “Jenner “vaccinated” ( vacca , Latin for “cow”) a patient with pustule matter from “cowpox” sores on a milkmaid’s hands; ‒ Patient remained healthy when challenged with smallpox virus • Jenner wrote he suspected that the agent causing cowpox, which he called vaccinia , actually originated in horses and was transferred from horses to cows’ udders by contaminated farm workers’ hands. The College of Physicians of Philadelphia. Accessed July 15, 2021. https:// www.historyofvaccines.org © 2023 Tonix Pharmaceuticals Holding Corp.
4 Vaccinia Induces a Skin Reaction Called “Take” Described by Dr. Edward Jenner * Example of major cutaneous reaction, or “take,” resulting from a replication - competent live - virus vaccine with intradermal delivery, indicating successful vaccination 1,2 5 mm Vaccine Intra - epidermal vaccination Take 2 © 2023 Tonix Pharmaceuticals Holding Corp. • Biomarker of protection ‒ Smallpox was eradicated using this marker ‒ Revaccination indicated for recipients without “take” • Measure of T cell immunity ‒ No need for blood draws or complex laboratory studies ‒ No other functional T cell assay is approved or in clinical use for vaccination 1 Fulginiti VA, et al. Clin Infect Dis. 2003;37(2):241 - 250. 2 Centers for Disease Control and Prevention. Accessed April 15, 2020. https://phil.cdc.gov/Details.aspx?pid=32 76
5 TNX - 801 Development • U.S. smallpox vaccine manufactured in 1902 (H.K. Mulford) ‒ 99.7% similar to horsepox in core viral sequence 1,2 • Tonix - 801 is based on a sequence of an isolated horsepox (HPXV) clone 3 − Synthesized 4 in 2018 (isolate was unavailable outside of CDC) − No new gene elements introduced • Sequencing showed Tonix - 801 identical to CDC publication of a 1976 horsepox isolate 5 1 Tulman ER, et al. Genome of horsepox virus. J Virol . 2006 80(18):9244 - 58.PMID:16940 536 2 Schrick, L. et al An Early American Smallpox Vaccine Based on Horsepox N Engl J Med 2017; 377:149 3Noyce RS, et al.. Construction of an infectious horsepox virus vaccine from chemically synthesized DNA fragments. PLoS One . 2018 Jan 19;13(1):e0188453 4Trindade GS , et al. Serro 2 Virus Highlights the Fundamental Genomic and Biological Features of a Natural Vaccinia Virus Inf ecting Humans. Viruses 2016 Dec 10;8(12). pii: E328. PMID:27 9733 99 PMCID: PMC5192389 DOI: 10.3390/v8120328 5Noyce, RS, et al. Synthetic Chimeric Horsepox Virus (scHPXV) Vaccination Protects Macaques from Monkeypox* Presented as a poster at the American Society of Microbiology BioThreats Conf erence - January 29, 2020, Arlington, VA. ( https://content.equisolve.net/tonixpharma/media/10929ac27f4fb5f5204f5cf41d59a121.pdf ) © 2023 Tonix Pharmaceuticals Holding Corp.
6 Illustrative Safety Spectrum Of Pox - based Vaccine Vectors Optimizing Live Virus Vaccines Very safe but high, multiple dose ~1 death per million ~10 deaths per million Nonreplicating Poor Transgene immunogenicity Waning immunity Robust Replication Risk for Adverse Events Parental smallpox vaccines Dryvax Lister TianTan Copenhagen Tashkent MVA Canarypox Fowlpox Optimal Replicative Capacity (“sweet spot”) ΔF4L ΔJ2R ΔJ2R New Live Recombinant Poxvirus Vaccine (rPXV) Intermediate Replicative Capacity Robust Transgene Immunogenicity © 2023 Tonix Pharmaceuticals Holding Corp.
7 © 2023 Tonix Pharmaceuticals Holding Corp. Orthopoxvirus Virulence as Visualized by Plaque Assay
8 © 2023 Tonix Pharmaceuticals Holding Corp.
9 TNX - 801 Vaccination and Lethal Challenge in Macaques “Take” observed in all TNX - 801 vaccinated NHPs except one. • If no take by day 7 were revaccinated on day 14. Post - vaccination, no NHP showed lesions during first 60 days TNX - 801 (High Dose) TNX - 801 (Low Dose ) © 2023 Tonix Pharmaceuticals Holding Corp.
10 Immunogenicity: Total IgG (ELISA) 100% seroconversion in Tonix - 801 vaccinated groups with antibody titers 2 - to 16 - fold higher than baseline by day 28 and 4 - to 8 – fold higher at day 56. © 2023 Tonix Pharmaceuticals Holding Corp.
11 Immunogenicity: Neutralizing Antibody (PRNT 50 Assay) 88% of TNX - 801 vaccinated NHPs had neutralizing antibody responses 8 - to 50 - fold from baseline © 2023 Tonix Pharmaceuticals Holding Corp.
12 Measured Virus Shedding: Oral Swabs TNX - 801 (High Dose) © 2023 Tonix Pharmaceuticals Holding Corp. TNX - 801 (Low Dose) rVACV Mock Minimal or no virus shedding in Tonix - 801 vaccinated groups
13 Measured Viremia TNX - 801 (High Dose) © 2023 Tonix Pharmaceuticals Holding Corp. TNX - 801 (Low Dose) rVACV Mock Minimal sporadic or no viremia in Tonix - 801 vaccinated groups
14 Clinical Disease: Weight Loss TNX - 801 (High Dose) © 2023 Tonix Pharmaceuticals Holding Corp. TNX - 801 (Low Dose) rVACV Mock Minimal or no weight loss in Tonix - 801 vaccinated groups
15 Clinical Signs After MPXV Challenge NHPs vaccinated with Tonix - 801: No lesions observed after MPXV challenge in any of the eight animals 1 Noyce, RS, et al. Synthetic Chimeric Horsepox Virus (scHPXV) Vaccination Protects Macaques from Monkeypox* Presented as a poster at the American Society of Microbiology BioThreats Conf erence - January 29, 2020, Arlington, VA. ( https://content.equisolve.net/tonixpharma/media/10929ac27f4fb5f5204f5cf41d59a121.pdf ) © 2023 Tonix Pharmaceuticals Holding Corp. TNX - 801 High Dose TNX - 801 Low Dose rVACV
16 Clinical Disease: Lethality No deaths in Tonix - 801 vaccinated groups © 2023 Tonix Pharmaceuticals Holding Corp.
17 © 2023 Tonix Pharmaceuticals Holding Corp. Study Conclusions for TNX - 801 Non - Human Primate Challenge • A single dose vaccination was well tolerated ‒ No severe adverse events • Vaccination was immunogenic • Mpox disease (lesions) was not observed following MPXV (Zaire) challenge • All vaccinated NHPs survived lethal challenge
18 Live Recombinant Poxvirus (rPXV) Vaccine Platform Profile POTENTIALLY LONGER DURABILITY DUE TO POX - ENGINEERED ARCHITECTURE • Live virus vaccines present unique “danger signals” (PAMPs) • Results in strong immune response PROGRAMMABLE VECTOR DESIGN FOR USE IN DIFFERENT DISEASES • Large capacity for expressing inserted genes • Wide range of clinical applications: pandemic, biodefense, infectious disease, smallpox, oncology LIVE VIRUS - BASED SCIENCE IS WELL ESTABLISHED • Streamlined development • Ability to vertically integrate development and manufacturing • Standard cold - chain requirements © 2023 Tonix Pharmaceuticals Holding Corp.
19 Approved Recombinant Poxvirus - Based Commercial Products 1 - 3 Product Application / disease Location Poxvirus vector Host restricted? Doses released to environment TROVAC - AIV H5N1 Boehringer Ingelheim Agriculture/avian influenza Mexico, Central America TROVAC - AIV H5N1 No Replication competent 2 billion (as of 2006) Purevax FeLV Boehringer Ingelheim Companion animals (cats)/FeLV US, others ALVAC - FeLV Gag/Pol Yes Replication incompetent Unknown Purevax Rabies Boehringer Ingelheim Companion animals (cats)/rabies US, others ALVAC - RG Yes Replication incompetent Unknown Recombitek Boehringer Ingelheim Companion animals (dogs)/canine distemper US, others ALVAC - HA, F Yes Replication incompetent Unknown Raboral V - RG Rabisin Boehringer Ingelheim Wildlife control of rabies US, Europe, Israel Vaccinia Copenhagen RG No Replication competent 250 million doses 5 million doses/year © 2022 Tonix Pharmaceuticals Holding Corp. 1 Boehringer Ingelheim. Accessed July 15, 2021. https://w ww.boehringer - ingelheim.com/animal - health/ products 2 Bublot M, Pritchard N, Sw ayne DE, et al. Development and use of fow lpox vectored vaccines for avian influenza. Ann N Y Acad Sci . 2006;1081:193 - 201. 3 Maki J, Guiot AL, Aubert M, et al. Oral vaccination of w ildlife using a vaccinia - rabies - glycoprotein recombinant virus vaccine (RABORAL V - RG ® ): a global review . Vet Res . 2017;48(1):57.
20 Emerging Infectious Disease R&D and Manufacturing Capability © 2023 Tonix Pharmaceuticals Holding Corp.
21 © 2023 Tonix Pharmaceuticals Holding Corp. American Pandemic Preparedness Plan (AP3) White House OSTP AP3 Plan Element Tonix rPXV Vaccine Platform Potential Rapid Design, Testing Review <100 days 4 - 6 mo. Design - to - FIH trial Rapid Production Scale Up Large scale production <130 days possible Distribution Stable Traditional cold - chain Administration Intraepidermal : BFN or skin patch Non - Sterile No syringes Adaptation rPXV platform can express large inserts Public Health Strategy Potential to reduce onward transmission 1 dose only Ideal for Ring Vaccination Strategy
22 © 2022 Tonix Pharmaceuticals Holding Corp. Investigators and Collaborators Tonix • Seth Lederman • Siobhan Fogarty • Sina Bavari • Scott Goebel • Bruce Daugherty • Farooq Nasar • Helen Stillwell 1 Univ. of Alberta • Ryan Noyce • David Evans Current Addresses 1 University of Pennsylvania 2 IITRI Univ. of Maryland – Institute of Human Virology • José Esparza Southern Research • Fusataka Koide • Landon Westfall 2 • Karen Gilbert 3 LINQ Pharma Consulting • Onesmo Mpanju 3 National Toxicology Program (NTP) at National Institute of Environmental Health Sciences (NIEHS), NIH; Artic Slope Regional Corp.
THANK YOU © 2023 Tonix Pharmaceuticals Holding Corp.