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08/18/20 12:35 PM

#9083 RE: Curt D #9072

RLFTF: FDA Grants Inhaled Use IND for RLF-100 (Aviptadil) to Treat Patients With Moderate and Severe COVID-19 Aiming to Prevent
August 5, 2020, 10:30 PM PDT

FDA Grants Inhaled Use IND for RLF-100 (Aviptadil) to Treat Patients With
Moderate and Severe COVID-19 Aiming to Prevent Progression to Respiratory
Failure

* Aviptadil is now shown as the first COVID therapeutic to block replication
of the SARS-CoV-2 virus in human lung cells and monocytes, while also
preventing synthesis of cytokines in the lung
* RLF-100 is a patented formulation of aviptadil (synthetic human Vasoactive
Intestinal Polypeptide, VIP), which has been granted FDA Fast Track
Designation, FDA emergency use IND authorization, and an expanded access
protocol.

Business Wire

RADNOR, Pa. & GENEVA -- August 6, 2020

NeuroRx, Inc. and Relief Therapeutics Holdings AG (SIX:RLF, OTC:RLFTF)
“Relief” today announced that NeuroRx has been granted Investigational New
Drug (IND) permission to test RLF-100 (aviptadil) for inhaled use in patients
with moderate and severe COVID-19 in order to prevent progression to
respiratory failure.

The study is posted at https://clinicaltrials.gov/ct2/show/NCT04360096 . The
first phase will commence with patients hospitalized for severe COVID-19 who
do not yet have respiratory failure. If promising results are seen in the
inpatient setting, the trial will expand to patients at home with mild and
moderate COVID-19 in order to prevent the need for hospital admission.

Professor Jonathan Javitt, MD, MPH, CEO of NeuroRx said, “Now that we know VIP
suppresses replication of the SARS-CoV-2 virus in human lung cells, based on
the outstanding work of the Oswaldo Cruz Institute (Rio de Janeiro).^1 We are
optimistic that treatment with VIP will not only help patients on ventilators,
but will help to stop the advancement of the virus in patients with earlier
stages of COVID-19. By blocking cytokine synthesis in the lung cells and
increasing the production of surfactant, which is key to the lung’s ability to
transmit oxygen, we are hopeful that inhaled VIP will prove to be of clinical
benefit across a wider array of patients suffering respiratory complications
from COVID-19 infection.”

The clinical trial of the inhaled formulation of RLF-100 is expected to begin
on or before September 1, 2020.

About VIP in Lung Injury

Vasoactive Intestinal Polypeptide (VIP) was first discovered by the late Dr.
Sami Said in 1970. Although first identified in the intestinal tract, VIP is
now known to be produced throughout the body and to be primarily concentrated
in the lungs. VIP has been shown in more than 100 peer-reviewed studies to
have potent anti-inflammatory/anti-cytokine activity in animal models of
respiratory distress, acute lung injury, and inflammation. Most importantly,
70% of the VIP in the body is bound to a rare cell in the lung, the Alveolar
Type II cell, which is critical for the transmission of oxygen to the body.
VIP has a 20-year history of safe use in humans in multiple human trials for
sarcoidosis, pulmonary fibrosis, asthma/allergy, and pulmonary hypertension.

COVID-19-related death is primarily caused by respiratory failure. Before this
acute phase, however, there is evidence of early viral infection of the
alveolar type 2 cells. These cells are known to have angiotensin converting
enzyme 2 (ACE2) receptors at high levels, which serve as the route of entry
for the SARS-CoV-2 into the cells. Coronaviruses are shown to replicate in
alveolar type 2 cells, but not in the more numerous type 1 cells. These same
type 2 alveolar cells have high concentrations of VIP receptors on their cell
surfaces giving rise to the hypothesis that VIP could specifically protect
these cells from injury.

Injury to the type 2 alveolar cells is an increasingly plausible mechanism of
COVID-19 disease progression (Mason 2020). These specialized cells replenish
the more common type 1 cells that line the lungs. More importantly, type 2
cells manufacture surfactant that coats the lung and is essential for oxygen
exchange. Other than RLF-100, no currently proposed treatments for COVID-19
specifically target these vulnerable type 2 cells.

About RLF-100

RLF-100 (aviptadil) is a patented formulation of Vasoactive Intestinal
Polypeptide (VIP) that was developed based on Dr. Said’s original work and was
originally approved for human trials by the FDA in 2001 and the European
Medicines Agency in 2005. VIP is known to be highly concentrated in the lungs
and to inhibit a variety of inflammatory cytokines. Relief’s predecessor
company, Mondo Biotech, was awarded Orphan Drug Designation in 2001 by the
U.S. FDA for aviptadil in the treatment of Acute Respiratory Distress Syndrome
and in 2005 for treatment of Pulmonary Arterial Hypertension. Mondo was
awarded Orphan Drug Designation by the European Medicines Agency in 2006 for
the treatment of acute lung injury and in 2007 for the treatment of
sarcoidosis. Both Mondo and Relief have worked on the development of an
inhaled formulation of aviptadil for several years. Both the U.S. FDA and the
EMEA have granted Investigational New Drug licenses for human trials of
aviptadil.

About RELIEF THERAPEUTICS Holding AG

The Relief group of companies focus primarily on clinical-stage projects based
on molecules of natural origin (peptides and proteins) with a history of
clinical testing and use in human patients or a strong scientific rationale.
Currently, Relief is concentrating its efforts on developing new treatments
for respiratory disease indications.

Relief Therapeutics holds orphan drug designations from the U.S. Food and Drug
Administration and the European Union for the use of VIP to treat ARDS,
pulmonary hypertension, and sarcoidosis. Relief Therapeutics also holds a U.S.
patent (US8178489 formulation for aviptadil) for RLF-100 and proprietary
manufacturing processes for its synthesis.

RELIEF THERAPEUTICS Holding AG is listed on the SIX Swiss Exchange under the
symbol RLF.

About NeuroRx, Inc.

NeuroRx draws upon more than 100 years of collective drug development
experience and is led by former senior executives of Johnson & Johnson, Eli
Lilly, Pfizer, and AstraZeneca, PPD. In addition to its work on RLF-100,
NeuroRx has been awarded Breakthrough Therapy Designation and a Special
Protocol Agreement to develop NRX-101 for the treatment of suicidal bipolar
depression and is currently in Phase 3 trials. Its Board of Directors and
Advisors includes Hon. Sherry Glied, former Assistant Secretary, U.S. Dept. of
Health and Human Services; Mr. Chaim Hurvitz, former President of the Teva
International Group, Lt. Gen. HR McMaster, the 23rd National Security Advisor,
Wayne Pines, former Associate Commissioner of the U.S. Food and Drug
Administration, Judge Abraham Sofaer, and Daniel Troy, former Chief Counsel,
U.S. Food and Drug Administration.

Disclaimer: This communication expressly or implicitly contains certain
forward-looking statements concerning RELIEF THERAPEUTICS Holding AG, NeuroRx,
Inc. and their businesses. Such statements involve certain known and unknown
risks, uncertainties and other factors, which could cause the actual results,
financial condition, performance or achievements of RELIEF THERAPEUTICS
Holding AG and/or NeuroRx, Inc. to be materially different from any future
results, performance or achievements expressed or implied by such
forward-looking statements. RELIEF THERAPEUTICS Holding AG is providing this
communication as of this date and does not undertake to update any
forward-looking statements contained herein as a result of new information,
future events or otherwise.

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1 Temerozo JR, Sacramenta Q, Fintelman-Rodriques N, et. al. The neuropeptides
VIP and PACAP inhibit SARS-CoV-2 replication in monocytes and lung epithelial
cells, decrease the production of proinflammatory cytokines, and VIP levels
are associated with survival in severe Covid-19 patients doi:
https://doi.org/10.1101/2020.07.25.220806.
https://www.biorxiv.org/content/10.1101/2020.07.25.220806v2.full

View source version on businesswire.com:
https://www.businesswire.com/news/home/20200805006124/en/

Contact:

CORPORATE
US Inquiries
Jonathan C. Javitt, M.D., MPH
Chief Executive Officer
NeuroRx, Inc.

ceo@neurorxpharma.com
Europe Inquiries
Yves Sagot, Ph.D.
Chief Scientific Officer
Relief Therapeutics Holding AG
yves.sagot@relieftherapeutics.com

https://www.bloomberg.com/press-releases/2020-08-06/fda-grants-inhaled-use-ind-for-rlf-100-aviptadil-to-treat-patients-with-moderate-and-severe-covid-19-aiming-to-prevent-kdid2n2s