NRx Pharmaceuticals Announces Initiation of Emergency Use Training and Extension of Phase 2/3 Inhaled ZYESAMI (Aviptadil-acetate) Trial in the Nation of Georgia

NRx Pharmaceuticals (Nasdaq: NRXP) (NRx), a clinical stage biopharmaceutical company, today announced it is initiating clinical training of Nation of Georgia (Georgia) ICU physicians, in the use of intravenous ZYESAMI™ (Aviptadil- acetate) for emergency use in patients suffering with Critical COVID-19, and inhaled ZYESAMI™ for use in phase 2/3 clinical trials, for patients suffering with COVID-19.

NRx also announced that the ongoing phase 2/3 trial for the use of inhaled ZYESAMI™ has extended to Georgia, with the potential to also extend to neighboring countries in the Caucasus region, in partnership with Cromos, LLC and Denk Pharma (Georgia), operating as BriLife, LLC. NRx expects to ship clinical drug supplies to Georgia within two weeks. The development of intravenous Aviptadil-acetate, in non-GMP form was partially-funded by a collaboration agreement with Relief Therapeutics (SIX:RLF,OTCBB:RLFTF).

"We at NRx have been deeply touched by the warmth and hospitality extended by the people of Georgia, from the Prime Minister and the Minister of Health to the front-line doctors and nurses who are battling this lethal pandemic, that continues to rage despite great progress with vaccinations," said Prof. Jonathan C. Javitt, MD, MPH, Chairman and CEO of NRx. "We look forward to our expanding partnership with Georgia and its people, a partnership supported by the US Congress through its funding of the Senator Richard G. Lugar Center for Public Health Research, at a time when the first lethal generations of Coronavirus (SARS and MERS) first threatened humanity. In the coming weeks, we hope to broaden this partnership in Georgia, as well as with our partners at the National Institutes of Health and elsewhere."

About ZYESAMI™/VIP in COVID-19

ZYESAMI™ (Aviptadil-acetate) is a synthetic form of Vasoactive Intestinal Polypeptide (VIP) first discovered by the late Prof. Sami Said in 1970, and ZYESAMI™ is named in his honor. Although primarily concentrated in the lung, it was first purified from the intestinal tract. VIP binds specifically to the alveolar type II cell (ATII) in the air sac (alveolus) of the lung, where it has been shown to have potent anti-inflammatory/anti-cytokine activity in animal models of respiratory distress, acute lung injury, and inflammation. Most importantly, VIP stimulates ATII cells to make the surfactant that must coat the lining of the lungs in order for them to exchange oxygen with the blood.  Loss of surfactant causes respiratory failure and alveolar collapse, which are hallmarks of COVID-19.

COVID-19-related respiratory failure is caused by selective infection of the ATII cell by the SARS-CoV-2 virus. The ATII cells are vulnerable because of their (ACE2) surface receptors, which serve as the route of entry for the virus. Coronavirus infection of the ATII cell shuts down surfactant production, triggers the formation of inflammatory cytokines, and causes cell death. VIP is shown to upregulate surfactant production, block Coronavirus replication in the ATII cell, block cytokine synthesis, and prevent viral-induced cell death. Other than ZYESAMI™, no currently proposed treatments for COVID-19 specifically target this mechanism of action. ZYESAMI™ is not approved by any regulatory authority, including the FDA and European Medicines Agency.

About NRx Pharmaceuticals

NRx  draws upon more than 300 years of collective, scientific and drug-development experience to bring improved health to patients. In addition to its work on ZYESAMI™ (Aviptadil-Acetate), the United States Food and Drug Administration has granted Breakthrough Therapy Designation and a Special Protocol Agreement to NRx to develop NRX-101, an investigational medicine to treat suicidal bipolar depression. NRX-101 is currently in Phase 3 trials, with readouts expected in 2022. NRx is led by executives who have held senior roles at Allergan, J&J, Lilly, Novartis, Pfizer, and the US FDA. NRx is publicly traded on the Nasdaq Global Select Exchange under the stock ticker NRXP.