Study to Assess the Safety, Tolerability and PK/PD After 4 Weekly SC Injections of PB1046 in Subjects With Stable HFrEF

Inclusion Criteria

• Willing and able to sign a written informed consent and follow all study-related procedures,
• Male subjects and female subjects of reproductive or childbearing potential must practice effective contraception during the study and be willing and able to continue contraception for 30 days after their last dose of study drug,
• Body mass index ≥ 18 kg/m2 and ≤ 45 kg/m2,
• Receipt of stable pharmacological therapy(ies) for heart failure for a minimum of 1 month prior to screening and between screening and randomization and are in stable clinical condition,
• NYHA Class II or III heart failure diagnosis (ischemic or non-ischemic confirmed by medical history) at least 6 months prior to screening,
• Stable HF defined as no hospitalizations for cardiac related issues within the previous 3 months prior to the screening visit or between screening and randomization,
• A screening or historical Left Ventricular Ejection Fraction ≤ 40% by centralized reading of 2-D echocardiography,
• Screening hemoglobin ≥ 9.0 g/dL secondary to the volume of blood to be collected during the study period,
• Willing and able to return to the study unit for specified study visits, and be able to self-monitor blood pressure while at home,
• Live and work in an area with reliable cellular services (e.g., Sprint®) for real time transmission of telemetry data to the core laboratory.

Exclusion Criteria

• Have previously received PB1046 or have a known allergy to the study drug or any of its components,
• Participating in any other study and have received any other investigational medication or device within 30 days prior to screening or are taking part in a non-medication study which, in the opinion of the Investigator, would interfere with study compliance or outcome assessments,
• Diagnosed with acute coronary syndrome (ACS) or an acute myocardial infarction (MI) within 3 months of screening,
• Canadian Cardiovascular Society (CCS) Class III or IV angina necessitating frequent use of as needed short acting nitroglycerin,
• Cardiac surgery or valvuloplasty within 3 months prior to screening,
• Cerebrovascular accident or transient ischemic attack within 3 months prior to screening,
• Sustained systolic blood pressure (SBP) 100 beats per minute (BPM) at screening (V1) or prior to randomization,
• History or evidence of clinically significant arrhythmias (uncontrolled by drug therapy or use of an implantable defibrillator), long QT syndrome or evidence of QT prolongation demonstrating QTcF > 460 ms prior to randomization (Subjects with QTcF >460 ms due to electronic pacing by an implanted pacemaker/ICD device may be enrolled),
• Clinically significant renal dysfunction as measured by the estimated glomerular filtration rate (eGFR) of 3.0 × the upper limit of normal (ULN), aspartate aminotransferase >3.0 × the ULN, or serum bilirubin ≥ 1.6 mg/dL at screening, or a clinically significant change in liver function between screening and baseline,
• Pregnant or lactating female subjects,
• Known history of or active alcohol abuse or use of illicit drugs within 1 year prior to randomization,
• Positive screening for human immunodeficiency virus antibodies, hepatitis B surface antigen, or hepatitis C virus antibodies,
• Any major surgical procedure within 1 month prior to screening or planned surgical procedure during the study period,
• Other medical or psychiatric condition which, in the opinion of the Investigator, would place the subject at increased risk or would preclude obtaining voluntary consent/assent or would confound the secondary objectives of study.