This study will be a sequential multiple-dose escalation study that will enroll (randomize and dose) approximately 28 subjects in four cohorts consisting of 3 active and 1 placebo in Cohort 1 and 6 active and 2 placebo in subsequent cohorts. Randomized subjects will receive a fixed weekly dose of study drug or placebo for a 4 week dosing period.
Qualifying subjects will have a diagnosis of NYHA Class II or III heart failure with a reduced ejection fraction (HFrEF), be in stable condition, and be taking clinician-directed appropriate pharmacological therapy (e.g., angiotensin converting enzyme inhibitors, angiotensin receptor blockers or an evidence based beta blocker) for heart failure at stable doses (with the exception of diuretics) for at least 1 month prior to screening. During the period between screening and randomization (planned first dose), the study subject will remain on stable pharmacological therapy for heart failure. Also the study subject will be in stable health with no hospitalizations or clinically significant acute illnesses between screening and randomization that would put the subject at increased risk for study participation. Randomized subjects will receive a fixed weekly dose of study drug or placebo for a 4 week dosing period. Dose escalation in subsequent cohorts will continue if the safety and pharmacokinetic profile are deemed acceptable as assessed by the Study Review Committee.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
29
Four weekly subcutaneous injections of PB1046.
Four weekly subcutaneous injections of placebo.
Pinnacle Research Group, LLC
Anniston, Alabama, United States
Phoenix Medical Research
Peoria, Arizona, United States
Cardiology Associates Research Company
Daytona Beach, Florida, United States
Revivial Research
Miami, Florida, United States
Telemetry
Number of participants with rhythm abnormalities as assessed by continuous mobile telemetry monitoring.
Time frame: Up to six weeks starting 7 to 10 days before first dose.
12-Lead ECG Assessment - Incidence of Clinically Significant Findings
Number of participants with a clinically significant change from baseline in 12-Lead ECG and presence of rhythm abnormalities and relationship to exposure of PB1046 compared to placebo
Time frame: Seven weeks starting the first week of dosing.
12-Lead ECG - Categorical Analysis of QT/QTc Interval - Participants With Clinically Significant Findings
Number of participants with a clinically significant change from baseline in 12-Lead ECG and presence or absence of rhythm abnormalities and relationship to exposure of PB1046 compared to placebo
Time frame: Seven weeks starting the first week of dosing.
Laboratory Parameters - Serum Chemistry - Participants With Clinically Significant Findings
Number of participants with clinically significant changes from baseline in laboratory parameters (serum chemistry) and the relationship to PB1046 compared to placebo
Time frame: Eight weeks starting one week before first dose.
Laboratory Parameters - Hematology - Participants With Clinically Significant Findings
Number of participants with clinically significant changes from baseline in laboratory parameters (hematology) and the relationship to PB1046 compared to placebo
Time frame: Eight weeks starting one week before first dose.
Laboratory Parameters - Urinalysis - Participants With Clinically Significant Findings
Number of participants with clinically significant changes from baseline in laboratory parameters (urinalysis) and the relationship to PB1046 compared to placebo
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North Dallas Research Associates
McKinney, Texas, United States
Time frame: Eight weeks starting one week before first dose.
Laboratory Parameters - eGFR
Changes from baseline in laboratory parameters (eGFR) and the relationship to PB1046 compared to placebo. Calculated using Chronic Kidney Disease Epidemiology Collaboration Equation (CKD-EPI)
Time frame: Baseline, Week 2, 3, 4, 5 and 8.
Laboratory Parameters - Lipid Profile - Participants With Clinically Significant Findings
Number of participants with clinically significant changes from baseline in laboratory parameters (lipid profile) and the relationship to PB1046 compared to placebo
Time frame: Eight weeks starting one week before first dose (Baseline and at Week 8).
Vital Signs - Systolic Blood Pressure
Changes from baseline in vital signs (systolic blood pressure) and the relationship to PB1046 compared to placebo.
Time frame: Baseline, Day 0, Day 1, 2, 3, 5, 7, 14, 21, 22, 23, 24, 26, 28, 29, 30, 31, and 49.
Vital Signs - Heart Rate
Changes from baseline in vital signs (heart rate) and the relationship to PB1046 compared to placebo.
Time frame: Baseline, Day 0, Day 1, 2, 3, 5, 7, 14, 21, 22, 23, 24, 26, 28, 29, 30, 31, and 49.
Vital Signs - Temperature
Changes from baseline in vital signs (temperature) and the relationship to PB1046 compared to placebo.
Time frame: Baseline, Day 0, Day 1, 2, 3, 5, 7, 14, 21, 22, 23, 24, 26, 28, 29, 30, 31, and 49.
Vital Signs - Respiratory Rate
Changes from baseline in vital signs (respiratory rate) and the relationship to PB1046 compared to placebo.
Time frame: Baseline, Day 0, Day 1, 2, 3, 5, 7, 14, 21, 22, 23, 24, 26, 28, 29, 30, 31, and 49.
Vital Signs - Diastolic Blood Pressure
Changes from baseline in vital signs (systolic blood pressure) and the relationship to PB1046 compared to placebo.
Time frame: Baseline, Day 0, Day 1, 2, 3, 5, 7, 14, 21, 22, 23, 24, 26, 28, 29, 30, 31, and 49.
Pharmacokinetic Profile - Area Under the Curve Over the Dosing Interval [AUC(0-t)]
Comparison of dose exposures \[AUC(0-t)\] during once weekly administration of various doses of PB1046
Time frame: Pre-dose, Day 1 post-dose (1, 3, 24, 48, 72, 120 hours post-dose 1), Day 7, 14, 21 (1, 3, 24, 48, 72, 120 hours post-dose 4), Day 22, 23, 24, 26, 28, 29, 30, and 31.
Pharmacokinetic Profile - Maximum Serum Concentration (Cmax)
Comparison of dose exposures (Cmax) during once weekly administration of various doses of PB1046
Time frame: Pre-dose, Day 1 post-dose (1, 3, 24, 48, 72, 120 hours post-dose 1), Day 7, 14, 21 (1, 3, 24, 48, 72, 120 hours post-dose 4), Day 22, 23, 24, 26, 28, 29, 30, and 31.
Pharmacokinetic Profile - Time to Cmax (Tmax)
Comparison of dose exposures (Tmax) during once weekly administration of various doses of PB1046
Time frame: Pre-dose, Day 1 post-dose (1, 3, 24, 48, 72, 120 hours post-dose 1), Day 7, 14, 21 (1, 3, 24, 48, 72, 120 hours post-dose 4), Day 22, 23, 24, 26, 28, 29, 30, and 31.
Pharmacokinetic Profile - Elimination Rate Constant (Lambda z)
Comparison of dose exposures (lambda z) during once weekly administration of various doses of PB1046
Time frame: Pre-dose, Day 1 post-dose (1, 3, 24, 48, 72, 120 hours post-dose 1), Day 7, 14, 21 (1, 3, 24, 48, 72, 120 hours post-dose 4), Day 22, 23, 24, 26, 28, 29, 30, and 31.
Pharmacokinetic Profile - Elimination Half-life (t½)
Comparison of dose exposures (t½) during once weekly administration of various doses of PB1046
Time frame: Pre-dose, Day 1 post-dose (1, 3, 24, 48, 72, 120 hours post-dose 1), Day 7, 14, 21 (1, 3, 24, 48, 72, 120 hours post-dose 4), Day 22, 23, 24, 26, 28, 29, 30, and 31.
Pharmacokinetic Profile - Clearance (CL/F), Uncorrected for Bioavailability
Comparison of dose exposures (CL/F) during once weekly administration of various doses of PB1046
Time frame: Pre-dose, Day 1 post-dose (1, 3, 24, 48, 72, 120 hours post-dose 1), Day 7, 14, 21 (1, 3, 24, 48, 72, 120 hours post-dose 4), Day 22, 23, 24, 26, 28, 29, 30, and 31.
Pharmacokinetic Profile - Volume of Distribution (Vz/F), Uncorrected for Bioavailability (F)
Comparison of dose exposures (Vz/F) during once weekly administration of various doses of PB1046
Time frame: Pre-dose, Day 1 post-dose (1, 3, 24, 48, 72, 120 hours post-dose 1), Day 7, 14, 21 (1, 3, 24, 48, 72, 120 hours post-dose 4), Day 22, 23, 24, 26, 28, 29, 30, and 31.
Immunogenicity
Number of participants reporting positive immunogenicity (four-fold increase of pre-dose titer)
Time frame: Eleven weeks starting the first week of dosing.