Study of Verinurad in Heart Failure With Preserved Ejection Fraction

Inclusion Criteria:

Patient must be ≥ 40 years of age at the time of signing the ICF
Patients with hyperuricaemia defined as sUA level of > 6 mg/dL.

Patients with documented diagnosis of symptomatic HFpEF according to all of the following criteria:

Have NYHA functional class II-III at enrolment
Have medical history of typical symptoms/signs of HF > 6 weeks before enrolment
LVEF ≥ 45%
NT-proBNP ≥ 125 pg/mL (≥ 14.75 pmol/L) at Visit 1 for patients without ongoing atrial fibrillation/flutter.

Patients able to exercise to near exhaustion during a CPET as exhibited by RER

≥ 1.05 during CPET conducted during screening. If patient does not achieve RER ≥ 1.05 the CPET may be repeated once, at least 48 hours but less than 2 weeks (but before randomisation) after the initial test; in such cases the second test will serve as baseline.

Male or female

Exclusion Criteria:

eGFR < 30ml/min/1.73m2 (based on CKD-EPI formula)
Presence of any condition that precludes exercise testing
Known history of a documented LVEF < 40%
Probable alternative or concomitant diagnoses which in the opinion of the Investigator could account for the patient's HF symptoms and signs (eg, anaemia, hypothyroidism)

Known carrier of the Human Leukocyte Antigen-B (HLA-B) *58:01 allele: HLA-B

*58:01 genotyping is mandatory prior to randomization for all patients.

Patients diagnosed with tumor lysis syndrome or Lesch-Nyhan syndrome
Patients who are severely physically or mentally incapacitated and who in the opinion of investigator are unable to perform the patients' tasks associated with the protocol
Presence of any condition which, in the opinion of the investigator, places the patient at undue risk or potentially jeopardises the quality of the data to be generated
Current acute decompensated HF or hospitalisation due to decompensated HF < 4 weeks prior to enrolment
Myocardial infarction, unstable angina, coronary revascularisation (percutaneous coronary intervention or coronary artery bypass grafting), ablation of atrial flutter/fibrillation, valve repair/replacement, implantation of a cardiac resynchronisation therapy device, stroke or transient ischemic attack within 6 months prior to enrolment.
Planned coronary revascularisation, ablation of atrial flutter/fibrillation and/or valve repair/replacement
Atrial fibrillation with persistent resting heart rate > 110 beats per minute.