| E.1 Medical condition or disease under investigation | 
| E.1.1 | Medical condition(s) being investigated  | 
| Indication: Symptomatic Pulmonary Arterial Hypertension | 
 
 
 | 
| MedDRA Classification | 
| E.1.2 Medical condition or disease under investigation | 
| E.1.2 | Version  | 9.1 | 
 
| E.1.2 | Level  | LLT | 
 
| E.1.2 | Classification code  | 10064911 | 
 
| E.1.2 | Term  | Pulmonary arterial hypertension | 
 
 
 | 
| E.1.3 | Condition being studied is a rare disease  |  Yes  | 
| E.2 Objective of the trial | 
| E.2.1 | Main objective of the trial  | 
To compare the safety and tolerability of inhaled iloprost delivered by power disc-15 or power disc-6 up to 12 weeks treatment in patients with symptomatic PAH. 
 | 
 
 
 | 
| E.2.2 | Secondary objectives of the trial  | 
| To compare the inhalation times of inhaled iloprost delivered by I-neb using the power disc-15 or power disc-6 up to 12 weeks treatment in patients with symptomatic PAH. | 
 
 
 | 
| E.2.3 | Trial contains a sub-study  |  No  | 
| E.3 | Principal inclusion criteria  | 
1.Signed informed consent prior to initiation of any study mandated procedure, 
 2.Patients with symptomatic idiopathic, familial pulmonary arterial hypertension or pulmonary hypertension associated with HIV or drugs/toxins (APAH) in NYHA functional class II to IV who have completed study AC-063A301, 
 3.Women of childbearing potential* with a negative urine pre-treatment pregnancy test and who consistently and correctly use (from screening and up to 28 days after discontinuation of study drug) a reliable method of contraception with a Pearl index of <1% (oral hormonal contraceptive, implant, vaginal hormone ring, or intrauterine system [IUS]), during the entire study duration and for at least 1 month after last study drug intake. Their partner, if not vasectomised, must use a condom in addition. 
 | 
 
 
 | 
| E.4 | Principal exclusion criteria | 
1.Pulmonary arterial hypertension related to any condition other than those specified in the inclusion criteria, 
 2.Pulmonary arterial hypertension associated with significant venous or capillary involvement (PCWP > 15 mmHg), known pulmonary veno-occlusive disease, or pulmonary capillary hemangiomatosis, 
 3.HIV seropositive with any of the following: •Active opportunistic infections within 3 months prior to randomization •Changes in antiretroviral regimen within 3 months of randomization •Using inhaled pentamidine 
 4.Moderate to severe obstructive lung disease: forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) < 70% and FEV1 < 65% of predicted value after bronchodilator administration, 
 5.Moderate to severe restrictive lung disease: total lung capacity (TLC) < 60% of predicted value, 
 6.Pregnant or breast-feeding women, 7.Systemic hypertension (systolic blood pressure > 160 mmHg or diastolic blood pressure > 100 mmHg on repeated measurement), 
 8.Systolic blood pressure < 95 mmHg, 
 9.Moderate to severe hepatic impairment, i.e., Child-Pugh Class B or C, 
 10.Chronic renal insufficiency defined by serum creatinine > 2.5 mg/dL (221 μmol/L) or ongoing dialysis, 
 11.Clinically relevant bleeding disorder or active bleeding, 
 12.Known hypersensitivity to iloprost or any of its excipients. 
 | 
 
 
 | 
| E.5 End points | 
| E.5.1 | Primary end point(s) | 
•Treatment-emergent adverse events (AEs) from the first inhalation of study drug to the day before the end of 12-week treatment period or up to last inhalation in case of early discontinuation •Treatment-emergent serious adverse events (SAEs) from the first inhalation of study drug to the day before the  end of 12-week treatment period or up to last inhalation in case of early discontinuation •AEs leading to premature discontinuation of study drug. 
 | 
 
 
 | 
| E.6 and E.7 Scope of the trial | 
| E.6 | Scope of the trial | 
| E.6.1 | Diagnosis |  No  | 
| E.6.2 | Prophylaxis |  No  | 
| E.6.3 | Therapy |  No  | 
| E.6.4 | Safety |  Yes  | 
| E.6.5 | Efficacy |  No  | 
| E.6.6 | Pharmacokinetic |  No  | 
| E.6.7 | Pharmacodynamic |  No  | 
| E.6.8 | Bioequivalence |  No  | 
| E.6.9 | Dose response |  No  | 
| E.6.10 | Pharmacogenetic |  No  | 
| E.6.11 | Pharmacogenomic |  No  | 
| E.6.12 | Pharmacoeconomic |  No  | 
| E.6.13 | Others |  No  | 
| E.7 | Trial type and phase | 
| E.7.1 | Human pharmacology (Phase I) |  No  | 
| E.7.1.1 | First administration to humans |  No  | 
| E.7.1.2 | Bioequivalence study |  No  | 
| E.7.1.3 | Other |  No  | 
| E.7.1.3.1 | Other trial type description |  | 
| E.7.2 | Therapeutic exploratory (Phase II) |  No  | 
| E.7.3 | Therapeutic confirmatory (Phase III) |  Yes  | 
| E.7.4 | Therapeutic use (Phase IV) |  No  | 
| E.8 Design of the trial | 
| E.8.1 | Controlled |  No  | 
| E.8.1.1 | Randomised |  Yes  | 
| E.8.1.2 | Open |  No  | 
| E.8.1.3 | Single blind |  No  | 
| E.8.1.4 | Double blind  |  Yes  | 
| E.8.1.5 | Parallel group |  No  | 
| E.8.1.6 | Cross over  |  No  | 
| E.8.1.7 | Other |  No  | 
| E.8.2 |  Comparator of controlled trial | 
| E.8.2.1 | Other medicinal product(s) |  No  | 
| E.8.2.2 | Placebo  |  No  | 
| E.8.2.3 | Other |  Information not present in EudraCT  | 
| E.8.3 | 
                                The trial involves single site in the Member State concerned
                             |  Yes  | 
| E.8.4 |  The trial involves multiple sites in the Member State concerned  |  No  | 
| E.8.4.1 | Number of sites anticipated in Member State concerned | 1 | 
| E.8.5 | The trial involves multiple Member States |  Yes  | 
| E.8.5.1 | Number of sites anticipated in the EEA | 2 | 
| E.8.6 Trial involving sites outside the EEA | 
| E.8.6.1 | Trial being conducted both within and outside the EEA |  Yes  | 
| E.8.6.2 | Trial being conducted completely outside of the EEA |  Information not present in EudraCT  | 
| E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned | 
 | 
| E.8.7 | Trial has a data monitoring committee |  No  | 
| E.8.8 | 
                        Definition of the end of the trial and justification where it is not the last
                        visit of the last subject undergoing the trial
                     |  | 
| E.8.9 Initial estimate of the duration of the trial | 
| E.8.9.1 | In the Member State concerned years | 0 | 
| E.8.9.1 | In the Member State concerned months | 9 | 
| E.8.9.1 | In the Member State concerned days | 0 | 
| E.8.9.2 | In all countries concerned by the trial years | 0 | 
| E.8.9.2 | In all countries concerned by the trial months | 9 | 
| E.8.9.2 | In all countries concerned by the trial days | 0 |