| E.1 Medical condition or disease under investigation | 
| E.1.1 | Medical condition(s) being investigated | 
| The intended indication is Pulmonary Arterial Hypertension |  | 
| E.1.1.1 | Medical condition in easily understood language | 
| Pulmonary Arterial Hypertension is an increase in blood pressure in the pulmonary arteries leading to shortness of breath, dizziness, fainting and other symptoms. |  | 
| E.1.1.2 | Therapeutic area | Diseases [C] - Cardiovascular Diseases [C14] | 
| MedDRA Classification | 
| E.1.2 Medical condition or disease under investigation | 
| 
| E.1.2 | Version | 14.1 |  
| E.1.2 | Level | PT |  
| E.1.2 | Classification code | 10064911 |  
| E.1.2 | Term | Pulmonary arterial hypertension |  
| E.1.2 | System Organ Class | 10038738 - Respiratory, thoracic and mediastinal disorders |  | 
| 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 demonstrate the effect of ACT-293987 on time to first morbidity and mortality (MM) event in patients with pulmonary arterial hypertension (PAH). |  | 
| E.2.2 | Secondary objectives of the trial | 
| To evaluate the effect of ACT-293987 on exercise capacity and other secondary and exploratory efficacy endpoints in patients with PAH. 
 To evaluate the safety and tolerability of ACT-293987 in patients with PAH.
 |  | 
| E.2.3 | Trial contains a sub-study | No | 
| E.3 | Principal inclusion criteria | 
| - Signed informed consent prior to initiation of any study-mandated procedure. - Male and female patients aged from 18 years to 75 years inclusive with    symptomatic PAH.
 - Documented hemodynamic diagnosis of PAH.
 |  | 
| E.4 | Principal exclusion criteria | 
| - Patients who have received prostacyclin (epoprostenol) or prostacyclin analogs (i.e., treprostinil, iloprost, beraprost) within 1 month before Baseline Visit, or are scheduled to receive any of these compounds during the trial.
 - Patients with moderate or severe obstructive lung disease.
 - Patients with moderate or severe restrictive lung disease.
 - Patients with moderate or severe hepatic impairment (Child-Pugh B and C).
 - Patients with documented left ventricular dysfunction.
 - Patients with severe renal insufficiency.
 - Patients with BMI <18.5 Kg/m2.
 |  | 
| E.5 End points | 
| E.5.1 | Primary end point(s) | 
| Time to first CEC-confirmed Morbidity and mortality event (MM), up to 7 days after last study drug intake defined as: • Death (all-cause mortality)
 • Hospitalization for worsening of PAH
 • Worsening of PAH resulting in need for lung transplantation or balloon atrial septostomy
 • Initiation of parenteral prostanoid therapy or chronic oxygen therapy due to worsening of PAH
 • Disease progression
 
 MM events will be adjudicated in a blinded fashion by an independent Critical Event Committee.
 |  | 
| E.5.1.1 | Timepoint(s) of evaluation of this end point | 
| It's an event-driven trial. |  | 
| E.5.2 | Secondary end point(s) |  | 
| E.5.2.1 | Timepoint(s) of evaluation of this end point |  | 
| 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 | Yes | 
| E.6.6 | Pharmacokinetic | Yes | 
| 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 | Yes | 
| E.6.13.1 | Other scope of the trial description |  | 
| 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 | Yes | 
| 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 | Yes | 
| 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 | Yes | 
| E.8.2.3 | Other | No | 
| E.8.2.4 | Number of treatment arms in the trial | 2 | 
| E.8.3 | The trial involves single site in the Member State concerned | No | 
| E.8.4 | The trial involves multiple sites in the Member State concerned | Yes | 
| E.8.4.1 | Number of sites anticipated in Member State concerned | 2 | 
| E.8.5 | The trial involves multiple Member States | Yes | 
| E.8.5.1 | Number of sites anticipated in the EEA | 60 | 
| 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 | No | 
| 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 | 
| Argentina |  
| Australia |  
| Austria |  
| Belarus |  
| Belgium |  
| Canada |  
| Chile |  
| China |  
| Colombia |  
| Czech Republic |  
| Denmark |  
| France |  
| Germany |  
| Greece |  
| Hungary |  
| India |  
| Ireland |  
| Israel |  
| Italy |  
| Korea, Republic of |  
| Malaysia |  
| Mexico |  
| Netherlands |  
| Peru |  
| Poland |  
| Romania |  
| Russian Federation |  
| Serbia |  
| Singapore |  
| Slovakia |  
| Spain |  
| Sweden |  
| Switzerland |  
| Taiwan |  
| Thailand |  
| Turkey |  
| Ukraine |  
| United Kingdom |  
| United States |  | 
| E.8.7 | Trial has a data monitoring committee | Yes | 
| 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 | 
| End of study will coincide with Study Closure (if no premature drug discontinuation) |  | 
| E.8.9 Initial estimate of the duration of the trial | 
| E.8.9.1 | In the Member State concerned years | 4 | 
| E.8.9.1 | In the Member State concerned months | 6 | 
| E.8.9.1 | In the Member State concerned days | 0 | 
| E.8.9.2 | In all countries concerned by the trial years | 4 | 
| E.8.9.2 | In all countries concerned by the trial months | 6 | 
| E.8.9.2 | In all countries concerned by the trial days | 0 |