| E.1 Medical condition or disease under investigation | 
| E.1.1 | Medical condition(s) being investigated  | 
| Inoperable chronic thromboembolic pulmonary hypertension (CTEPH) | 
 
 
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| E.1.1.1 | Medical condition in easily understood language  | 
| Form of pulmonary hypertension caused by the blockage of blood vessels in the lung with blood clots, which can not be treated by surgery | 
 
 
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| 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  | 19.0 | 
 
| E.1.2 | Level  | LLT | 
 
| E.1.2 | Classification code  | 10068739 | 
 
| E.1.2 | Term  | Chronic thromboembolic pulmonary hypertension | 
 
| E.1.2 | System Organ Class  | 100000004855 | 
 
 
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| 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 evaluate the effect of macitentan 10 mg on pulmonary vascular resistance (PVR) at rest in comparison with placebo in subjects with inoperable chronic thromboembolic pulmonary hypertension (CTEPH). | 
 
 
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| E.2.2 | Secondary objectives of the trial  | 
• To evaluate the effects of macitentan 10 mg in comparison with placebo on: – Exercise capacity – Dyspnea (assessed by the Borg dyspnea index) – WHO functional class (FC) 
 • To evaluate the safety and tolerability of macitentan 10 mg in this subject population. | 
 
 
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| E.2.3 | Trial contains a sub-study  |  No  | 
| E.3 | Principal inclusion criteria  | 
- Male or female ≥ 18 and ≤ 80 years of age. - Subject with CTEPH (WHO Group 4) judged as inoperable due to the localization of the obstruction being surgically inaccessible (i.e., distal disease). | 
 
 
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| E.4 | Principal exclusion criteria | 
- Previous pulmonary endarterectomy. - Recurrent thromboembolism despite sufficient oral anticoagulants. - Symptomatic acute pulmonary embolism in the 6-month period prior to randomization. - Known moderate-to-severe restrictive lung disease (i.e., TLC < 60% of predicted value) or obstructive lung disease (i.e., FEV1 < 70% of predicted, with FEV1/FVC < 65%) or known significant chronic lung disease diagnosed by chest imaging (e.g., interstitial lung disease, emphysema). - Acute or chronic conditions (other than dyspnea) that limit the ability to comply with study requirements in the 3-month period prior to Screening visit or during the Screening period. | 
 
 
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| E.5 End points | 
| E.5.1 | Primary end point(s) | 
| PVR at rest at Week 16 expressed as percent of baseline PVR at rest | 
 
 
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| E.5.1.1 | Timepoint(s) of evaluation of this end point | 
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| E.5.2 | Secondary end point(s) | 
- Change from baseline to Week 24 in exercise capacity, as measured by the 6MWD. - Change from baseline to Week 24 in Borg dyspnea index collected at the end of the 6MWT. - Proportion of subjects with worsening in WHO FC from baseline to Week 24. | 
 
 
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| 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 |  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) |  Yes  | 
| E.7.3 | Therapeutic confirmatory (Phase III) |  No  | 
| 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 | 24 | 
| 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 | 
| Austria | 
 
| Belgium | 
 
| Canada | 
 
| Chile | 
 
| China | 
 
| Czech Republic | 
 
| France | 
 
| Germany | 
 
| Hungary | 
 
| Korea, Republic of | 
 
| Lithuania | 
 
| Mexico | 
 
| Netherlands | 
 
| Poland | 
 
| Russian Federation | 
 
| South Africa | 
 
| Switzerland | 
 
| Thailand | 
 
| Ukraine | 
 
| United Kingdom | 
 
| United States | 
 
| Vietnam | 
 
 
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| 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
                     | 
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| E.8.9 Initial estimate of the duration of the trial | 
| E.8.9.1 | In the Member State concerned years | 2 | 
| E.8.9.1 | In the Member State concerned months | 3 | 
| E.8.9.1 | In the Member State concerned days |  | 
| E.8.9.2 | In all countries concerned by the trial years | 2 | 
| E.8.9.2 | In all countries concerned by the trial months | 3 |