| E.1 Medical condition or disease under investigation | 
| E.1.1 | Medical condition(s) being investigated | 
| Inoperable chronic thromboembolic pulmonary hypertension (CTEPH) |  | 
| 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 |  | 
| 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 | 18.1 |  
| 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 |  | 
| 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). |  | 
| 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.
 |  | 
| 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).
 |  | 
| 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.
 |  | 
| 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 |  | 
| E.5.1.1 | Timepoint(s) of evaluation of this end point |  | 
| 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.
 |  | 
| 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 | Yes | 
| E.8.4 | The trial involves multiple sites in the Member State concerned | No | 
| 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 |  | 
| 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 |  | 
| 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 |