| E.1 Medical condition or disease under investigation | 
| E.1.1 | Medical condition(s) being investigated |  | 
| E.1.1.1 | Medical condition in easily understood language |  | 
| E.1.1.2 | Therapeutic area | Analytical, Diagnostic and Therapeutic Techniques and Equipment [E] - Surgical Procedures, Operative [E04] | 
| MedDRA Classification | 
| E.1.3 | Condition being studied is a rare disease | No | 
| E.2 Objective of the trial | 
| E.2.1 | Main objective of the trial | 
| To assess the effect of macitentan on exercise capacity (measured by peak oxygen uptake [VO2]) in comparison with placebo in Fontan-palliated subjects. |  | 
| E.2.2 | Secondary objectives of the trial | 
| To assess the effect of macitentan on long-term excersise capacity ( measured by peak VO2 over 52 weeks). To assess the effect of macitentan on daily Physical Activity measured by Accelometer (PA-Ac).
 To evaluate the safety and tolerability of macitentan.
 |  | 
| E.2.3 | Trial contains a sub-study | No | 
| E.3 | Principal inclusion criteria | 
| - Written informed consent/assent from the subject and/or a legal representative prior to initiation of any study-mandated procedures - Fontan-palliated subjects with either intra-atrial lateral tunnel total cavopulmonary connection (LT-TCPC), or extra cardiac tunnel TCPC (EC-TCPC) surgery > 1 year before Screening. Either LT- or EC-TCPC can be primary or secondary to atrio-pulmonary connection
 - New York Heart Association (NYHA) functional class (FC) II or III (assessed by the investigator using the Specific Activity Scale
 - Age range: >= 12 years old
 - Women of childbearing potential must have a negative serum pregnancy test at the Randomization visit, perform monthly pregnancy tests, and use reliable contraception
 |  | 
| E.4 | Principal exclusion criteria | 
| - Pattern of Fontan circulation severity - Deterioration of the Fontan-palliated condition
 - Systolic BP < 90 mmHg (< 85 mmHg for < 18 years old and < 150 cm of height) at rest or during Cardiopulmonary exercise testing at screening or baseline
 - Criteria related to macitentan use
 - Limitations to Cardiopulmonary exercise testing (CPET)
 - Peak VO2 < 15 mL/kg/min.
 - Any known factor or disease that may interfere with treatment compliance or full participation in the study
 |  | 
| E.5 End points | 
| E.5.1 | Primary end point(s) | 
| - Change in peak VO2 (oxygen uptake) |  | 
| E.5.1.1 | Timepoint(s) of evaluation of this end point | 
| At Baseline (Randomization/Visit 2) and Week 16 (Visit 4) |  | 
| E.5.2 | Secondary end point(s) | 
| Efficacy - Change in mean count per minute of daily PA-Ac
 - Change in peak VO2
 
 Safety
 - Treatment-emergent AEs and SAEs
 - AEs leading to premature discontinuation of study treatment
 
 Pharmacokinetics (PK)
 - Trough (pre dose) plasma concentrations
 |  | 
| E.5.2.1 | Timepoint(s) of evaluation of this end point | 
| Efficacy -At Baseline (Visit 2) and Week 16 (Visit 4)
 - from Baseline (Visit 2) over 52 weeks
 
 Safety
 - up to 30 days after study treatment discontinuation.
 
 PK
 - at Week 4 (see PRL §6.5) and Week 16 (Visit 4), or at EOT in the case of premature study drug discontinuation.
 |  | 
| 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 | Yes | 
| E.6.13 | Others | Yes | 
| E.6.13.1 | Other scope of the trial description | 
| Quality of life assessment |  | 
| 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 | Yes | 
| E.8.1.7.1 | Other trial design description |  | 
| 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 | 11 | 
| 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 | 
| Australia |  
| China |  
| Czech Republic |  
| Denmark |  
| France |  
| Germany |  
| Ireland |  
| New Zealand |  
| Poland |  
| Taiwan |  
| 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 |  | 
| 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 | 10 | 
| 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 | 10 |