| E.1 Medical condition or disease under investigation | 
| E.1.1 | Medical condition(s) being investigated | 
| 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 | 20.0 |  
| 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 | No | 
| E.2 Objective of the trial | 
| E.2.1 | Main objective of the trial | 
| To evaluate the effect of selexipag on daily life physical activity (DLPA) of patients with pulmonary arterial hypertension (PAH) as assessed by a
 wearable actigraphy device.
 |  | 
| E.2.2 | Secondary objectives of the trial | 
| • To evaluate the effect of selexipag on PAH symptoms and their impacts in patients’ daily life. • To evaluate the effect of selexipag on exercise capacity, and disease severity in patients with PAH.
 • To evaluate the safety and tolerability of selexipag in patients with PAH.
 |  | 
| E.2.3 | Trial contains a sub-study | No | 
| E.3 | Principal inclusion criteria | 
| - Male or female between 18 and 75 years old inclusive. - Women of childbearing potential must have a negative serum
 pregnancy test at planned visits and use an acceptable method of birth control from screening up to 30 days after study treatment
 discontinuation.
 - Symptomatic PAH belonging to one of the following subgroups only:
 . Idiopathic
 . Heritable
 . Drug or toxin induced
 . Associated with one of the following: connective tissue disease; HIV
 infection; corrected simple congenital heart disease.
 - With the following hemodynamic characteristics assessed by right
 heart catheterization (RHC) prior to randomization:
 . Mean pulmonary artery pressure (mPAP) ≥ 25 mmHg
 . Pulmonary vascular resistance (PVR) ≥ 240 dyn•sec/cm5 (or 3 Wood Units)
 . Pulmonary artery wedge pressure (PCWP) or left ventricular end-diastolic pressure (LVEDP) ≤ 15 mmHg.
 - Treatment with an endothelin receptor antagonist (ERA) for at least
 90 days and on a stable dose for 30 days prior to randomization.
 - Possible treatment with a Phosphodiesterase-5 inhibitor or sGC
 stimulator must be ongoing for at least 90 days and on a stable dose for 30 days prior to randomization.
 - WHO functional class (FC) II or III at randomization.
 - 6-minute walk distance (6MWD) ≥ 100 m at screening.
 - Ability to walk without a walking aid.
 - Valid baseline data for daily life physical activity (DLPA) and PAH-SYMPACT®.
 |  | 
| E.4 | Principal exclusion criteria | 
| - Patients on a PAH-specific monotherapy targeting the nitric oxide pathway (i.e. PDE-5 inhibitor or sGC stimulator).
 - Patients treated with prostacyclin, prostacyclin analog or selexipag at any time prior to Day 1.
 - Any hospitalization during the last 30 days prior to screening (Visit 1).
 - Severe coronary heart disease or unstable angina.
 - Documented severe hepatic impairment or severe renal insufficiency at screening (Visit 1).
 - Participation in a cardio-pulmonary rehabilitation program based on
 exercise training within 8 weeks prior to screening.
 - Any factor or condition likely to affect full participation in the study or compliance with the protocol (such as adherence to protocol mandated procedures), as judged by the investigator.
 |  | 
| E.5 End points | 
| E.5.1 | Primary end point(s) | 
| - Change from baseline to Week 24 / EOT in actigraphy-assessed daily life physical activity (DLPA) as measured by: . Daily time spent (minutes) in non-sedentary activity
 (> 100 activity counts per minute)
 . Percentage of daily time spent in non-sedentary activity (> 100 activity counts per minute)
 . Total DLPA in counts/min
 . Sleep variables: Total sleep time (minutes); wake after sleep onset (minutes);  number of awakenings, sleep efficiency (percentage)
 |  | 
| 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 / EOT for following PAH SYMPACT® domain scores: . Cardiovascular symptom domain score
 . Cardiopulmonary symptom domain score
 . Physical impact domain score
 . Cognitive/emotional impact domain score
 
 - Change from baseline to Week 24 / EOT for following variables:
 . WHO FC
 . 6MWD
 . Borg dyspnea index at 6MWT
 . N-terminal pro b-type natriuretic peptide (NT-proBNP)
 |  | 
| 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 | No | 
| 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 | Yes | 
| E.6.13.1 | Other scope of the trial description | 
| effect of selexipag on daily life physical activity of patients with pulmonary arterial hypertension |  | 
| 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) | No | 
| E.7.4 | Therapeutic use (Phase IV) | Yes | 
| 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 | 16 | 
| 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 |  
| France |  
| Germany |  
| Ireland |  
| Netherlands |  
| Norway |  
| Portugal |  
| Sweden |  
| Switzerland |  
| United Kingdom |  
| United States |  | 
| 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 | 
| end of study telephone call 30 days after end of treatment of the last patient |  | 
| E.8.9 Initial estimate of the duration of the trial | 
| E.8.9.1 | In the Member State concerned years | 1 | 
| E.8.9.1 | In the Member State concerned months | 8 | 
| E.8.9.1 | In the Member State concerned days | 0 | 
| E.8.9.2 | In all countries concerned by the trial years | 1 | 
| E.8.9.2 | In all countries concerned by the trial months | 8 | 
| E.8.9.2 | In all countries concerned by the trial days | 0 |