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P2B001 is an investigational drug that comprised of low doses of two drugs, pramipexole and rasagiline, which are both approved drugs and routinely used in standard therapy for Parkinson's disease. The two drugs work in two different mechanisms that help each other, so there is a reason to believe that their combined activity will be better than each individual drug, and that lower doses can be used without losing the therapeutic effect. Thus, the development of P2B001 is intended to provide a combination of low doses of these two drugs, in an improved formulation, that is hoped to be more effective in controlling Parkinson's disease symptoms and with less side effects than each of the drugs taken alone or the current available commercial drugs taken together. In a previously completed clinical trial a significant improvement in Parkinson's disease symptoms was seen in patients treated with P2B001 compared to patients that were treated with placebo.
In this phase 3 study , the safety and efficacy of P2B001 will be assessed by comparing P2B001 to its individual components pramipexole and rasagiline. This will be done by monitoring the motor and non-motor symptoms, evaluating responses participants provide on questionnaires relating to Parkinson's disease and quality of life that will be completed on every visit. In addition, this study will also compare P2B001 to a marketed drug of pramipexole ER. Approximately 525 patients will participate in this research study and the participation in this study will last between 14 to 18 weeks.
A total of 525 eligible subjects with early untreated Parkinson's disease (PD), will be randomized to 4 treatment groups. Each subject will participate in the study for approximately 18 weeks including a 30 day screening period, 12 week treatment period, and 2 weeks follow-up period. Subjects will be requested to take one capsule and 1-3 tablets of study drug by mouth with a glass of water every day for 13 weeks. The study requires seven visits to the clinic one every 2-4 weeks.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| P2B001 0.6/0.75 mg | Experimental | Fixed dose combination once daily capsule of pramipexole 0.6mg and rasagiline 0.75mg, + matching placebo tablet |
|
| rasagiline 0.75mg | Experimental | Rasagiline 0.75mg Once daily capsule, component of P2B001, + matching placebo tablet |
|
| Pramipexole 0.6mg | Experimental | Pramipexole 0.6mg once daily capsule, component of P2B001 + matching placebo tablet |
|
| Pramipexole Extended Release | Active Comparator | Marketed pramipexole ER tablet titrated to optimal dose of 1.5, 3.0 or 4.5mg + matching placebo capsule |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| P2B001 0.6/0.75 mg | Drug | Fixed low dose extended release combination capsule of pramipexole and rasagiline |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change in Total Unified Parkinson's Disease Rating Scale (UPDRS) Score (Defined as Sum of Parts II and III, Scores (0-160). | Differences between P2B 0.6/0.75 mg as compared to its individual components in the change of total UPDRS score (defined as sum of parts II and III, scores (0-160). UPDRS- Unified Parkinson's Disease Rating Scale, minimum value is 0 points and maximum value is 160. High score mean worse outcome. | baseline to week 12 |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Epworth Sleepiness Scale (ESS) Score. | Differences between P2B 0.6/0.75 mg as compared to pramipexole ER tablets in the change of Epworth Sleepiness Scale (ESS) score. Scale is 0-24 , when 24 is worse outcome | baseline to week 12 |
| Change From Baseline to Week 12 in Total UPDRS III Motor |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Pninit Litman | Pharma2b LTD | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| P2B001/003 Site Scottsdale | Scottsdale | Arizona | 85258 | United States | ||
| P2B001/003 study site Scottsdale |
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| ID | Title | Description |
|---|---|---|
| FG000 | P2B001 | Fixed dose combination once daily capsule of pramipexole and rasagiline P2B001: Fixed dose once daily combination capsule of pramipexole and rasagiline |
| FG001 | Rasagiline Capsule |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Nov 18, 2020 | Oct 30, 2022 |
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4 arms
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double blind study
| Rasagiline 0.75 mg | Drug | Rasagiline 0.75 mg oral extended release capsule, component |
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| Pramipexole 0.6 mg | Drug | Pramipexole 0.6 mg oral extended release capsule, component |
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| Marketed Pramipexole ER | Drug | Marketed Pramipexole ER titrated to optimal dose of 1.5, 3 or 4.5 mg tablet |
|
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Differences between P2B 0.6/0.75 mg as compared to its individual components in the change of Motor UPDRS score (UPDRS Part III ). UPDRS- Unified Parkinson's Disease Rating Scale, part III motor . min is 0 and Max is 108 (Worse outcome) |
| baseline to week 12 |
| Change From Baseline to Week 12 in Total UPDRS II ADL | Differences between of P2B 0.6/0.75 mg as compared to its individual components in the change of ADL UPDRS score (UPDRS part II) Activity of daily Life UPDRS part II minimum is 0 point and max is 52 point (worse outcome) | Baseline to week 12 |
| Change From Baseline to End of Week 12 Visit in ADL Subscale of PDQ39 | The efficacy of P2B 0.6/0.75 mg as compared to Pramipexole ER tablet titrated to optimal dose. ADL PDQ39- Activity of daily life part in Parkinson's Disease Questionaries' 39 Score 0-100 when 100 is the worse outcome | Baseline to week 12 |
| Scottsdale |
| Arizona |
| 85259 |
| United States |
| P2B001/003 Study site little Rock | Little Rock | Arkansas | 72205 | United States |
| P2B001 site Los Angeles | Los Angeles | California | 90033 | United States |
| P2B001 Study site Englewood, | Englewood | Colorado | 80113 | United States |
| P2B001 Study Vernon | Vernon | Connecticut | 06066 | United States |
| P2B001/003 site Boca Raton | Boca Raton | Florida | 33431 | United States |
| P2B001/003 Site Boca Raton | Boca Raton | Florida | 33486 | United States |
| P2B001/003 study site Jacksonville | Jacksonville | Florida | 32209 | United States |
| P2B001/003 site Miami | Miami | Florida | 33136 | United States |
| P2B001/003 Site Port Charlotte | Port Charlotte | Florida | 33980 | United States |
| P2B001/003 Site Sarasota | Sarasota | Florida | 34243 | United States |
| P2B001/003 Site Tampa | Tampa | Florida | 33613 | United States |
| P2B001/003 Site Augusta | Augusta | Georgia | 30912 | United States |
| P2B001/003 study site Honolulu | Honolulu | Hawaii | 96819 | United States |
| P2B001/003 site Chicago | Chicago | Illinois | 60612 | United States |
| P2B001/003 Site Winfield | Winfield | Illinois | 60190 | United States |
| P2B001/003 site Kansas City | Kansas City | Kansas | 66160 | United States |
| P2B001/003 Site Lexington | Lexington | Kentucky | 40536 | United States |
| P2B001/003 study site Boston | Boston | Massachusetts | 02118 | United States |
| P2B001/003 Site East Lansing | East Lansing | Michigan | 48824 | United States |
| P2B001/003 study site west Bloomfield | West Bloomfield | Michigan | 48322 | United States |
| P2B001/003 Site Golden Valley | Golden Valley | Minnesota | 55427 | United States |
| P2B001/003 site St. Louis | St Louis | Missouri | 63110 | United States |
| P2B001/003 study site New Hampshire | Lebanon | New Hampshire | 03756 | United States |
| P2B001/003 Study site Camden | Camden | New Jersey | 08103 | United States |
| P2B001 Study site Edison | Edison | New Jersey | 08820 | United States |
| P2B001/003 Study site Albuquerque | Albuquerque | New Mexico | 87108 | United States |
| P2B001/003 Study site Brooklyn | Brooklyn | New York | 11203 | United States |
| P2B001/003 Site Commack | Commack | New York | 11725 | United States |
| P2B001/003 New York | New York | New York | 10029 | United States |
| P2B001 Study site Syracuse | Syracuse | New York | 13210 | United States |
| P2B001/003 Study site Williamsville | Williamsville | New York | 14221 | United States |
| P2B001/003 Site Asheville | Asheville | North Carolina | 28806 | United States |
| P2B001 study site Cincinnati | Cincinnati | Ohio | 45219 | United States |
| P2B001/003 Site Toledo | Toledo | Ohio | 43614 | United States |
| P2B001/003 Study site Hershey | Hershey | Pennsylvania | 17033 | United States |
| P2B001/003 Greenville | Greenville | South Carolina | 29615 | United States |
| P2B0011/003 Study Veracity Neuroscience | Memphis | Tennessee | 38157 | United States |
| p2B001/003 Study site Memphis | Memphis | Tennessee | 38163 | United States |
| P2B001/003 Study site Nashville | Nashville | Tennessee | 37232 | United States |
| P2B001/003 Site Dallas | Dallas | Texas | 75390 | United States |
| P2B001/003 Study site Alexandria | Alexandria | Virginia | 22311 | United States |
| P2B001/003 | Falls Church | Virginia | 22042 | United States |
| P2B001/003 Site Kirkland | Kirkland | Washington | 98034 | United States |
| P2B001/003 study site Toronto | Toronto | Ontario | M5T 2S8 | Canada |
| P2B001/003 Study site Freiburg | Freiburg im Breisgau | Baden-Wurttemberg | 79106 | Germany |
| P2B001/003 study site Ulm | Ulm | Baden-Wurttemberg | 89081 | Germany |
| P2B001/003 study site Haag | Haag | Bavaria | 83527 | Germany |
| P2B001/003 Study site Haag | Haag | Bavaria | Germany |
| P2B001/003 Study site München | München | Bavaria | 81675 | Germany |
| P2B001/003 Study site Hanau | Hanau | Hesse | 63450 | Germany |
| P2B001/003 Study site Bochum | Bochum | North Rhine-Westphalia | 44791 | Germany |
| P2B001/003 Study site Münster | Münster | North Rhine-Westphalia | 48149 | Germany |
| P2B001/003 Study site Dresden | Dresden | SaACHSEN | 01307 | Germany |
| P2B001/003 study site Leipzig | Leipzig | Saxony | 04103 | Germany |
| P2B001/003 study site Gera Germany | Gera | Thuringia | 07551 | Germany |
| P2B001/003 Study site Gera | Gera | Thuringia | 07551 | Germany |
| P2B001/003 Study site Berlin | Berlin | 12163 | Germany |
| P2B001/003 Study site Berlin | Berlin | 12203 | Germany |
| P2B001/003 site Munich | Munich | Germany |
| P2B001/003 Study site Sant Cugat del Vallés | Sant Cugat Del Vallés | Barcelona | 08190 | Spain |
| P2B001/003 study site Mostoles | Móstoles | Madridid | 28938 | Spain |
| P2B001/003 Study site Pamplona | Pamplona | Navarre | 31008 | Spain |
| P2B001/003 Study site La Paz | Madrid | S | 28046 | Spain |
| P2B001/003 Study site Barcelona | Barcelona | 08025 | Spain |
| P2B001/003 Study site Vall d'Hebrón | Barcelona | 08035 | Spain |
| P2B001/003 Study site Navarra Madrid | Madrid | 28027 | Spain |
| P2B001/003 study site Madrid | Madrid | 28034 | Spain |
| P2B001/003 Study site Madrid | Madrid | 28040 | Spain |
| P2B0011/003 Study site HM Centro Integral de Neurociencias (CINAC) | Madrid | 28938 | Spain |
| P2B001/003 Study site Puerta de Hierro - Majadahonda | Majadahonda | 28222 | Spain |
rasagiline Once daily capsule
Rasagiline: Rasagiline oral capsule
| FG002 | Pramipexole Capsule | Pramipexole once daily capsule Pramipexole: Pramipexole low dose oral capsule |
| FG003 | Pramipexole Extended Release | pramipexole ER tablet titrated to optimal dose of 1.5, 3.0 or 4.5mg Pramipexole ER: Pramipexole ER titrated to optimal dose |
| COMPLETED |
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| NOT COMPLETED |
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The dispensing of the investigational product was based on a "just-in-time" shipping strategy per subject. Randomization was done at the end of the Screening period and before the Baseline Visit to allow for shipping of the kit to the site. Twenty-five (25) subjects were enrolled and randomized into treatment groups, but withdrew from study prior to first dose. They did not came to baseline visit , receive study drug nor did they receive a post-randomization evaluation.
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| ID | Title | Description |
|---|---|---|
| BG000 | P2B001 | Fixed dose combination once daily capsule of pramipexole and rasagiline P2B001: Fixed dose once daily combination capsule of pramipexole and rasagiline |
| BG001 | Rasagiline Capsule | rasagiline Once daily capsule Rasagiline: Rasagiline oral capsule |
| BG002 | Pramipexole Capsule | Pramipexole once daily capsule Pramipexole: Pramipexole low dose oral capsule |
| BG003 | Pramipexole Extended Release | pramipexole ER tablet titrated to optimal dose of 1.5, 3.0 or 4.5mg Pramipexole ER: Pramipexole ER titrated to optimal dose |
| BG004 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants | Participants |
| |||||||||||
| Age, Continuous | Mean | Standard Deviation | Years |
| ||||||||||
| Sex: Female, Male | Count of Participants | Participants |
| |||||||||||
| Race (NIH/OMB) | Count of Participants | Participants |
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| Region of Enrollment | Number | participants |
| |||||||||||
| Total UPDRS | Unified Parkinson's Disease Rating Scale , score 0-160 minimum is 0 and maximum is 160 points . High score mean worse outcome | Twenty-five (25) subjects as explained above were enrolled and randomized into treatment groups, but withdrew from study prior to first dose. They did not came to baseline visit , receive study drug nor did they receive a post-randomization evaluation. The baseline was measured to 519 subjects who came to baseline visit , had assessment and took at least one dose of study medication . These are also the safety dataset. | Mean | Standard Deviation | units on a scale |
| ||||||||
| Epworth Sleepiness Score | scale from 0-24. Minimum is 0 and maximum 24. high score mean worse outcome | Twenty-five (25) subjects as explained above were enrolled and randomized into treatment groups, but withdrew from study prior to first dose. They did not came to baseline visit , receive study drug nor did they receive a post-randomization evaluation. The baseline was measured to 519 subjects who came to baseline visit , had assessment and took at least one dose of study medication . These are also the safety dataset. | Mean | Standard Deviation | units on a scale |
|
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Change in Total Unified Parkinson's Disease Rating Scale (UPDRS) Score (Defined as Sum of Parts II and III, Scores (0-160). | Differences between P2B 0.6/0.75 mg as compared to its individual components in the change of total UPDRS score (defined as sum of parts II and III, scores (0-160). UPDRS- Unified Parkinson's Disease Rating Scale, minimum value is 0 points and maximum value is 160. High score mean worse outcome. | mITT | Posted | Least Squares Mean | Standard Error | score on a scale | baseline to week 12 |
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| Secondary | Change in Epworth Sleepiness Scale (ESS) Score. | Differences between P2B 0.6/0.75 mg as compared to pramipexole ER tablets in the change of Epworth Sleepiness Scale (ESS) score. Scale is 0-24 , when 24 is worse outcome | mITT | Posted | Least Squares Mean | Standard Error | score on a scale | baseline to week 12 |
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| Secondary | Change From Baseline to Week 12 in Total UPDRS III Motor | Differences between P2B 0.6/0.75 mg as compared to its individual components in the change of Motor UPDRS score (UPDRS Part III ). UPDRS- Unified Parkinson's Disease Rating Scale, part III motor . min is 0 and Max is 108 (Worse outcome) | mITT | Posted | Least Squares Mean | Standard Error | score on a scale | baseline to week 12 |
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| Secondary | Change From Baseline to Week 12 in Total UPDRS II ADL | Differences between of P2B 0.6/0.75 mg as compared to its individual components in the change of ADL UPDRS score (UPDRS part II) Activity of daily Life UPDRS part II minimum is 0 point and max is 52 point (worse outcome) | mITT | Posted | Least Squares Mean | Standard Error | score on a scale | Baseline to week 12 |
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| Secondary | Change From Baseline to End of Week 12 Visit in ADL Subscale of PDQ39 | The efficacy of P2B 0.6/0.75 mg as compared to Pramipexole ER tablet titrated to optimal dose. ADL PDQ39- Activity of daily life part in Parkinson's Disease Questionaries' 39 Score 0-100 when 100 is the worse outcome | mITT | Posted | Least Squares Mean | Standard Error | score on a scale | Baseline to week 12 |
|
14 weeks
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | P2B001 | Fixed dose combination once daily capsule of pramipexole and rasagiline P2B001: Fixed dose once daily combination capsule of pramipexole and rasagiline | 0 | 150 | 3 | 150 | 78 | 150 |
| EG001 | Rasagiline Capsule | rasagiline Once daily capsule Rasagiline: Rasagiline oral capsule | 0 | 147 | 2 | 147 | 52 | 147 |
| EG002 | Pramipexole Capsule | Pramipexole once daily capsule Pramipexole: Pramipexole low dose oral capsule | 0 | 148 | 3 | 148 | 86 | 148 |
| EG003 | Pramipexole Extended Release | pramipexole ER tablet titrated to optimal dose of 1.5, 3.0 or 4.5mg Pramipexole ER: Pramipexole ER titrated to optimal dose | 0 | 74 | 0 | 74 | 54 | 74 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Hypokalaemia | Metabolism and nutrition disorders | MedDRA (20.1) | Systematic Assessment |
| |
| Cerebrovascular accident | Nervous system disorders | MedDRA (20.1) | Systematic Assessment |
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| Pneumothorax | Respiratory, thoracic and mediastinal disorders | MedDRA (20.1) | Systematic Assessment |
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| Anaemia | Blood and lymphatic system disorders | MedDRA (20.1) | Systematic Assessment |
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| Gastrointestinal haemorrhage | Gastrointestinal disorders | MedDRA (20.1) | Systematic Assessment |
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| corona virus | Infections and infestations | MedDRA (20.1) | Systematic Assessment |
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| Muscle haemorrhage | Musculoskeletal and connective tissue disorders | MedDRA (20.1) | Systematic Assessment |
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| Haematochezia | Gastrointestinal disorders | MedDRA (20.1) | Systematic Assessment |
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| Prostatitis | Reproductive system and breast disorders | MedDRA (20.1) | Systematic Assessment |
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| Klebsiella sepsis | Infections and infestations | MedDRA (20.1) | Systematic Assessment |
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| Sepsis | Infections and infestations | MedDRA (20.1) | Systematic Assessment |
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| Acute kidney injury | Renal and urinary disorders | MedDRA (20.1) | Systematic Assessment |
|
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| nausea | Gastrointestinal disorders | MedDRA (20.1) | Systematic Assessment |
| |
| fatigue | General disorders | MedDRA (20.1) | Systematic Assessment |
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| somnolence | Nervous system disorders | MedDRA (20.1) | Systematic Assessment |
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| dizziness | Nervous system disorders | MedDRA (20.1) | Systematic Assessment |
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| insomnia | Psychiatric disorders | MedDRA (20.1) | Systematic Assessment |
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| headache | Nervous system disorders | MedDRA (20.1) | Systematic Assessment |
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| constipation | Gastrointestinal disorders | MedDRA (20.1) | Systematic Assessment |
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| pain in extremity | Musculoskeletal and connective tissue disorders | MedDRA (20.1) | Systematic Assessment |
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| fall | Injury, poisoning and procedural complications | MedDRA (20.1) | Systematic Assessment |
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| memory impairment | Congenital, familial and genetic disorders | MedDRA (20.1) | Systematic Assessment |
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| Orthostatic hypotension | Vascular disorders | MedDRA (20.1) | Systematic Assessment |
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| Decreased appetite | Gastrointestinal disorders | MedDRA (20.1) | Systematic Assessment |
|
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Pninit Litman study director | Pharma 2B LTD | +972 8 9472672 | pninit@pharma2b.com |
| Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan: SAP P2B protocol P2B001_003 NCT03329508 2021_10_21 | Oct 21, 2021 | Oct 30, 2022 | SAP_001.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan: Addendum to Statistical Analysis | Nov 11, 2021 | Oct 30, 2022 | SAP_002.pdf |
| ICF | No | No | Yes | Informed Consent Form | Aug 5, 2019 | Oct 30, 2022 | ICF_003.pdf |
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| ID | Term |
|---|---|
| D010300 | Parkinson Disease |
| ID | Term |
|---|---|
| D020734 | Parkinsonian Disorders |
| D001480 | Basal Ganglia Diseases |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D009069 | Movement Disorders |
| D000080874 | Synucleinopathies |
| D019636 | Neurodegenerative Diseases |
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| ID | Term |
|---|---|
| C031967 | rasagiline |
| D000077487 | Pramipexole |
| ID | Term |
|---|---|
| D052160 | Benzothiazoles |
| D013844 | Thiazoles |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
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| United States |
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| Germany |
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| Spain |
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| Mean Difference (Net) |
| -3.30 |
| Standard Error of the Mean |
| 0.85 |
| 2-Sided |
| 95 |
| -4.96 |
| -1.63 |
| Superiority |
| Units | Counts |
|---|---|
| Participants |
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