US Placebo Results Don't Seem Possible

From the announcement
....in contrast, vehicle responses in the USA were unexpectedly high, at almost twice the response for
combined inflammatory lesion reduction (45.9% reduction in the USA versus a 26.4% reduction in
Australia) and more than four times the response for non-inflammatory lesion reduction (24.7% in the
USA versus 5.5% in Australia).

The question is how? 45.9% is an incredible result. As @Jaoumec stated, it is a super viable acne treatment in its own right. Swap the placebo for one of the BOT drugs and we'd be on a guaranteed ride. How can it be that a placebo is so effective? If it is, let's just take that placebo formula to phase 3 and sell it.

The reading for the US placebo results, mean it just doesn't seem plausible that assignment of placebos and drugs was done properly, and that also implies the possibility that placebo was applied to patients and identified as BTX 1503.

It's all so questionable as to need clarification.