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  "documentTitle": "Harmony Biosciences (HRMY)",
  "authorId": "58_Scorpion_Capital",
  "authorName": "Scorpion Capital",
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  "presentationDate": "2023-03-28 00:00:00",
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  "notes": "The slide uses clinical trial data to undermine the efficacy claims of a drug by highlighting the placebo response.",
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      "text": "Large placebo effect with improvement every week over 8 week trial duration, and no separation vs. placebo after weeks 2 and 3 (visits 4 and 5)",
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      "text": "Figure 3: Changes in Epworth sleepiness scale (ESS) score",
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      "text": "ESS score: -5.8",
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      "text": "ESS reduction in the pitolisant arm was -5.8, modafinil -6.9, placebo -3.4. The large placebo effect is a red flag, indicate of the subjective, unreliable patient-reported endpoint, with the placebo group improving consistently every week to week 8.",
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      "text": "Source: https://pubmed.ncbi.nlm.nih.gov/24107292/; https://epworthsleepinessscale.com/about-the-ess/",
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      "text": "Harmony 1 trial paper, published 2013 in The Lancet - table of efficacy results with primary endpoint",
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      "text": "Aside from paltry absolute reductions in ESS, pitolisant performed far worse than modafinil and only modestly better than placebo.",
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