{ "docId": "019dd923-622c-750b-8b9a-21918ac10c17", "docSlug": "f3db2294dcf9", "documentTitle": "Harmony Biosciences (HRMY)", "authorId": "58_Scorpion_Capital", "authorName": "Scorpion Capital", "documentKindSlug": "research-note", "documentKindLabel": "Research note", "sourceTypeSlug": "short_seller", "sourceTypeLabel": "Short seller", "presentationDate": "2023-03-28 00:00:00", "orientation": "landscape", "aspectRatio": 1.3333334, "pageNumber": 284, "pageCount": 366, "prevPage": 283, "nextPage": 285, "slideType": "nominee_bio", "function": "introduce_nominees", "density": "dense", "nDataPoints": 3, "notes": "The slide uses a Q&A format to document a specific adverse event case study.", "elementsJson": [ "headline_text", "paragraph", "quote_block", "footnote" ], "metadataConfidence": 1, "imagePath": null, "slideHref": "/slides/019dd923-622c-750b-8b9a-21918ac10c17/284", "deckHref": "/decks/019dd923-622c-750b-8b9a-21918ac10c17", "deckJsonHref": "/decks/019dd923-622c-750b-8b9a-21918ac10c17.json", "deckAnchorHref": "/decks/019dd923-622c-750b-8b9a-21918ac10c17#slide-284", "components": [ { "bbox": null, "kind": "callout", "text": "So, the patient is only taking one antihypertensive for mild elevated blood pressure, 42, healthy, shows up in the ER with QT prolongation.", "attrs": null, "subkind": null, "toolName": "Visual emphasis", "toolSlug": "visual-emphasis", "confidence": null, "componentId": "019dd953-70f3-714d-84c7-180fec6949f3", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.58, "w": 0.86, "x": 0.07, "y": 0.33 }, "kind": "paragraph", "text": "Q: \"So, what happened with the patient with the QT prolongation?\"\nA: \"Like I said, a pretty healthy guy. He was at dinner with his wife, and all of a sudden, he got diaphoretic, sweaty. Kind of said, I'm not feeling very good, clammy and diaphoretic. His wife happened to be a nurse. And she said, if you don't feel well, let's go home. So, on their way home, he was really just somnolent, not feeling good. They get home, and she happens to have a BP machine at home that also checks heart rate and sats. She checks it and his heart rate is just off, and she's checking his pulse, and it's irregular. And so, she's worried that he's having a heart attack. Obviously, she calls 911. They take him into the hospital, hook him up, and it's clear as day that he's got an arrhythmia, they thought maybe he was a-fib because his dad had a history of a-fib but upon further review by cardiology and electrophysiologist saw him, and they're like, oh yeah, he's got a long QT. And so, with the family history of a-fib, they're like, well, this is not a-fib. And they were going through all the medicines like that, anything new, medical history. They kind of said, hey, this is a newer medicine that you said. The cardiologist was pretty astute. He kind of looked up the info and said, hey, this medication can actually cause that, and I don't know necessarily that that's caused it, but certainly something to talk to your neurologist about. So, they work him up. He gets discharged and follows up with me. He's like, hey doc, this is what happened. And then I'm like, whoa, okay. In that case, the first thing is we're going to stop that medicine and see how things play out. So, obviously, we did.\"\nQ: \"And how long had the patient been on Wakix before this event occurred?\"\nA: \"He had been on it for 8 weeks, 2 months.\"\nQ: \"And what was the age of the patient?\"\nA: \"Forty-two. So, needless to say, it caused everybody to pay a little bit more attention.\"\nQ: \"At 42, was the person obese or had other cardiac morbidities? You said the person was otherwise healthy or pretty healthy?\"\nA: \"Yeah, pretty healthy guy. There is, overall, no real medical history. You know, blood pressure's up a little bit, but nothing major. He was taking one antihypertensive, and he was well-controlled on that.\"\nQ: \"So, the patient is only taking one antihypertensive for mild elevated blood pressure, 42, healthy, shows up in the ER with QT prolongation.\"\nA: \"That's right..\" -Neurologist at a large hospital system in a Midwest state", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "22fbeb88-4082-482f-8183-18e45b16bea1", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.05, "w": 0.86, "x": 0.07, "y": 0.27 }, "kind": "paragraph", "text": "Otherwise healthy 42-year old taken to emergency room within two months of starting Wakix and diagnosed with QT prolongation", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "78834666-1ab9-4f25-9e80-df1912f10dc9", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "quote", "text": "Like I said, a pretty healthy guy otherwise. He was at dinner with his wife, and all of a sudden, he got diaphoretic, sweaty. Kind of said, I'm not feeling very good, clammy and diaphoretic. His wife happened to be a nurse. And she said, if you don't feel well, let's go home. So, on their way home, he was really just somnolent, not feeling good. They get home, and she happens to have a BP machine at home that also checks heart rate and sats. She checks it and his heart rate is just off, and she's checking his pulse, and it's irregular. And so, she's worried that he's having a heart attack. Obviously, she calls 911. They take him into the hospital, hook him up, and it's clear as day that he's got an arrhythmia, and they thought maybe he was a-fib because his dad had a history of a-fib but upon further review by cardiology and electrophysiologist saw him, and they're like, oh yeah, he's got a long QT. And so, with the family history of a-fib, they're like, well, this is not a-fib. And they were going through all the medicines like that, anything new, medical history. They kind of said, hey, this is a newer medicine that you said. The cardiologist was pretty astute. He kind of looked up the info and said, hey, this medication can actually cause that, and I don't know necessarily that that's what caused it, but certainly something to talk to your neurologist about. So, they work him up. He gets discharged and follows up with me. He's like, hey doc, this is what happened. And then I'm like, whoa, okay. In that case, the first thing is we're going to stop that medicine and see how things play out. So, obviously, we did. — Prescriber #15", "attrs": null, "subkind": null, "toolName": "Authority citation", "toolSlug": "authority-citation", "confidence": null, "componentId": "019dd953-70f3-714d-84c7-1ddf4b16412d", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "subkind": null, "toolName": null, "toolSlug": null, "confidence": null, "componentId": "286dd701-e9c1-40b7-8823-3403ea4029e1", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.06 }, "kind": "title", "text": "Prescriber #15: Physician at a large hospital system in the Midwest with 50 narcolepsy patients, who as initially keen to try Wakix after studying the literature and put about a dozen patients on it. Became alarmed after a 42-year old patient was hospitalized for QT prolongation. He disclosed the risk to his patients - and all but two quickly discontinued.", "attrs": null, "subkind": "headline", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "2e9f7e48-4e54-4f1c-839c-c6384e0d1b2b", "frameworkName": null, "frameworkSlug": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "imagePathAlt": null, "thumbSrc": null, "thumbSrcAlt": null, "locked": true }