{ "docId": "019dd923-622c-750b-8b9a-3bcd52c6e583", "docSlug": "f06b0b5d2079", "documentTitle": "Soleno Therapeutics (SLNO)", "authorId": "58_Scorpion_Capital", "authorName": "Scorpion Capital", "documentKindSlug": "activist-deck", "documentKindLabel": "Activist deck", "sourceTypeSlug": "short_seller", "sourceTypeLabel": "Short seller", "presentationDate": "2025-08-15 00:00:00", "orientation": "landscape", "aspectRatio": 1.3333334, "pageNumber": 109, "pageCount": 415, "prevPage": 108, "nextPage": 110, "slideType": "expose_contradiction", "function": "expose_contradiction", "density": "dense", "nDataPoints": 0, "notes": "The slide uses direct quotes from medical experts to highlight a potential flaw in the company's clinical approach.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "metadataConfidence": 1, "imagePath": null, "slideHref": "/slides/019dd923-622c-750b-8b9a-3bcd52c6e583/109", "deckHref": "/decks/019dd923-622c-750b-8b9a-3bcd52c6e583", "deckJsonHref": "/decks/019dd923-622c-750b-8b9a-3bcd52c6e583.json", "deckAnchorHref": "/decks/019dd923-622c-750b-8b9a-3bcd52c6e583#slide-109", "components": [ { "bbox": null, "kind": "callout", "text": "Soleno had no good answer to diabetes risk; physician is under the impression that Soleno is sending glucose monitors", "attrs": null, "subkind": null, "toolName": "Visual emphasis", "toolSlug": "visual-emphasis", "confidence": null, "componentId": "019dd953-64ce-7561-b29e-6dd242ce649f", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.35, "w": 0.85, "x": 0.07, "y": 0.16 }, "kind": "paragraph", "text": "An endocrinologist at an academic center and 8 colleagues, with ~50 PWS patients, all met the rep: “they’re going to basically prescribe the medication with a glucometer...a process where the glucometer gets sent to the family with the medication.” He stated that measures to control Vykat-induced hyperglycemia – titrating slowly or taking the patient off drug – may not work as it may already have tipped into diabetes; and that dose reductions in PWS patients are mechanistically different than lowering diazoxide in infants with hyperinsulinism – “if you’re hyperglycemic, I don’t know how it’s going to get better by going up more slowly on the dose or then you hold it a lower dose...is that okay?...somebody did bring that up, and they were like, oh, we just go up more slowly...I’m not sure...by that point, it may be too late...because if you already have type 2 diabetes and you’re making it worse, are you really helping the problem?”", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "be2f48f1-ffc6-4f86-8402-f74ca6b92d6f", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.18, "w": 0.85, "x": 0.07, "y": 0.76 }, "kind": "quote", "text": "“And they suggested insulin resistance. But if you’re hyperglycemic, I don’t know how it’s going to get better by going up more slowly on the dose or then you hold it a lower dose. Is that okay? Somebody did bring that up, and they were like, oh, we just go up more slowly. I’m not sure. With the mechanism of action of what it’s doing. It’s not like a GLP-1 where your body gets used to it. When they first started designing this and thinking about it, but it is in a group of people that you’re very worried about, and you could probably make the argument, too, that a lot of those people, if they’re more hyperphagic, if they get type 2 diabetes, they’re probably the people that would benefit the most from it. But by that point, it may be too late. Because if you already have type 2 diabetes and you’re making it worse, are you really helping the problem?” - Pediatric endocrinologist at a Delaware academic center with eight endocrinologists and ~50 PWS patients", "attrs": null, "subkind": "testimonial", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "c4a60013-176e-4ed8-90c5-70da5e760114", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.15, "w": 0.85, "x": 0.07, "y": 0.57 }, "kind": "quote", "text": "“All the things about diabetes and the blood sugar risk, they’re going to basically prescribe the medication with a glucometer. They’re going to actually — I think they’re going to have a process where the glucometer gets sent to the family with the medication. And using one medication to treat the other —. I saw lots of babies that were put on diazoxide, and the dose was too high, and they had hyperglycemia, so, we decreased it. But there’s not really a good — in the babies with hyperinsulinism, we’re adjusting it because of hyperinsulinism. And these guys, they’re at risk for diabetes or they might be pre-diabetic.” - Pediatric endocrinologist at a Delaware academic center with eight endocrinologists and ~50 PWS patients", "attrs": null, "subkind": "testimonial", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "ef8fb9f5-acbe-427d-ab1f-c411137f665f", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "quote", "text": "\"All the things about diabetes and the blood sugar risk, they're going to basically prescribe the medication with a glucometer. They're going to actually — I think they're going to have a process where the glucometer gets sent to the family with the medication. And using one medication to treat the other —. I saw lots of babies that were put on diazoxide, and the dose was too high, and they had hyperglycemia, so, we decreased it. But there's not really a good — in the babies with hyperinsulinism, we're adjusting it because of hyperinsulinism. And these guys, they're at risk for diabetes or they might be pre-diabetic.\" — Pediatric endocrinologist at a Delaware academic center with eight endocrinologists and ~50 PWS patients", "attrs": null, "subkind": null, "toolName": "Authority citation", "toolSlug": "authority-citation", "confidence": null, "componentId": "019dd953-64ce-7561-b29e-72522eedc1cc", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.03, "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": "3ed52391-7bbe-4d01-abea-71a67eb6d5fb", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.08, "w": 0.85, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Soleno’s fear of diabetes is evident in Vykat drug rep meetings in recent weeks.", "attrs": null, "subkind": "headline", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "3f2e0129-2233-496d-b2a0-8ea60f2fa87d", "frameworkName": null, "frameworkSlug": null } ], "metrics": [], "tools": [], "frameworks": [ { "name": "fraud-exposure", "slug": null, "matchId": "ed322175-4250-4008-acc5-7d30034a79c1", "evidence": "The slide uses expert testimony to expose a contradiction in the company's clinical safety claims.", "confidence": 0.9 } ], "arcBeats": [], "loops": [], "imagePathAlt": null, "thumbSrc": null, "thumbSrcAlt": null, "locked": true }