{ "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": 150, "pageCount": 415, "prevPage": 149, "nextPage": 151, "slideType": "expose_contradiction", "function": "expose_contradiction", "density": "dense", "nDataPoints": 0, "notes": "The slide uses a direct quote from a physician to undermine the company's marketing claims.", "elementsJson": [ "paragraph", "callout_box", "footnote" ], "metadataConfidence": 1, "imagePath": null, "slideHref": "/slides/019dd923-622c-750b-8b9a-3bcd52c6e583/150", "deckHref": "/decks/019dd923-622c-750b-8b9a-3bcd52c6e583", "deckJsonHref": "/decks/019dd923-622c-750b-8b9a-3bcd52c6e583.json", "deckAnchorHref": "/decks/019dd923-622c-750b-8b9a-3bcd52c6e583#slide-150", "components": [ { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "callout", "text": "Soleno appears to be worried about permanent edema, as their rep suggested patients remaining on diuretics as “standard of care” with Vykat; physicians “surprised” at the answer; edema is a “known side effect” of diazoxide", "attrs": null, "subkind": "primary", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "427fc488-eec3-4ff0-b364-aa2467bf273c", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Soleno’s marketing to endocrinologists suggests paranoia of pulmonary edema and cardiovascular risks, as Vykat reps appear to be advising diuretics as a combination therapy – in addition to providing handouts to alert families to signs of edema. Endocrinologists who attended drug rep presentations in recent weeks at their respective clinics said they were taken aback at the suggestion of permanent edema requiring continuous diuretic therapy. One, at an academic center who attended the meeting with 8 endocrinology colleagues, indicated skepticism of the rep’s answers - \"it’s a known side effect...I was a little bit surprised that they were talking about treating kids with diuretics as a standard of care with this medication - that was one of the things that the rep said...I was surprised about that because if I have somebody with congenital hyperinsulinism that has a mutation that responds to diazoxide...I would not treat that kid with a diuretic.\"", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "ce0d0186-6d97-4df0-8695-fd112c82e5b6", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.63 }, "kind": "quote", "text": "“Every baby less than a year old, we put on diuretics, so it's a known side effect. When they get older, we actually stop it. Most of the time they don't still need it, which I was a little bit surprised that they were talking about treating kids with diuretics as a standard of care with this medication — that was one of the things that the rep said. I was surprised about that because if I have somebody with congenital hyperinsulinism that has a mutation that responds to diazoxide, and we continue to treat them, and there's a couple later on in life, I would not treat that kid with a diuretic. Usually, they're old enough and they do fine. And maybe it's because it's twice a day and it's not extended-release.” - Pediatric endocrinologist at an academic center with eight endocrinologists and ~50 PWS patients", "attrs": null, "subkind": "testimonial", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "cd44b905-0053-4eb4-8b82-3645a6276821", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "quote", "text": "“Every baby less than a year old, we put on diuretics, so it's a known side effect. When they get older, we actually stop it. Most of the time they don't still need it, which I was a little bit surprised that they were talking about treating kids with diuretics as a standard of care with this medication — that was one of the things that the rep said. I was surprised about that because if I have somebody with congenital hyperinsulinism that has a mutation that responds to diazoxide, and we continue to treat them, and there's a couple later on in life, I would not treat that kid with a diuretic. Usually, they're old enough and they're old enough and they do fine. And maybe it's because it's twice a day and it's not extended-release.” — Pediatric endocrinologist at an 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-b2a3-7451ca843423", "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": "fb5e0b86-8df0-4cdf-8813-ddef34b06c46", "frameworkName": null, "frameworkSlug": null } ], "metrics": [], "tools": [], "frameworks": [ { "name": "ceo-quote-contradiction", "slug": null, "matchId": "02ed6d34-83f8-400c-86ec-823055fbd63d", "evidence": "Contrasts company marketing claims with expert physician testimony.", "confidence": 0.9 } ], "arcBeats": [], "loops": [], "imagePathAlt": null, "thumbSrc": null, "thumbSrcAlt": null, "locked": true }