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  "documentTitle": "Soleno Therapeutics (SLNO)",
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  "authorName": "Scorpion Capital",
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  "presentationDate": "2025-08-15 00:00:00",
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  "notes": "The slide uses Q&A transcripts to highlight internal knowledge of safety risks and potential for generic substitution.",
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      "text": "I can't think of any reason why the substitution couldn't achieve the same result...yeah, I agree with your assessment.",
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      "text": "No reason why generic liquid diazoxide cannot be substituted for Vykat, based on PK data",
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      "text": "Kids in trial were not able to swallow the pill; choking is a serious risk; expects pediatric PWS patients to be prescribed generic liquid instead; Soleno looked for ways to get kids to swallow a tablet",
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      "text": "An ex-employee who played key roles in the clinicals trials stated that generic diazoxide oral suspension is perfectly substitutable for Vykat, based on Soleno’s own PK data despite their protestations to the contrary, and expects to see the substitution occur; and that the liquid is safer than Vykat given “serious issue” with kids swallowing tablets and choking risk – of which Soleno was allegedly keenly aware: “I recall from our PK data...I can’t think of any reason why the substitution couldn’t achieve the same result”; “there were definitely kids not able to swallow it...it is a very serious issue in these patients...the oral suspension would make more sense for delivery...if people start taking that approach...I can see most pediatric patients preferring that rout...there was definitely a discussion around it...there were giving to them in applesauce...to find a way to make it more palatable to swallow.”",
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      "text": "Q: “They haven’t even published any proper PK data, just that poster. One of the investigators called it a horse pill. I don’t know if the pill is really that large. I don’t know if he was exaggerating, but he said, these kids were chewing it anyway. The label says you’re not supposed to chew it or cut it, because then it’s no longer extended release.”\nA: “There were definitely kids not able to swallow it...for a small child, any pill is difficult to take.”\nQ: “The standard of care for pediatrics is a liquid suspension. Did you guys see issues with kids swallowing it? One of the investigators said, choking is a fourth leading cause of death for these kids.”\nA: “It is. It is a very serious issue in these patients. I think the oral suspension would make more sense for delivery. And I think if people start taking that approach and are comfortable, I can see most pediatric patients preferring that route.”\nQ: “Was there a discussion inside the company around kids having issues swallowing the pill?”\nA: “I think there was definitely a discussion around it. And I think they were giving it to them in applesauce. And I think the solution was just to find a way to make it more palatable to swallow.” – Ex-senior Soleno employee #2, oversight of clinical trial program",
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      "text": "Q: “What is your assessment of the risk from people just writing generic diazoxide? There’s seems to be no reason to write Vykat tablets.”\nA: “I can’t see any significant risk.”\nQ: “You do or don’t see any risk to substitution?”\nA: “I don’t. Thinking back to what I recall from our PK data. I can’t think of any reason why the substitution couldn’t achieve the same result...yeah, I agree with your assessment.” – Ex-senior Soleno employee #2, oversight of clinical trial program",
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      "text": "“I recall from our PK data...I can't think of any reason why the substitution couldn't achieve the same result”; “there were definitely kids not able to swallow it...it is a very serious issue in these patients...the oral suspension would make more sense for delivery...if people start taking that approach...I can see most pediatric patients preferring that rout...there was definitely a discussion around it...there were giving to them in applesauce...to find a way to make it more palatable to swallow.” — Ex-senior Soleno employee #2, oversight of clinical trial program",
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      "text": "Source: Scorpion Capital consultation calls with experts",
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