{ "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": 221, "pageCount": 415, "prevPage": 220, "nextPage": 222, "slideType": "expose_contradiction", "function": "expose_contradiction", "density": "dense", "nDataPoints": 0, "notes": "The slide uses a Q&A transcript format to build a case against the drug's physical formulation.", "elementsJson": [ "paragraph", "quote_block" ], "metadataConfidence": 1, "imagePath": null, "slideHref": "/slides/019dd923-622c-750b-8b9a-3bcd52c6e583/221", "deckHref": "/decks/019dd923-622c-750b-8b9a-3bcd52c6e583", "deckJsonHref": "/decks/019dd923-622c-750b-8b9a-3bcd52c6e583.json", "deckAnchorHref": "/decks/019dd923-622c-750b-8b9a-3bcd52c6e583#slide-221", "components": [ { "bbox": { "h": 0.04, "w": 0.86, "x": 0.07, "y": 0.47 }, "kind": "callout", "text": "Vykat is a “horse pill” that is problematic for PWS patients to swallow; results in chewing instead", "attrs": null, "subkind": "primary", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "fe5ad7be-d44e-40a2-a727-ee4f63cbfb78", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.19 }, "kind": "paragraph", "text": "We quote one of most prominent, published, and influential authorities in PWS, who has a long history with Soleno and played a key role in the trials: “it’s like a horse pill”; “they’re going to chew it”; “I was concerned because the fourth most common cause of death...is choking...they can’t swallow...they have dry mouth...their suck reflex is poor...their choking reflex is poor...it’s a problem...I saw that...they would chew, those that I witnessed...concerns with that big pill....make sure your child doesn’t choke...after I saw the size of that pill and said, oh my God, they’re never going to swallow this...I guess if you chew it, you swallow it in smaller pieces.”", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "643f2690-a3b4-4e5f-93b0-e93506e31efa", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.42, "w": 0.86, "x": 0.07, "y": 0.52 }, "kind": "paragraph", "text": "Q: “What did you observe about the formulation? Because it seems to me like, how do you get a four-year-old kid to swallow an extended-release tablet? Because extended release, you can’t cut it or chew it?”\nA: “Well. You can’t. That was a concern I had, too, when I first came in. It’s like a horse pill. But what happens? I don’t know if you’ve ever seen Prader Willi patients, but you put something in their mouth what they do, they’re going to chew it and swallow it, probably people that are constantly eating anything and everything. And I was concerned because the fourth most common cause of death, in Prader-Willi Syndrome is choking. For a four-year-old, the most common cause of death in a four-year-old Prader-Willi is choking on a hot dog...they can’t swallow, they have poor teeth, they have dry mouth, they swallowing difficulties, their suck reflex is poor, their choking reflex is poor. It’s a problem. I saw that. I said, that’s it. You can’t ever get this — they’re never going to swallow this pill. But what they do, they chew it...you can’t chew because you’ll destroy the drug; it has to stay intact —”\nQ: “[Redacted number] patients that you enrolled in the trial, were they all chewing the pill?”\nA: “Pretty much. They would chew, those I witnessed. Once every three months, I’d see them and they would.”\nQ: “They’re not supposed to chew it. That ruins the extended release.”\nA: “Well, but some of them do. They chew it, but they’ll chew it into maybe a half a piece, but it’s still opened up. So, it’s an issue....the big pill, I was concerned about that because the swallowing difficulties...That was something I addressed with them. About concerns with that big pill: we got to make sure that your child doesn’t choke because we’re concerned about the dry mouth, the poor dentition, poor enamel, and the swallowing difficulties...because after I saw the size of that pill and said, oh my God, they’re never going to swallow this. But then I said, well, they’re chewing it. Okay. Well, I guess if you chew it, you swallow in smaller pieces.” - Trial investigator and physician; one of the leading KOL’s in the PWS field", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "88dc5ade-5a0d-471f-8f5d-8e12e52de523", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "quote", "text": "“it’s like a horse pill”; “they’re going to chew it”; “I was concerned because the fourth most common cause of death...is choking...they can’t swallow...their choking reflex is poor...it’s a problem...I saw that...they would chew, those that I witnessed...concerns with that big pill....make sure your child doesn’t choke...after I saw the size of that pill and said, oh my God, they’re never going to swallow this...I guess if you chew it, you swallow it in smaller pieces.” — Trial investigator and physician; one of the leading KOL’s in the PWS field", "attrs": null, "subkind": null, "toolName": "Authority citation", "toolSlug": "authority-citation", "confidence": null, "componentId": "019dd953-64ce-7561-b2a8-eed10f94aa2e", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.02, "w": 0.25, "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": "99ae1f7f-6249-4d5c-bac7-43306aa664c6", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Investigators and other endocrinologists expressed concern about the risks of Vykat’s tablet versus oral suspension, as noted in the interview chapters – several called it a “horse pill” given its unusual size.", "attrs": null, "subkind": "headline", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "51e1a65f-f52e-4086-825f-dff25cdf21df", "frameworkName": null, "frameworkSlug": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "imagePathAlt": null, "thumbSrc": null, "thumbSrcAlt": null, "locked": true }