{ "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": 299, "pageCount": 415, "prevPage": 298, "nextPage": 300, "slideType": "expose_contradiction", "function": "expose_contradiction", "density": "overcrowded", "nDataPoints": 3, "notes": "The slide uses direct Q&A transcripts to highlight the investigator's negative sentiment and concerns about patient safety (diabetes/hyperglycemia).", "elementsJson": [ "paragraph", "quote_block" ], "metadataConfidence": 1, "imagePath": null, "slideHref": "/slides/019dd923-622c-750b-8b9a-3bcd52c6e583/299", "deckHref": "/decks/019dd923-622c-750b-8b9a-3bcd52c6e583", "deckJsonHref": "/decks/019dd923-622c-750b-8b9a-3bcd52c6e583.json", "deckAnchorHref": "/decks/019dd923-622c-750b-8b9a-3bcd52c6e583#slide-299", "components": [ { "bbox": { "h": 0.03, "w": 0.85, "x": 0.07, "y": 0.79 }, "kind": "callout", "text": "Price unjustified for repurposed, generic diazoxide – “disgusted” and unlikely to recommend it", "attrs": null, "subkind": "primary", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "4aa6a2d6-109e-4908-9df6-098fa7227786", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.06, "w": 0.85, "x": 0.07, "y": 0.46 }, "kind": "callout", "text": "“Horrified” at price and “not so interested” in prescribing it; 2 out of 15 patients developed diabetes and others became hyperglycemic – ‘that’s the role of this drug’", "attrs": null, "subkind": "primary", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "a32b4f7f-8feb-43fe-82ab-2994f74c82e6", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.25, "w": 0.85, "x": 0.07, "y": 0.53 }, "kind": "paragraph", "text": "Q: “The drug costs $500,000 to $1 million a year per patient, when there's a generic version available. I don't know if you're aware of that.” A: “Oh, I know that. And I think it's disgusting, but — I've asked them, how did they justify — ” Q: “If you could prescribe an oral solution once or twice a day versus a tablet — which one would you prescribe?” A: “Well, I actually asked the question because I was horrified when I saw it was $400,000. It's not like it's gene therapy or a new enzyme that's being developed. It's diazoxide, for Christ's sake, you know. And I'm still waiting for an answer.” Q: “Is that going to change your prescribing behavior?” A: “Well, it makes me not so interested in supporting this drug. I don't see $400,000 of benefit because two of my patients developed diabetes. Two out of 15 developed diabetes and others developed hyperglycemia, which is what it's supposed to do. I mean, it's not surprising that it causes that because that's the role of the drug...I'm just not sure how they justify charging $400,000. That, to me, I still find it mind-boggling...I don't really understand that, can you just pull a number out of the air and charge it for your drug?” – Physician, KOL, and Vykat trial investigator", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "6d4e533f-ec54-4eac-9102-6d692a38075a", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.13, "w": 0.85, "x": 0.07, "y": 0.83 }, "kind": "paragraph", "text": "Q: “I don't get the sense you're going to put many patients on the drug. Do you think your colleagues are going to put many patients on the drug ? If they ask you what you think, what would you tell them? They're obviously going to ask because you're well-known.” A: “Yeah, they would. My big problem is the price. I just don't think there's any justification. I think if it's ten times less than that, that would be enough of a profit for them. And if it was like a newfangled drug, I would understand, but it's just packaged diazoxide. Right? Which is a cheap drug. How they can charge — even ten times would still make them a big profit...it's outrageous. And I'm disgusted, quite frankly. And if they weren't pricing, I would be more sympathetic to recommending it.” – Physician, KOL, and Vykat trial investigator", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "722f8293-41a7-468e-b5f7-0dc485201fa1", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.25, "w": 0.85, "x": 0.07, "y": 0.19 }, "kind": "paragraph", "text": "In particular, the investigator exhibited resentment that “two of my patients developed diabetes...and others developed hyperglycemia” while on the drug. The investigator stated that diabetic risk is inherent to Vykat’s mechanism of action: “hyperglycemia...which it’s supposed to do. I mean, it’s not surprising that it causes that because that’s the role of the drug.” The investigator stated that Vykat is just old, cheap diazoxide: “it’s not like it’s gene therapy...it’s diazoxide for Christ’s sake”; “I just don’t think there’s any justification”; “it’s just packaged diazoxide...which is a cheap drug...it’s outrageous...I’m disgusted”; “mind-boggling...I don’t really understand...”", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "7af643c0-7bb6-4be7-bcba-e08aa485f46e", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "quote", "text": "“I was horrified” — Trial investigator #2. “Well, I actually asked the question because I was horrified when I saw it was $400,000. It’s not like it’s gene therapy or a new enzyme that’s being developed. It’s diazoxide, for Christ’s sake, you know. And I’m still waiting for an answer.” — Physician, KOL, and Vykat trial investigator.", "attrs": null, "subkind": null, "toolName": "Authority citation", "toolSlug": "authority-citation", "confidence": null, "componentId": "019dd953-64ce-7561-b2b0-29f7d4d25d17", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.97 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "subkind": null, "toolName": null, "toolSlug": null, "confidence": null, "componentId": "f4fa7f69-2eaa-45b6-b5c5-1f1f0824a525", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.12, "w": 0.85, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Trial investigator #2 slammed the price of the drug as well as its lack of effectiveness and toxicity – “I was horrified”", "attrs": null, "subkind": "headline", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "3a545a34-d6af-4210-85de-cc96d60ffa94", "frameworkName": null, "frameworkSlug": null } ], "metrics": [], "tools": [], "frameworks": [ { "name": "antagonist-introduction", "slug": null, "matchId": "4d00bbd6-893a-4580-91e9-371763f03a71", "evidence": "The slide frames the drug company as the antagonist through the investigator's critical testimony.", "confidence": 0.8 } ], "arcBeats": [], "loops": [], "imagePathAlt": null, "thumbSrc": null, "thumbSrcAlt": null, "locked": true }