{ "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": 325, "pageCount": 415, "prevPage": 324, "nextPage": 326, "slideType": "expose_contradiction", "function": "expose_contradiction", "density": "dense", "nDataPoints": 0, "notes": "The slide uses direct quotes from a pediatric endocrinologist to build a case against the drug's safety profile.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "metadataConfidence": 1, "imagePath": null, "slideHref": "/slides/019dd923-622c-750b-8b9a-3bcd52c6e583/325", "deckHref": "/decks/019dd923-622c-750b-8b9a-3bcd52c6e583", "deckJsonHref": "/decks/019dd923-622c-750b-8b9a-3bcd52c6e583.json", "deckAnchorHref": "/decks/019dd923-622c-750b-8b9a-3bcd52c6e583#slide-325", "components": [ { "bbox": null, "kind": "callout", "text": "Personally, I would always be ordering echos on any child before and during treatment with diazoxide.", "attrs": null, "subkind": null, "toolName": "Visual emphasis", "toolSlug": "visual-emphasis", "confidence": null, "componentId": "019dd953-64ce-7561-b2b1-9b065646edb7", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "paragraph", "text": "“in the other condition we use diazoxide for, pulmonary edema is a massive concern of ours...the main adverse event that I would be worried about with this drug and the potential for that...difficult to predict who will develop that...personally, I would always be ordering echos on any child before and during treatment.” The investigator indicated that PWS patients are already at risk of elevated pulmonary pressures, thereby exacerbating the risk of cardiac events: “they’re likely to have problems with their left ventricular function...as a result of obesity and blood pressure...you don’t know it until you start a drug that increases pulmonary pressures...that is one thing I would worry about...that’s the side effect that worries me with this drug.”", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "d0d3ee27-1e57-41df-9418-e04ce24b79aa", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.78 }, "kind": "quote", "text": "Highly concerned about increase in pulmonary pressures from Vykat in PWS patients Q: “And do Prader-Willi patients sometimes have high pulmonary pressures? They’re obese, all kinds of other comorbidities.” A: “Well, this is the thing.— what we know with Prader-Willi is they’re likely to have problems with their left ventricular function, probably as a result of obesity and blood pressure trending higher and things like that. So, left ventricular function can be altered, but pulmonary pressures, normally you’d expect to be okay, but you never know. There could be someone that’s susceptible. You don’t know it until you start a drug that increases pulmonary pressures. That is one thing I would worry about...that’s the side effect that worries me with this drug.” - Trial investigator, pediatric endocrinologist", "attrs": null, "subkind": "testimonial", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "2b1d6878-d256-4a08-8a19-5df1eb10eeae", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.52 }, "kind": "quote", "text": "Cardiac events and pulmonary edema “is a massive concern of ours”; “the main adverse event that I would be worried about” Q: “I heard from somebody that there were two hospitalizations for cardiac events. It sounds like they were related to edema. I think one was in Massachusetts, and I heard one was in the UK. I heard it was maybe pulmonary edema with the heart being implicated.” A: “Certainly, in the other condition we use diazoxide for, pulmonary edema is a massive concern of ours. We use it in babies, and we need to make sure that the children have all had echos before they go on it and at regular intervals afterwards. That, I guess, would be the main adverse event that I would be worried about with this drug is the potential for that. And what we have found is that it’s difficult to predict who will develop that. I don’t know enough about the UK case to be able to comment on its own, but that is the adverse event that would make me kind of make sure that I’ve explained that to the family, that there is that risk. And personally, I would always be ordering echos on any child before and during treatment with diazoxide.” - Trial investigator, pediatric endocrinologist", "attrs": null, "subkind": "testimonial", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "7b8022b5-2448-4d35-920e-69724d904ad7", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "quote", "text": "\"in the other condition we use diazoxide for, pulmonary edema is a massive concern of ours...the main adverse event that I would be worried about with this drug and the potential for that...difficult to predict who will develop that...personally, I would always be ordering echos on any child before and during treatment.\" — Trial investigator, pediatric endocrinologist", "attrs": null, "subkind": null, "toolName": "Authority citation", "toolSlug": "authority-citation", "confidence": null, "componentId": "019dd953-64ce-7561-b2b1-9e4f2af8b11f", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.03, "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": "f1b86a80-b7b9-4089-8e0a-c94fa9eb153f", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Trial investigator #6 expressed extreme concern about pulmonary edema and cardiac events, based on extensive experience using diazoxide for hyperinsulinism", "attrs": null, "subkind": "headline", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "0d17c360-b310-418d-b478-8a7453232d9c", "frameworkName": null, "frameworkSlug": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "imagePathAlt": null, "thumbSrc": null, "thumbSrcAlt": null, "locked": true }