{ "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": 343, "pageCount": 415, "prevPage": 342, "nextPage": 344, "slideType": "testimonial", "function": "expose_contradiction", "density": "dense", "nDataPoints": 0, "notes": "The slide presents a direct challenge to the commercial viability of 'Vykat' by highlighting a physician's preference for a cheaper, off-label alternative.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "metadataConfidence": 0.95, "imagePath": null, "slideHref": "/slides/019dd923-622c-750b-8b9a-3bcd52c6e583/343", "deckHref": "/decks/019dd923-622c-750b-8b9a-3bcd52c6e583", "deckJsonHref": "/decks/019dd923-622c-750b-8b9a-3bcd52c6e583.json", "deckAnchorHref": "/decks/019dd923-622c-750b-8b9a-3bcd52c6e583#slide-343", "components": [ { "bbox": null, "kind": "callout", "text": "I predict that I can achieve similar plasma levels and clinical efficacy with both an oral formulation and at low cost, even if it requires off-label prescribing. I'm totally in. That is an easy win for me...", "attrs": null, "subkind": null, "toolName": "Visual emphasis", "toolSlug": "visual-emphasis", "confidence": null, "componentId": "019dd953-64ce-7561-b2b3-7b44624952ed", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.03, "w": 0.9, "x": 0.05, "y": 0.32 }, "kind": "paragraph", "text": "“I will for sure” use generic diazoxide off-label instead of Vykat", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "34a12ae5-f025-4e6b-bbdb-0b5108403f43", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.3, "w": 0.9, "x": 0.05, "y": 0.6 }, "kind": "quote", "text": "Q: “You can go to ChatGPT and ask for the dose of diazoxide that's the equivalent to the Vykat extended-release tablet... A: “Oh yeah, I just did the same thing and it told me to give 11.5 ml of diazoxide suspension... That's so cool. I love it. Would you like a conversion table or a prescription? [chuckles].. Soleno is going to hate that you're talking to me, because I find this completely intriguing and informative...it's important that clinicians like me hear this alternative option...this will change my practice behavior, and, as a result, how I might respond to a question about future prescribing is substantially altered by this insight.”", "attrs": null, "subkind": "testimonial", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "4f122f25-1166-4feb-a6da-68f5ceef45db", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.2, "w": 0.9, "x": 0.05, "y": 0.36 }, "kind": "quote", "text": "Q: “There's a branded version called Proglycem. It mainly comes in an oral suspension. Why would anyone not just use that off-label?” A: “Well, I would and I'd be very happy to. I do off-label and generic prescribing all the time... I predict that I can achieve similar plasma levels and clinical efficacy with both an oral formulation and at low cost, even if it requires off-label prescribing. I'm totally in. That is an easy win for me, and I'm super happy to prescribe it both off-label and in this different oral formulation if it works as well...I will for sure take that approach rather than prescribing an outrageously priced drug.”", "attrs": null, "subkind": "testimonial", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "f4321f94-12d2-414b-80de-0ca079328b6c", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "quote", "text": "“Well, I would and I'd be very happy to. I do off-label and generic prescribing all the time for things like ketoconazole for my patients with advanced Cushing's...I predict that I can achieve similar plasma levels and clinical efficacy with both an oral formulation and at low cost, even if it requires off-label prescribing. I'm totally in. That is an easy win for me, and I'm super happy to prescribe it both off-label and in this different oral formulation if it works as well...I will for sure take that approach rather than prescribing an outrageously priced drug.” — Endocrinologist with academic and community hospital affiliations", "attrs": null, "subkind": null, "toolName": "Authority citation", "toolSlug": "authority-citation", "confidence": null, "componentId": "019dd953-64ce-7561-b2b3-7f360892ac8b", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.05, "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": "8b700e97-63f1-4345-a2ae-5b7f4c5020fb", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.25, "w": 0.9, "x": 0.05, "y": 0.05 }, "kind": "title", "text": "Endocrinologist #1: Thinks that generic diazoxide suspension is pharmacokinetically identical to Vykat and plans to use it instead if any patients want it vs. “an outrageously priced drug”...", "attrs": null, "subkind": "headline", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "13454c8e-cc51-4c6f-81be-f2ee0554e408", "frameworkName": null, "frameworkSlug": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "imagePathAlt": null, "thumbSrc": null, "thumbSrcAlt": null, "locked": true }