{ "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": 354, "pageCount": 415, "prevPage": 353, "nextPage": 355, "slideType": "testimonial", "function": "expose_contradiction", "density": "dense", "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight expert skepticism.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "metadataConfidence": 1, "imagePath": null, "slideHref": "/slides/019dd923-622c-750b-8b9a-3bcd52c6e583/354", "deckHref": "/decks/019dd923-622c-750b-8b9a-3bcd52c6e583", "deckJsonHref": "/decks/019dd923-622c-750b-8b9a-3bcd52c6e583.json", "deckAnchorHref": "/decks/019dd923-622c-750b-8b9a-3bcd52c6e583#slide-354", "components": [ { "bbox": null, "kind": "callout", "text": "Vykat mechanism of action creates inherent diabetes risk – “like pouring gasoline into the fire. I 100,000% agree”", "attrs": null, "subkind": null, "toolName": "Visual emphasis", "toolSlug": "visual-emphasis", "confidence": null, "componentId": "019dd953-64ce-7561-b2b4-71e347cec771", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.62, "w": 0.86, "x": 0.07, "y": 0.33 }, "kind": "paragraph", "text": "Has heard no enthusiasm from other endocrinologists at MGH; no PWS patient has inquired about it\nQ: “Have you heard any comments around Vykat? Are you the only person at Mass General that treats PWS patients? Have you heard other colleagues that treat PWS? Have you heard anything from them about it?”\nA: “I’m sure some of my other colleagues probably have some because some of us are also like obesity certified. But I haven’t heard anything from anybody else about it.”\nQ: “Have you had any patient inquiries out of your five patients saying, hey, this got FDA approved? I want to try it.”\nA: “I have not. No, they haven’t given me any inquiries. No.”\nQ: “Is there anything else here in your thinking about Vykat that might be useful for me to understand?”\nA: “I think we probably just need more data. I’m feeling neutral about it because diazoxide has its own issues and side effects. So, I guess it’s more of a we’ll wait and see.”\nQ: “What are the other side effects you’re concerned about from diazoxide?”\nA: “The big one is hyperglycemia. I know there can be some dizziness, nausea. The biggest ones, we talked about sodium and water retention, hyperglycemia. I think rarely there can be some hematologic problems, but one is the sugar issues and swelling.” - Endocrinologist at Massachusetts General Hospital\n\nVykat mechanism of action creates inherent diabetes risk – “like pouring gasoline into the fire. I 100,000% agree”\nQ: “The entire mechanism of this drug is to raise blood sugar by suppressing insulin, which is why you’ve used it for hypoglycemia. In the context of obese Prader-Willi patients, I’ve heard figures saying maybe 30%, 40% of them are diabetic to begin with. Why would you give them a drug that does this?”\nA: “Right. Well put. You’re totally right. It could be like pouring gasoline into the fire. I 100,000% agree…I’ve used diazoxide previously, not for PWS, but diazoxide helps raise blood sugar, so I’ve used it in hypoglycemia, non-diabetic, hypoglycemic. We’d have to be careful about diazoxide because it brings up blood sugar. You don’t want to cause too much hyperglycemia in these PWS patients” - Endocrinologist at Massachusetts General Hospital", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "7bd94b51-bb9d-4c91-9f91-8402365a22ae", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "quote", "text": "“The big one is hyperglycemia. I know there can be some dizziness, nausea. The biggest ones, we talked about sodium and water retention, hyperglycemia. I think rarely there can be some hematologic problems, but one is the sugar issues and swelling.” — Endocrinologist at Massachusetts General Hospital", "attrs": null, "subkind": null, "toolName": "Authority citation", "toolSlug": "authority-citation", "confidence": null, "componentId": "019dd953-64ce-7561-b2b4-76581feb3999", "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": "df7ced65-2c9e-4d0e-85d0-b6d62ffce414", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Endocrinologist #3: Indicated that he as heard no enthusiasm from other endocrinologists at MGH and that no PWS patient has inquired about; and that Vykat’s insulin suppression mechanism is “like pouring gasoline on a fire…I 100,000% agree” as far as diabetes risk - “I’m feeling neutral” and “wait and see” because of risks like edema and hematologic problems; “I haven’t heard anything from anybody else about it”; “diazoxide has its own issues and side effects”; “the big one is hyperglycemia…there can be some dizziness, nausea…the biggest ones…sodium and water retention, hyperglycemia…swelling”; “we’d have to be careful about diazoxide…you don’t want to cause too much hyperglycemia in these PWS patients.”", "attrs": null, "subkind": "headline", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "83282801-2484-4dd7-98b9-ad188b1369b7", "frameworkName": null, "frameworkSlug": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "imagePathAlt": null, "thumbSrc": null, "thumbSrcAlt": null, "locked": true }