{ "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": 374, "pageCount": 415, "prevPage": 373, "nextPage": 375, "slideType": "expose_contradiction", "function": "expose_contradiction", "density": "dense", "nDataPoints": 0, "notes": "The slide uses a Q&A transcript format to expose potential flaws in clinical trial methodology and physician sentiment.", "elementsJson": [ "paragraph", "footnote" ], "metadataConfidence": 1, "imagePath": null, "slideHref": "/slides/019dd923-622c-750b-8b9a-3bcd52c6e583/374", "deckHref": "/decks/019dd923-622c-750b-8b9a-3bcd52c6e583", "deckJsonHref": "/decks/019dd923-622c-750b-8b9a-3bcd52c6e583.json", "deckAnchorHref": "/decks/019dd923-622c-750b-8b9a-3bcd52c6e583#slide-374", "components": [ { "bbox": null, "kind": "callout", "text": "you're saying the parents knew what score they needed to be included in the study, correct?", "attrs": null, "subkind": null, "toolName": "Visual emphasis", "toolSlug": "visual-emphasis", "confidence": null, "componentId": "019dd953-64ce-7561-b2b6-720d06047bae", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.5, "w": 0.86, "x": 0.07, "y": 0.4 }, "kind": "list", "text": "Q: “Your edema point is really interesting because the other thing that a couple investigators told me - one of them sees more than 50 Prader-Willi patients. I'm sure you know who he is. I asked him how many of those 50 patients are on Vykat. He said none. I asked, why?”\nA: “Oh, geez.”\nQ: “He said he said, well, I didn't see $500,000 worth of benefit from the drug. I didn't even see $5,000 of benefit from the drug. That's pretty much verbatim. He and other investigators told me that the HQ-CT scores were not reliable because the inclusion criteria was 13. They felt that parents just inflated the scores to get to 13. He felt the HQ-CT score bounced up and down 30% to 40% depending on which caregiver filled out the survey.”\nA: “How would the parents know? How would the parents know what score was required?”\nQ: “It's published on the inclusion-exclusion criteria. It's online at clinicaltrials.gov.”\nA: “But it's a research score. That's what it is. Basically, you're saying that parents use the higher score to get into the trial. That's what they said?”\nQ: “Well, the entire endpoint for the study was a survey called the HQ-CT. You can go online.”\nA: “No, I understand. But the question is, you're saying the parents knew what score they needed to be included in the study, correct?”\nQ: “It was online on clinicaltrials.gov.”\nA: “That seems somewhat odd. I'm glad you're bringing up these points. These are important points, and it's always good to hear.”\nQ: “The clinical trial protocols are published. It's probably also in the patient consent form.”\nA: “No, I understand that....I wasn't part of the trial...” - Division Chief for pediatric endocrinology at a major NE academic center", "attrs": null, "subkind": "bullet", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "9056f041-6d6c-44ed-818f-a942ed951617", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.05, "w": 0.86, "x": 0.07, "y": 0.34 }, "kind": "paragraph", "text": "Endocrinologist became alarmed/disturbed when we shared color from investigator calls re clinical trial problems like gamed HQ-CT scores; concerned that other investigators are skeptical of prescribing Vykat", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "5c17e585-cf89-467d-a970-30dac8276612", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "quote", "text": "“I didn't see $500,000 worth of benefit from the drug. I didn't even see $5,000 of benefit from the drug.” — Division Chief for pediatric endocrinology at a major NE academic center", "attrs": null, "subkind": null, "toolName": "Authority citation", "toolSlug": "authority-citation", "confidence": null, "componentId": "019dd953-64ce-7561-b2b6-75682a6ab86c", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.03, "w": 0.3, "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": "69cab89c-09d7-4bcd-8e88-5e40756b7361", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The endocrinologist's nervousness during the call was notable, as we shared concern about HQ-CT scores - inflated baselines from parents gaming the inclusion criteria, subjective from week to week – as well as color from study investigators indicating their lack of interest in using the drug: “Oh, geez... you're saying the parents knew what score they needed to be included in the study, correct?...I'm glad you're bringing up these points...these are important points, and it's always good to hear.”", "attrs": null, "subkind": "headline", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "1cfe4833-2919-472e-a93f-44fcd862317d", "frameworkName": null, "frameworkSlug": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "imagePathAlt": null, "thumbSrc": null, "thumbSrcAlt": null, "locked": true }