{ "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": 411, "pageCount": 415, "prevPage": 410, "nextPage": 412, "slideType": "testimonial", "function": "illustrate_case", "density": "dense", "nDataPoints": 2, "notes": "The slide uses a Q&A format to highlight the administrative burden and slow approval process for the drug Vykat.", "elementsJson": [ "headline_text", "paragraph", "quote_block", "footnote" ], "metadataConfidence": 1, "imagePath": null, "slideHref": "/slides/019dd923-622c-750b-8b9a-3bcd52c6e583/411", "deckHref": "/decks/019dd923-622c-750b-8b9a-3bcd52c6e583", "deckJsonHref": "/decks/019dd923-622c-750b-8b9a-3bcd52c6e583.json", "deckAnchorHref": "/decks/019dd923-622c-750b-8b9a-3bcd52c6e583#slide-411", "components": [ { "bbox": null, "kind": "callout", "text": "I haven’t gotten approved…we have filled out the form…oh yeah, it’s taking time.", "attrs": null, "subkind": null, "toolName": "Visual emphasis", "toolSlug": "visual-emphasis", "confidence": null, "componentId": "019dd953-64cf-7128-a314-8fbbcaf4bb78", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.29 }, "kind": "paragraph", "text": "Nephrologist who manages 5-7 PWS patients for edema and electrolyte imbalances\nA: “I’ve been in practice for 20 years. I practiced both adult and pediatric nephrology. We do have a good number of Prader-Willi patients. This are a rare, rare cases, so we don’t have too many in the community. But when they do come, we do follow them for long-term treatment.. And they come to our service because they may have some electrolyte imbalance. And they are followed by developmental delay, neurologist, pediatric neurologist as well. And they may have lower extremity edema. And sometimes, they have proteinuria; sometimes they don’t. They may have a skin rash. They may have excessive hair growth. They may have hyperglycemia.”\nQ: “I wasn’t aware that nephrologists also treat PWS patients? Are you called in to consult for the presentation? Or do you actually manage PWS patients?”\nA: “Well, we’re co-managing this because they may be managing the hyperglycemia. But sometimes these patients have edema, and they need diuretics. They have electrolyte imbalance in the hypokalemia-hyperkalemia, acidosis-alkalosis. So, we’re kind of managing that together…we’re in the suburbs of Chicago. Our group is very large. We get a lot of tertiary referrals…we have five tertiary care centers in our area. And there’s not a lot of community nephrologists that can handle academic-level work.” – Nephrologist who manages PWS patients,", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "551357e3-d71a-452e-9988-19b7b3ef677b", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.3, "w": 0.86, "x": 0.07, "y": 0.65 }, "kind": "paragraph", "text": "Only 1 PWS patients out of 5-7 has applied for Vykat; still unapproved by insurer; possibly a second patient in a few months\nQ: “But does it make you think twice before you put a PWS patient — have you put any patients on Vykat yet? Have any of them filled out the form or gotten approval or anything?”\nA: “We’re in process. I haven’t gotten approved yet. We have filled out the form, and we’re working with our partners in endocrinology, because they’re kind of leading the discussion, and we’re co-managing them. So, we’re taking care of the proteinuria and the management of the edema. I know that there were a few patients that were already on Vykat that were referred for edema and proteinuria, and we were able to put them on an SGLT-2 and a GLP-1. That’s where I do my management of it.”\nQ: “You’ve had one patient out of these 5 or 7 apply. When did they apply? Do you know how long insurance approvals are taking?”\nA: “Oh yeah, it’s taking time, so we applied for it, and I have not heard that it got approved because I know it’s several thousand dollars a year.”\nQ: “How many more patients do you plan to put on it? Are you going to put this one on it and try it for six months or year? What’s your thinking on how aggressively to prescribe?”\nA: “I think I might have another patient in the next few months that I may start on it and see if it gets approved. I want to get some experience.” – Nephrologist who manages PWS patients,", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "ccffd338-6574-4ba8-8c58-053921aa23f5", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "quote", "text": "“I haven’t gotten approved…we have filled out the form…oh yeah, it’s taking time.” — Nephrologist who manages PWS patients", "attrs": null, "subkind": null, "toolName": "Authority citation", "toolSlug": "authority-citation", "confidence": null, "componentId": "019dd953-64cf-7128-a314-925e10e6b196", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.96 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "subkind": null, "toolName": null, "toolSlug": null, "confidence": null, "componentId": "a15da33d-928b-4749-8dbe-a50a4c4fbb8c", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "PWS nephrologist #11: Manages 5 to 7 PWS patients in conjunction with endocrinologists at a large community care system in a major metropolitan area, mainly for edema and electrolyte imbalances like acidosis-alkalosis prevalent in the disease state. Has submitted only one Vykat start form which remains unapproved – “I haven’t gotten approved…we have filled out the form…oh yeah, it’s taking time.”", "attrs": null, "subkind": "headline", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "001c2c8f-1625-4cc9-8d3c-2059c0f850ba", "frameworkName": null, "frameworkSlug": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "imagePathAlt": null, "thumbSrc": null, "thumbSrcAlt": null, "locked": true }