{ "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": 65, "pageCount": 415, "prevPage": 64, "nextPage": 66, "slideType": "expose_contradiction", "function": "expose_contradiction", "density": "overcrowded", "nDataPoints": 0, "notes": "The slide uses direct quotes from a trial investigator to undermine the drug's efficacy and safety profile.", "elementsJson": [ "headline_text", "bullet_list", "footnote" ], "metadataConfidence": 1, "imagePath": null, "slideHref": "/slides/019dd923-622c-750b-8b9a-3bcd52c6e583/65", "deckHref": "/decks/019dd923-622c-750b-8b9a-3bcd52c6e583", "deckJsonHref": "/decks/019dd923-622c-750b-8b9a-3bcd52c6e583.json", "deckAnchorHref": "/decks/019dd923-622c-750b-8b9a-3bcd52c6e583#slide-65", "components": [ { "bbox": null, "kind": "callout", "text": "Indicated the drug has no benefit in hyperphagia as it still requires restrictive food security measures, defeating its purpose: \"not going to be helpful at all to the families who don't have the ability to control the environment.\"", "attrs": null, "subkind": null, "toolName": "Visual emphasis", "toolSlug": "visual-emphasis", "confidence": null, "componentId": "019dd953-64ce-7561-b29b-4fe3e4648c15", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.08, "w": 0.85, "x": 0.07, "y": 0.4 }, "kind": "list", "text": "Admitted that the trials were basically unblinded because the side effects were obvious - “she got hairy...so I was pretty sure she on real drug...”; “there certainly was potential for unblinding...no question.”", "attrs": null, "subkind": "bullet", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "40d21410-6852-4499-a2ba-760c2e59fd4c", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.1, "w": 0.85, "x": 0.07, "y": 0.49 }, "kind": "list", "text": "Noted significant adverse effects like edema, hyperglycemia, and hairiness, stating that Vykat raised patients’ fasting glucose levels and caused concern about a diabetes safety signal: “I’ll probably be quite cautious in the population that’s already got blood glucose intolerance.”", "attrs": null, "subkind": "bullet", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "4543f05d-c383-4e72-b60d-97aa37f3b8a8", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.12, "w": 0.85, "x": 0.07, "y": 0.27 }, "kind": "list", "text": "Even more telling, the investigator elaborated upon a Vykat patient who “probably put on 50 pounds during the 13-week C-601 [pivotal phase 3] trial and then rolled over [to open label] and continued to put on weight...the family withdrew her in order to hospitalize her” due to the uncontrolled weight gain.", "attrs": null, "subkind": "bullet", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "5be372ab-d30a-4dca-8a4b-cb37ade28d62", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.14, "w": 0.85, "x": 0.07, "y": 0.6 }, "kind": "list", "text": "Stated that the Vykat tablet was too large for some patients and that they had to use several of the smaller dose tablets instead; and indicated they even tried to exclude patients who couldn’t swallow a tablet - “in order to get in the study, you had to be able to demonstrate that you could swallow a pill” - “some folks couldn’t swallow that big a pill, so we had to use the 75 mg for them instead...so yeah, the 150 mg is a big pill.”", "attrs": null, "subkind": "bullet", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "64ededd8-1748-4d1d-bce4-ab2a822d1779", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.1, "w": 0.85, "x": 0.07, "y": 0.16 }, "kind": "list", "text": "Indicated the drug has no benefit in hyperphagia as it still requires restrictive food security measures, defeating its purpose: “not going to be helpful at all to the families who don’t have the ability to control the environment.”", "attrs": null, "subkind": "bullet", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "9dcde354-dce4-46c0-8e42-d3911639e3a3", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.15, "w": 0.85, "x": 0.07, "y": 0.75 }, "kind": "list", "text": "Given the self-evident danger of a “horse pill” in PWS patients with impaired swallowing and high risk of choking, we asked why physicians wouldn’t just use generic diazoxide suspension instead: “no, I don’t think you’re missing anything...just out of the goodness of my heat, maybe I’ll end up prescribing plain old diazoxide...I guess we’ll see in a little while, because there’ll be plenty of people who will be doing it”; “everybody can take that, whereas not everybody can swallow a pill.”", "attrs": null, "subkind": "bullet", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "b278e50c-55e9-44de-89c1-a8f61282bf2c", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "quote", "text": "\"not going to be helpful at all to the families who don't have the ability to control the environment.\" — Trial investigator #5; \"probably put on 50 pounds during the 13-week C-601 [pivotal phase 3] trial and then rolled over [to open label] and continued to put on weight...the family withdrew her in order to hospitalize her\" — Trial investigator #5; \"she got hairy...so I was pretty sure she on real drug...\"; \"there certainly was potential for unblinding...no question.\" — Trial investigator #5; \"I'll probably be quite cautious in the population that's already got blood glucose intolerance.\" — Trial investigator #5; \"in order to get in the study, you had to be able to demonstrate that you could swallow a pill\" — \"some folks couldn't swallow that big a pill, so we had to use the 75 mg for them instead...so yeah, the 150 mg is a big pill.\" — Trial investigator #5; \"no, I don't think you're missing anything...just out of the goodness of my heat, maybe I'll end up prescribing plain old diazoxide...I guess we'll see in a little while, because there'll be plenty of people who will be doing it\"; \"everybody can take that, whereas not everybody can swallow a pill.\" — Trial investigator #5", "attrs": null, "subkind": null, "toolName": "Authority citation", "toolSlug": "authority-citation", "confidence": null, "componentId": "019dd953-64ce-7561-b29b-522a9973dacd", "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": "cd0e52a3-b8ba-493d-a87a-a310ff72262b", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.08, "w": 0.85, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Trial investigator #5 (cont'd): Influential key opinion leader with >40 PWS patients currently.", "attrs": null, "subkind": "headline", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "f3f9aa9a-76cd-44ae-bf16-7e600d066237", "frameworkName": null, "frameworkSlug": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "imagePathAlt": null, "thumbSrc": null, "thumbSrcAlt": null, "locked": true }