{ "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": 70, "pageCount": 415, "prevPage": 69, "nextPage": 71, "slideType": "expose_contradiction", "function": "expose_contradiction", "density": "overcrowded", "nDataPoints": 2, "notes": "The slide uses a series of bullet points to contrast public posturing with private admissions.", "elementsJson": [ "paragraph", "bullet_list", "footnote" ], "metadataConfidence": 1, "imagePath": null, "slideHref": "/slides/019dd923-622c-750b-8b9a-3bcd52c6e583/70", "deckHref": "/decks/019dd923-622c-750b-8b9a-3bcd52c6e583", "deckJsonHref": "/decks/019dd923-622c-750b-8b9a-3bcd52c6e583.json", "deckAnchorHref": "/decks/019dd923-622c-750b-8b9a-3bcd52c6e583#slide-70", "components": [ { "bbox": null, "kind": "callout", "text": "Inadvertently revealed several red flags about the trials, while continuing to defend the drug despite an almost 100% discontinuation rate at the site.", "attrs": null, "subkind": null, "toolName": "Visual emphasis", "toolSlug": "visual-emphasis", "confidence": null, "componentId": "019dd953-64ce-7561-b29a-d6cb72e06f7b", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.61 }, "kind": "list", "text": "The investigator was reluctant to discuss a patient who rapidly developed impaired glucose tolerance after starting the drug - \"very much at the beginning of the trial...we didn't know how concerned we needed to be\" - but admitted that the patient was started on metformin and dropped out: \"I was worried about the glucose increase...\"", "attrs": null, "subkind": "bullet", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "38ab0333-b581-4823-8e21-9fdeb6cd19ee", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.41 }, "kind": "list", "text": "When we asked how many of the investigator's 35 PWS patients were likely to be prescribed the drug, the investigator evaded the question with an indirect but telling answer, stating that patients were either too young, or don't have severe hyperphagia, or are on other PWS clinical trials, or are at risk of diabetes - an admission of Vykat's potential to cause diabetes: \"I will be careful with patients that have impaired glucose tolerance because then type 2 diabetes, I think, is quite an issue.\"", "attrs": null, "subkind": "bullet", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "3fd5d14c-4504-49b4-9121-f4e195956d6c", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.27 }, "kind": "list", "text": "However, the investigator's private, critical commentary casts doubt on the integrity of the public posturing: almost all of this physician's Vykat trial enrollees have discontinued the drug due to \"drug reaction,\" \"side effects,\" or \"didn't want to be in the trial anymore.\"", "attrs": null, "subkind": "bullet", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "803b6138-80ec-41da-929c-703cc4f322b7", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.75 }, "kind": "list", "text": "Inadvertently revealed several red flags about the trials, while continuing to defend the drug despite an almost 100% discontinuation rate at the site. The investigator confirmed that \"most\" or \"all\" patients developed hypertrichosis (hairiness), thereby unblinding the trial - \"the patients that I saw, most of them developed some degree of hypertrichosis.\"", "attrs": null, "subkind": "bullet", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "d2f95e3d-6bf3-4c2e-9960-a9fa90eece1b", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "quote", "text": "I will be careful with patients that have impaired glucose tolerance because then type 2 diabetes, I think, is quite an issue. — Trial investigator #8", "attrs": null, "subkind": null, "toolName": "Authority citation", "toolSlug": "authority-citation", "confidence": null, "componentId": "019dd953-64ce-7561-b29a-db6a3064530d", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.02, "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": "61647c7c-fedc-4eb3-bfdb-fecde4b93f6f", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Trial investigator #8: Not considered a KOL or published authority on PWS, but was an investigator across the phase 3, open-label, and withdrawal studies, as well as a key co-author on Vykat papers, with a caseload of 35 PWS patients and around 10 patients enrolled in the trials. The investigator is a consultant and is publicly promotional on Soleno’s behalf, and was defensive during our interview and bristled at our questions.", "attrs": null, "subkind": "headline", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "38756dc8-c9f3-4465-a163-8fa6dc6a24cc", "frameworkName": null, "frameworkSlug": null } ], "metrics": [], "tools": [], "frameworks": [ { "name": "fraud-exposure", "slug": null, "matchId": "f162ace6-868b-455e-bffc-a02ddcda69ee", "evidence": "The slide systematically exposes contradictions between public claims and private admissions to undermine the credibility of a trial investigator.", "confidence": 0.9 } ], "arcBeats": [], "loops": [], "imagePathAlt": null, "thumbSrc": null, "thumbSrcAlt": null, "locked": true }