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  "documentTitle": "Soleno Therapeutics (SLNO)",
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  "presentationDate": "2025-08-15 00:00:00",
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      "text": "I was surprised about that because if I have somebody with congenital hyperinsulinism that has a mutation that responds to diazoxide...I would not treat that kid with a diuretic.",
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      "text": "Indicated fear of Vykat-induced edema and serious cardiac events, and was skeptical of the Vykat rep’s answers which suggested that Soleno views edema as a feature of the drug. During the meeting, Soleno allegedly “talked about” a Vykat + diuretic combination as standard of care with the medication, and that “it’s a known side effect...I was a little bit surprised that they were talking about treating kids with diuretics as a standard of care with this medication - that was one of the things that the rep said...I was surprised about that because if I have somebody with congenital hyperinsulinism that has a mutation that responds to diazoxide...I would not treat that kid with a diuretic.”",
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      "text": "Thinks that Soleno is worried about diabetes to the point that - according to the drug rep - “they’re going to basically prescribe the medication with a glucometer...I think they’re going to have a process where the glucometer gets sent to the family with the medication.” He stated that measures to control Vykat-induced hyperglycemia – such as titrating slowly or taking the patient off drug – are questionable as the patient may already be tipped into diabetes at that point; and that dose reductions in PWS patients at risk of diabetes are mechanistically different than lowering diazoxide in infants with hyperinsulinism – “if you’re hyperglycemic, I don’t know how it’s going to get better by going up more slowly on the dose or then you hold it a lower dose...is that okay?...somebody did bring that up, and they were like, oh, we just go up more slowly...I’m not sure...by that point, it may be too late...because if you already have type 2 diabetes and you’re making it worse, are you really helping the problem?”",
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      "text": "Was surprised at comments by the Soleno rep which he interpreted as meaning that “permanent edema” is a side effect of the drug, versus something transient – “as far as serious cardiac events, we did talk about pulmonary edema at the visit, and she even said something about giving people a handout and how to recognize edema...and I was just like, \"huh!\" I would expect something transient, but I wouldn’t expect a permanent edema, to be honest....” When we asked if Soleno was worried enough about edema to actually give families a handout, the physician replied “yes...they said something about the families are very good and teaching people how to recognize the edema at home, which, I’m an endocrinologist, and I can certainly do that, pitting versus not...but that’s not something we’re typically do.”",
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      "text": "“if you're hyperglycemic, I don't know how it's going to get better by going up more slowly on the dose or then you hold it a lower dose...is that okay?...somebody did bring that up, and they were like, oh, we just go up more slowly...I'm not sure...by that point, it may be too late...because if you already have type 2 diabetes and you're making it worse, are you really helping the problem?” — Endocrinologist #4",
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      "text": "Source: Scorpion Capital consultation calls with experts",
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      "text": "Endocrinologist #4 (cont’d): Academic center with 8 endocrinologists who manage ~50 PWS patients",
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