Kevin Dougherty v. Esperion Therapeutics

905 F.3d 971
CourtCourt of Appeals for the Sixth Circuit
DecidedSeptember 27, 2018
Docket17-1701
StatusPublished
Cited by40 cases

This text of 905 F.3d 971 (Kevin Dougherty v. Esperion Therapeutics) is published on Counsel Stack Legal Research, covering Court of Appeals for the Sixth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Kevin Dougherty v. Esperion Therapeutics, 905 F.3d 971 (6th Cir. 2018).

Opinion

SILER, Circuit Judge.

*975 Plaintiffs in securities-fraud suits are subject to a more onerous pleading burden than the average plaintiff. They must plead, among other things, a "strong inference of scienter" that is "cogent and at least as compelling as any opposing inference of nonfraudulent intent." Doshi v. Gen. Cable Corp. , 823 F.3d 1032 , 1039 (6th Cir. 2016) (quoting Tellabs, Inc. v. Makor Issues & Rights, Ltd. , 551 U.S. 308 , 314, 127 S.Ct. 2499 , 168 L.Ed.2d 179 (2007) ). In this case, the district court held that Plaintiffs, certain stockholders of Esperion Therapeutics, failed to adequately plead a strong inference that Esperion CEO Tim Mayleben willfully or recklessly made misleading statements to investors following a meeting with the FDA regarding the company's new cholesterol drug. Because Plaintiffs adequately alleged scienter, we REVERSE and REMAND.

I.

Esperion is a pharmaceutical company that was formed in 2008. Since its incorporation, Esperion has neither sold any products nor generated any revenue, relying instead upon investor funding. Esperion's sole focus is the development of ETC-1002, a first-in-class oral medication designed to lower LDL-cholesterol, also known as "bad cholesterol." Elevated LDL-cholesterol is a significant risk factor in cardiovascular disease and contributes to plaque deposits in arteries, which in turn cause heart attacks, strokes, and other medical issues. According to the Centers for Disease Control, approximately seventy-one million adults in the United States have elevated LDL-cholesterol levels.

The current standard of care for patients with high cholesterol is a family of drugs called statins. However, the use of statins is accompanied by a number of possible side effects-muscle pain or weakness, memory loss, and increased glucose levels, to name a few. Esperion estimates that between two and seven million American adults are statin-intolerant due to these side effects.

Compared to statins, ETC-1002 acts at an earlier point in the body's synthesis of cholesterol and avoids the muscle pain and weakness that statins produce in some patients. Esperion hopes to market ETC-1002 as an alternative treatment for statin-intolerant patients. Additionally, ETC-1002 could be used as an add-on therapy for patients who suffer from heterozygous familial hypercholesterolemia (HeFH) and clinical atherosclerotic cardiovascular disease (ASCVD). Patients with those conditions are often unable to reach their recommended LDL-cholesterol levels using statins alone, so the addition of ETC-1002 to their course of treatment might help those patients reach their cholesterol-level goals.

To that end, Esperion sought FDA approval for ETC-1002. Any new drug must be put through a series of clinical *976 trials before it can be marketed and sold in the United States. Following initial testing on animals, pharmaceutical companies must seek permission from the FDA to test the new drug on humans. N.J. Carpenters Pension & Annuity Funds v. Biogen IDEC Inc. , 537 F.3d 35 , 39 (1st Cir. 2008) (citations omitted). If approved by the FDA, human clinical trials proceed in three phases:

Phase I studies generally involve twenty to eighty subjects, and are designed to determine how the drug works in humans and the side effects associated with increasing doses. [ 21 C.F.R.] § 312.21(a)(1). Phase II studies usually involve no more than several hundred subjects, and are designed to evaluate the effectiveness of the drug, as well as common short-term side effects and risks. Id. § 312.21(b). Phase III studies are large-scale trials, usually involving several hundred to several thousand subjects, and are intended to gather the information necessary to provide an adequate basis for labeling the drug. Id. § 312.21(c).... After Phase III, the FDA considers the results of all of the clinical trials in determining whether to approve a drug for market. See id. §§ 314.125(b), 314.126(a).

Id.

By August 2015, Esperion had completed three Phase 1 studies and seven Phase 2 studies. In each trial, Esperion reported that ETC-1002 was well-tolerated in the study population and demonstrated significant average LDL-cholesterol reductions. That month, Esperion executives met with FDA officials for an "End-of-Phase 2 Meeting" to elicit feedback and advice regarding the path forward with Phase 3 of the approval process.

Following the meeting, Esperion published a press release on August 17, 2015, that contains two statements worth noting. First, the company stated that "[t]he FDA confirmed that LDL-C remains an acceptable clinical surrogate endpoint for the approval of an LDL-C lowering therapy such as ETC-1002 in patient populations who have a high unmet medical need, including patients with [HeFH] ... or [ASCVD]." Second, the company said that, "[b]ased upon feedback from the FDA, approval of ETC-1002 in the HeFH and ASCVD patient populations will not require the completion of a cardiovascular outcomes trial."

These statements require some explanation to be fully understood in context. A cardiovascular outcomes trial (CVOT) is a costly, lengthy study that measures a drug's effectiveness in reducing cardiovascular risk over several years. Because lower LDL-cholesterol is presumed to improve overall heart health, the FDA does not typically require companies seeking approval of a new cholesterol-lowering drug to complete a CVOT and prove that the drug actually reduces cardiovascular risk. Instead, the FDA treats LDL-cholesterol as a "surrogate endpoint," or proxy, for cardiovascular risk. In other words, if a new drug is shown to lower LDL-cholesterol, the FDA assumes that it also improves overall cardiovascular health.

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905 F.3d 971, Counsel Stack Legal Research, https://law.counselstack.com/opinion/kevin-dougherty-v-esperion-therapeutics-ca6-2018.