Milana v. Eisai, Inc.

CourtDistrict Court, M.D. Florida
DecidedMarch 22, 2022
Docket8:21-cv-00831
StatusUnknown

This text of Milana v. Eisai, Inc. (Milana v. Eisai, Inc.) is published on Counsel Stack Legal Research, covering District Court, M.D. Florida primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Milana v. Eisai, Inc., (M.D. Fla. 2022).

Opinion

UNITED STATES DISTRICT COURT MIDDLE DISTRICT OF FLORIDA TAMPA DIVISION

MARY MILANA and VICTOR MILANA,

Plaintiffs,

v. Case No: 8:21-cv-831-CEH-AEP

EISAI, INC. and ARENA PHARMACEUTICALS, INC.

Defendants. ___________________________________/ ORDER This cause comes before the Court upon Defendant Eisai, Inc.’s Partial Motion to Dismiss Plaintiffs’ Complaint (Doc. 19) and Defendant Arena Pharmaceuticals, Inc.’s Motion to Dismiss Pursuant to Federal Rule of Civil Procedure 12(b)(6) and 9(b) (Doc. 21). Plaintiffs Mary Milana and Victor Milana respond in opposition (Doc. 31). Eisai and Arena reply (Docs. 39, 40). This products-liability action centers on a prescription drug named Belviq. Mary Milana alleges that this prescription drug gave her breast cancer. She and her husband now sue Eisai, Inc., and Arena Pharmaceuticals, Inc., under state law. Eisai and Arena move for dismissal under Rule 12(b)(6). For the reasons set forth below, the Court will grant-in-part and deny-in-part Eisai’s Partial Motion to Dismiss and deny Arena’s Motion to Dismiss. I. FACTUAL BACKGROUND1 Mary Milana took Belviq from 2013 through 2020. Doc. 1 ¶15. Also known as

lorcaserin hydrochloride, Belviq is a first-in-class oral selective serotonin 5HT2c receptor agonist. Id. at ¶¶2, 63. The Food and Drug Administration initially approved Belviq in 2012 as “an adjunct to reduced-calorie diet and increased physical activity for chronic weight management” in adult patients whose body mass index exceeds, or is equal to, 30kg/m2 or adult patients whose body mass index exceeds, or is equal to, 27kg/m2, with at least one weight-related comorbid condition. Id. at ¶48. Available by

prescription only, users may take a 10mg dose twice per day or take one 20mg extended-release dose daily. Id. at ¶63. Dr. Wei Kao, Mary’s primary-care physician, and his colleague, Dr. Gerard Squittiere, prescribed Belviq to Mary as an adjunct to reduced-calorie diet and increased physical activity for chronic weight management.

Id. at ¶¶2, 16. As a result of using Belviq, Mary was diagnosed with breast cancer in 2017. Id. at ¶17. Eisai, Inc.’s business involved designing, researching, manufacturing, testing, advertising, promoting, marketing, selling, or distributing Belviq for the primary purpose of chronic weight management. Id. at ¶¶22, 26, 46. Similarly, Arena

Pharmaceuticals, Inc.’s business involved designing, researching, manufacturing, testing, labeling, advertising, promoting, marketing, selling, or distributing Belviq for chronic weight management. Id. at ¶¶38, 46.

1 The facts are derived from the complaint, the factual allegations of which the Court must accept as true in ruling on the motions. Erickson v. Pardus, 551 U.S. 89, 94 (2007). Before receiving the FDA’s approval, Belviq underwent trials. First, during the preclinical trial program for Belviq, Eisai and Arena conducted a two-year carcinogenic study in rats. Id. at ¶64. This study identified lorcaserin as a non-

genotoxic carcinogen that induced multiple types of tumors. Id. This identification resulted primarily from an increase in mammary tumors in both sexes near clinical exposure and in female rates at all doses. Id. The study also revealed an increase in astrocytomas, malignant schwannomas, hepatocellular adenoma and carcinoma, skin

subcutis fibroma, skim squamous carcinoma, and breast follicular cell adenoma in male rates. Id. at ¶65. Second, Eisai and Arena conducted a two-year carcinogenicity study in mice during the preclinical trial program, which demonstrated an increase in malignant hepatocellular carcinoma in male mice and schwannoma in female mice. Id. at ¶68.

Third, between 2006 and 2009, Eisai and Arena conducted the Behavioral Modification and Lorcaserin for Overweight and Obesity Management Trial, known as the “BLOOM trial,” to examine the efficacy of lorcaserin in reducing body weight. Id. at ¶72. Fourth, Eisai and Arena conducted the Behavioral Modification and Lorcaserin Second Student for Obesity Management Trial, known as the “BLOSSOM

trial,” to study the effects of lorcaserin on body weight, cardiovascular risk, and safety. Id. at ¶73. Because data from the BLOOM trial and the BLOSSOM trial revealed only a 3.3% mean weight loss after one year with lorcaserin over that of the placebo groups, lorcaserin failed to meet the mean efficacy criterion of the FDA’s obesity draft guidance. Id. at ¶74. In December of 2009, Arena filed its new drug application for Belviq. Id. at ¶75. In September of 2010, the FDA’s Endocrinologic and Metabolic Drugs Advisory Committee, known as “EMDAC,” met to discuss approval of Belviq based upon the

results of the preclinical trials, the BLOOM trial, and the BLOSSOM trial. Id. at ¶76. Based upon concerns about the preclinical carcinogenicity findings and marginal weight loss, the EMDAC panel voted against approving Belviq because the potential benefits did not outweigh the potential risks. Id. The next month, the FDA rejected

approval of Belviq, citing “uncertainty in diagnosis of mammary masses in rats, unresolved issues with the exposure-response relationship between lorcaserin and mammary adenocarcinoma, failure to identify a mode of action and a clear safety margin for brain astrocytoma, and marginal weight loss.” Id. at ¶77. In response to the rejection, Eisai and Arena convened a pathology working

group to blindly readjudicate the preclinical mammary tumor data in rats. Id. at ¶78. As to this readjudication, while the number of adenocarcinoma decreased in the lorcaserin group compared to the control group, lorcaserin still increased the incidence, tumor onset and multiplicity, and the lethality of mammary adenocarcinoma, with the high-dose lorcaserin group maintaining a statistically

significant increase in adenocarcinomas compared to the control group. Id. at ¶83. From December 2007 to August 2010, Eisai and Arena conducted the Behavioral Modification and Lorcaserin for Obesity and Overweight Management in Diabetes Mellitus Trial, known as the “BLOOM-DM trial,” to examine the efficacy and safety of lorcaserin for weight loss in patients with Type 2 Diabetes Mellitus. Id. at ¶80. In December of 2011, in response to FDA’s rejection, Eisai and Arena submitted the final report of the BLOOM-DM trial, data from the pathology working group’s readjudication, and data from other studies. Id. at ¶81. In May of 2012, a

second EDMAC panel met to discuss approval of Belviq with a focus on the pathology working group’s readjudication of preclinical data to analyze the drug’s potential carcinogenicity risk, to determine a safety margin for astrocytoma, and to discuss the results of the BLOOM-DM trial to determine efficacy. Id. at ¶85. The panel voted that the benefits of Belviq outweighed the risks for an overweight and obese population. Id.

On June 26, 2012, FDA Deputy Division Director Dr. Eric Colman indicated in his summary review of the application that the pathology working group’s analysis addressed the concerns about the original application and that he did not believe that Belviq posed a risk for mammary adenocarcinoma in humans. Id. at ¶86. However, he

also noted that the FDA’s pharmacology/toxicology reviewer concluded that the prolactin studies, while supportive of a plausible role of prolactin in tumor formation, fell short of definitive proof that elevated prolactin levels caused the increased tumors during the two-year carcinogenicity rat study. Id. On June 27, 2012, the FDA approved Arena’s application to market and sell

Belviq. Id. at ¶48.

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