UPDATED: A key Actos trial revs up in Vegas with demands for a $1B-plus judgment

Eyes are on Las Vegas today, where the latest trial over Actos' bladder-cancer risks is set to begin. With thousands of other Actos cases pending against Takeda, the case already was destined to be closely watched. And now, one of the plaintiff's lawyers says he's planning to seek the largest verdict in Nevada history.

As the Las Vegas Review-Journal reports, Delores Cipriano, 81, and Bertha Triana, 80, allege that Actos is responsible for their cancer. Cipriano was diagnosed in July 2012 after about 14 months of Actos use; Triana's diagnosis came in May of that same year after taking Actos for about two years. In 2011, the FDA announced that using the med for more than a year could be associated with an increased risk of the disease.

"Due to Takeda Pharmaceutical's conscious decision to keep this information from consumers and their doctors, we now have patients who are left to bear the permanent injury caused by Actos," Cipriano's lawyer, Robert Eglet, said in a statement seen by the newspaper. "That's why we will be asking for over a billion-dollar punitive damage verdict."

Takeda, however, maintains that Actos is a safe and effective treatment. "We have empathy for patients in this case, but we do not believe Actos was the cause of their condition," Sandy Rodriguez, Takeda Pharmaceuticals USA's senior director of corporate communications, told FiercePharma in an emailed statement. "The best science--including a 10-year study now in its final stages--shows no causal link between Actos and this disease."

Eglet's peers haven't been so successful in their own attempts. In two previous cases, judges canned much smaller judgments against Takeda. In the first bladder-cancer trial last April, a jury decided the Japanese pharma didn't do enough to warn the plaintiff about the drug's heightened risks and ordered the company to pay $6.5 million in damages. A judge threw out the case, saying lawyers didn't prove a link between the cancer and Actos use.

It was déjà vu a few months later, when in September a judge set aside a $1.7 million verdict for the family of deceased bladder-cancer victim and former Actos patient Diep An.

That hasn't deterred Eglet from seeking "a couple billion dollars." But as Florida doctor and lawyer Adam Levine told the Las Vegas paper, Takeda would unquestionably appeal any large verdict. "Even after you get a judgment, it's going to be a long time before you get dollar one," he said. Rodriguez said Takeda will continue to defend the company vigorously against future litigation.

Still, with more than 3,000 lawsuits still pending--hundreds of them consolidated in a federal trial taking place in Louisiana--the outcome here is still a critical one for the drugmaker. "It's an important case because there's many cases nationwide," Triana's attorney, Will Kemp, told the Review-Journal.

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Editor's note: This story has been updated with a statement from Takeda Pharmaceuticals USA.