More than 50 Invokana lawsuits related to the controversial diabetes drug have been consolidated in a U.S. District Court of New Jersey.

On Dec. 7, 2016, the U.S. Judicial Panel on Multidistrict Litigation ordered the cases be joined into a multidistrict legislation (MDL). The transfer order also includes lawsuits regarding Invokamet, another version of the type II diabetes drug.

Invokana Side Effects

Manufactured by the Johnson & Johnson subsidiary, Janssen Pharmaceuticals, Invokana and Invokamet are used to treat type II diabetes. The medications, approved by the Food and Drug Administration (FDA) in 2013, contain the active ingredient canagliflozin.

The drugs are classified as sodium glucose cotransporter 2 (SGLT2) inhibitors, which maintain glucose levels by depositing excess blood sugar through the urine. Because SGLT2 inhibitors work closely with the kidneys, it could lead to a condition known as ketoacidosis.

Ketoacidosis is caused by excess amounts of acid in the bloodstream. These toxins cause a number of serious symptoms, including abdominal pain, frequent urination, mental confusion, and shortness of breath. Left untreated, ketoacidosis may result in a medical emergency. 

From March 2013 to May 2015, the FDA tracked 73 cases of SGLT2 inhibitor ketoacidosis, stating “there are likely additional cases about which we are unaware.” Other complications linked to Invokana include acute kidney damage, bone fractures, heart attacks, strokes, infections, and amputations.

In 2015, the FDA issued a warning about ketoacidosis and kidney dangers linked to canagliflozin. One year later, the FDA released another warning about acute kidney injury. Legal teams assert the manufacturers of Invokana and Invokamet knew about the dangers linked to canagliflozin but chose not to inform patients about the associated risks.

According to the transfer order, “The actions thus implicate numerous common issues concerning the development, manufacture, testing, regulatory history, promotion, and labeling of the drugs”.

New Jersey Multidistrict Litigation

Judge Brian R. Martinotti will preside over Invokana and Invokamet lawsuits. For more than a decade, Judge Martinotti worked in the Superior Court of New Jersey on multidistrict litigations to expedite mass tort cases. The lawsuits were previously filed in various states, including Illinois, Kentucky, Missouri, Minnesota, Virginia and West Virginia.

An MDL combines multiple suits from different states under one court. The court in New Jersey is also handling lawsuits filed against Johnson & Johnson’s Baby Powder, whose talcum component has been linked to ovarian cancer. Johnson & Johnson is headquartered in New Jersey.

An MDL is often used to keep rulings consistent in a case with multiple plaintiffs. In addition, an MDL is meant to save time and resources. A major way an MDL accomplishes quicker resolutions is by collecting evidence in pretrial proceedings.

The transfer order also states, “Centralization will eliminate duplicative discovery, prevent inconsistent pretrial rulings on Daubert issues and other pretrial matters, and conserve the resources of the parties, their counsel, and the judiciary".

Though there have been complications from SGLT2 inhibitors Farxiga and Jardiance, the diabetes medications will not be included in the MDL because they are not manufactured by the same pharmaceutical company.

The MDL is intended to make Invokana and Invokamet lawsuits more efficient in the hopes of getting quicker resolutions. On Jan. 12, the parties held a conference to discuss the first case management order, focusing on discovery of evidence and future scheduling. The second case management conference takes place on Feb. 23, 2017.