AstraZeneca’s multibillion-dollar drug Seroquel (quetiapine) was in the spotlight again this week after internal documents showcased at a pre-trial examination of John Patterson, now-retired executive director of product development, suggested the company asked its salesforce to promote the drug as “weight neutral” despite evidence it caused “clinically significant” weight gain.

The focus of the pre-trial examination was a “dear colleague” letter written in 2001 by an AstraZeneca marketing official, according to a Bloomberg report which quoted the company as saying its “global strategy is to demonstrate to consumers that Seroquel has a weight-neutral profile”.

Patterson, the highest-ranking executive to testify in open court in these lawsuits, said: “If you look at the population as a whole, some are below weight, some are average weight and some are above weight, so taken together the effect of Seroquel is weight neutral”.

Yet if 45% of patients gained significant weight in a year, how could Seroquel be weight neutral?, plaintiff attorney Ed Blizzard was reported by Bloomberg as saying, citing internal emails dated four years previously, written by an AstraZeneca doctor.

Seroquel is the focus of more than 9,000 lawsuits in the USA claiming the company withheld information and failed to adequately warn of the risk of diabetes associated with the drug’s use. Some lawsuits also allege AstraZeneca promoted the drug for off-label indications. “The company has standards and procedures to ensure its sales representatives do not promote off-label,” Patterson said, but estimated that 30%-40% of Seroquel’s US sales come from non-approved uses. In 2008, Seroquel reeled in sales of $4.45 billion.