CARSON CITY, Nev. – The Nevada Supreme Court on Wednesday upheld a $58 million award to three women who claimed their breast cancer was caused by hormone replacement drugs made by Wyeth Pharmaceuticals.

In a unanimous ruling, justices rejected arguments by the company that the damages awarded in 2007 to Arlene Rowatt of Incline Village, Pamela Forrester of Yerington and Jeraldine Scofield of Fallon were excessive.

“The evidence supported the jury’s findings that Wyeth was negligent in failing to conduct appropriate studies on breast cancer and that it concealed material facts about its products’ safety,” Justice Michael Cherry wrote in the 47-page opinion.

Forrester and Rowatt have since died, making the ruling “bittersweet,” said Peter Wetherall, one of their attorneys.

“We hope they’re smiling down on this,” he said. “It took a lot of courage for them to stand up to the plate and sit in court for five weeks of this trial.”

The case is one of thousands pending against Wyeth involving Premarin, an estrogen replacement, and Prempro, a combination of estrogen and progestin. The drugs are prescribed to women to ease menopause symptoms.

New York-based Pfizer Inc. bought Wyeth for $68 billion in 2009.

Pfizer spokesman Chris Loder said the company was disappointed by the ruling.

“We believe that we had valid grounds for appeal, which the court recognized, despite upholding the judgment for plaintiffs,” Loder told The associated Press when reached by telephone. “We are now considering all of our legal options.”

Loder said hormone replacement remains “an important treatment option for many women with debilitating symptoms of menopause,” and noted that the several juries in other parts of the country have found in favor of the company.

In 2007, jurors in Reno initially awarded the women a combined $134.5 million. But after a bailiff overheard a discussion and jury confusion became apparent, Washoe District Judge Robert Perry ordered them to reconsider.

They slashed $100 million from the compensatory judgment, awarding a combined $35 million to the women for past and future medical expenses, pain and suffering. following a separate hearing, they imposed $99 million in punitive damages.

A judge later reduced the overall award to $58 million.

During a hearing before the Nevada Supreme Court in May, Lane Heard, a Washington, D.C., lawyer representing Madison, N.J.-based Wyeth, said the jury’s “premature” deliberation of punitive damages, and comments about Wyeth executives’ salaries made by the women’s attorneys, prejudiced jurors against the company.

But justices said the damages “are supported by substantial evidence.”

Wyeth knew in the mid-1970s that body organs such as breast tissue responded negatively to hormones, yet it failed to conduct or participate in any meaningful study of the estrogen-progestin drug combination until it gave its drug to the Women’s Health Initiative in 1992, the ruling said. that study was halted 10 years later when a significant number of women developed cancer.

The opinion also said that when published medical studies linked the drugs to increased breast cancer risk, “Wyeth sought to downplay the studies’ results and divert attention from the information.”

Punitive damages, the justices said, “are reasonable and proportionate to appellants’ actions, or lack thereof.”

The court also rejected Wyeth’s arguments that Rowatt’s and Scofield’s lawsuits should have been filed in the states where they lived when they began taking the hormone replacement drugs. The court agreed with the women’s attorneys that the “final event” — breast cancer — necessary to assert a claim against Wyeth didn’t exist until they were diagnosed in Nevada.

Justices agreed with Wyeth that the trial judge gave an improper jury instruction concerning theories of causation, but they determined the error was harmless.