A doctor for one of the three women suing pharmaceutical giant Wyeth said a report issued a decade after he began prescribing the hormone-replacement drugs changed his mind about how he would recommend they be used. 

Dr. Ronald Avery, the obstetrician/gynecologist who prescribed hormone replacement therapy drugs in 1994 for Pamela Forrester of Yerington, said the 2002 report from the Women's Health Initiative Study showed "some of the risks we thought were issues had now become risks."

"It changed the benefit-risk ratio," Avery said of the study by the National Institutes of Health. The risk of breast cancer became significant compared with the benefits of countering the symptoms of menopause, he said.

"If you knew in 1994 what you know now, would it change the way you would advise a patient?" asked Zoe Littlepage, a lawyer for Forrester, Jeraldine Scofield of Fallon and Arlene Rowatt of Incline Village.

"It doesn't mean you wouldn't give hormone replacement drugs," he said. "But you'd use a lower dosage and use a shorter time frame."

When asked by Wyeth lawyer Cathy Cochran whether reports from journals and studies continually helped doctors learn more about drugs, Avery agreed.

"Medicine is always changing," Avery responded. "That's why they call it the practice of medicine."

Forrester, 64; Scofield, 75; and Rowatt, 67, sued Wyeth in Washoe District Court claiming the company produced dangerous drugs that caused their breast cancers.

The lawsuit also claims Wyeth failed to test the hormone replacement drugs Premarine, an estrogen drug, or Prempro, a combination estrogen and progestin pill, and failed to adequately warn of their risks.

Avery said that the Women's Health Initiative study, was "the gold standard." It was the first large-scale study of the use of hormone-replacement therapy drugs, used to help women through menopause and thought to help offset osteoporosis, decrease "cardiovascular events" and help with tooth loss and eyesight, he said.

But after almost a decade of research, the 2002 report said Prempro resulted in a 41 percent increase in strokes, a 29 percent increase in heart attacks and a 26 percent increased risk in breast cancer.

The trial is expected to run five more weeks.