A Missouri trial court judge has affirmed the massive $4.69 billion verdict against Johnson & Johnson in a case involving 22 women and their families who alleged the company’s talc-based products, including its baby powder, contain asbestos and caused them to develop ovarian cancer.

J&J in a statement on Wednesday said it would continue to pursue all available appellate remedies. The company, which denies the allegations and says its talc is safe, previously said it was confident the verdict would be overturned on appeal.

In a series of orders on Tuesday evening, Judge Rex Burlison of the Circuit Court of the City of St. Louis affirmed the jury’s July 12 decision in favor of the women, six of whom have died.

“The Court finds there is no just reason for delay and hereby certifies this judgment as final for purposes of appeal,” Burlison wrote in the judgments.

Defendants in civil cases can generally file so-called post-trial motions, asking the trial court judge to reduce a verdict or set it aside entirely, but J&J did not file such motions. It can now take up the cases with a Missouri appeals court.

The jury found the company’s talc-based products had caused the women’s cancer, awarding $550 million in compensatory damages and $4.14 billion in punitive damages to all plaintiffs.

Mark Lanier, a lawyer for the women, in a statement on Wednesday said he was confident the judgment would be upheld on appeal.

“We hope this judgment will compel Johnson & Johnson to take responsible, effective action in acknowledging the inherent dangers of the use of talc, and specifically the use of Johnson’s Baby Powder and similar products,” Lanier said.

The verdict was the largest to date arising from lawsuits alleging products like J&J’s Baby Powder cause cancer. The company faces some 10,600 cases nationwide over talc, according to an August regulatory filing.

J&J has called the five-week St. Louis trial “fundamentally unfair” and its Chief Executive Alex Gorsky has expressed confidence the jury decision will be overturned on appeal.

J&J has been successful at having other talc verdicts in Missouri thrown out on appeal. A lawyer for the company told Reuters J&J would focus on jurisdictional arguments and put forth its case that scientific studies overwhelmingly show talc itself is safe and the company’s talc-based products never contained asbestos.