An Australian court upheld a landmark class-action lawsuit against Johnson & Johnson for "negligent" marketing of pelvic mesh implants on Friday, paving the way for thousands of women to receive compensation in a costly setback for the US pharma giant.

Johnson & Johnson had appealed the 2019 ruling that found the company guilty of "negligent" marketing and "deceptive conduct" while supplying thousands of pelvic meshes in Australia.

Victims said the mesh — designed to support weakened muscles holding up the pelvic organs — had caused disastrous side-effects including incontinence, infections and chronic pain.

"The risks were known, not insignificant, and on the respondents' own admission, could cause significant and serious harm," the judge said in the initial ruling.

A three-judge panel at the federal court dismissed the appeal on Friday, a decision that "confirmed that these women are entitled to be compensated for the losses and the life-altering complications that they have suffered as a result of these implants," said Rebecca Jancasukas, a lawyer for the claimants.

Shine Lawyers, which led the class action suit, said it would now vigorously pursue compensation claims possibly amounting to hundreds of millions of dollars.

The three women involved in the 2019 suit were awarded compensation ranging from Aus$556,000 to Aus$1.28 million (US$430,000-US$1 million).

The remaining members of the class action will now bring their own individual claims to court.

Responding to Friday's ruling, Johnson & Johnson said it "empathises with all women who experience medical complications" but would review the court decision and "consider its options".

Worldwide, more than two million women have had the mesh products implanted in their bodies and the Australian ruling is just one in a series globally.

Early last year, a judge in California ordered Johnson & Johnson to pay $344 million for false and deceptive marketing of pelvic mesh products used by tens of thousands of women in the state.

The company has settled similar claims with the state of Washington for $9.9 million and a coalition of 42 other states for $117 million.