WADA ...

Discussion in 'Steroid Forum' started by Michael Scally MD, May 1, 2011.

  1. SaneDog

    SaneDog Member

    Damn, you post a lot of really good threads on here. I'm definitely keeping my eyes out man, cheers.
  2. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    [OA] An Overview of Performance Enhancing Drugs (PED’s) in Sports and WADA

    The use of certain banned and illegal substances either to improve one’s cognitive skills or to enhance their performance by athletes has become widely prevalent.

    These substances are commonly referred as performance enhancing drugs or PED’s and are used without any therapeutic intent. They belong to a wide variety of classes, some of which include the anabolic steroids, hormonal agents, diuretics and the CNS stimulants.

    The WADA (World Anti-Doping Agency), a collaborated network between the sports authorities and the global governments was established to fight against doping so as to have a fair competition among the athletes.

    Although, the regulatory bodies have put forth stringent legislations that can prevent their misuse and safeguards the athletes against the adverse effects of such drugs, it has become rather difficult to keep doping under check as the recent developments have resulted in the emergence of so called designer drugs that are difficult to detect with the available analytical techniques.

    Subsequently, WADA came up with the concept of ABP (Athlete Biological Passport) which helped resolve some of these issues. This review tries to look into PED’s, the way they act, their ill-effects and also in brief about the designer drugs. It also highlights the role of WADA, ABP and the prohibited list of substances and methods for the year 2019.

    Sowjanya K, Girish C. An Overview of Performance Enhancing Drugs (PED’s) in Sports and WADA. Journal of Young Pharmacists. 2019;11(4):344-9. An Overview of Performance Enhancing Drugs (PED’s) in Sports and WADA | Journal of Young Pharmacists
  3. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Gene Doping: Present and Future

    Being an elite athlete is an extremely coveted position, which can lead an individual to use doping. As knowledge is extended, doping techniques have become increasingly sophisticated, and the newest method of doping is gene doping.

    This article aims to present an updated bibliographic survey that addresses gene doping between 1983 and 2018. Anti-doping agencies have not yet approved any detection technique for this type of doping.

    The possibility of eradicating such doping is almost zero mainly because gene therapy advances rapidly. In this scenario, the future of gene doping must be discussed and decided before irreversible limits are exceeded.

    Cantelmo RA, Da Silva AP, Mendes-Junior CT, Dorta DJ. Gene doping: Present and future [published online ahead of print, 2019 Dec 1]. Eur J Sport Sci. 2019;1–9. https://www.tandfonline.com/doi/abs/10.1080/17461391.2019.1695952?journalCode=tejs20

    Attached Files:

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  4. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Performance Profiling As An Intelligence-Led Approach To Anti-Doping In Sports

    The current prevalence of doping in elite sport is unknown. Existing data from the World Anti-Doping Agency (WADA) suggests that the number of adverse analytical findings (AAF) was 1.43% in 2017 (4,596 AAFs from 322,050 samples1). Moreover, data from the recently formed Athletic Integrity Unit (AIU) place the number of antidoping rule violations (ADRV) at 65 ADRVs from 8,489 samples (<1%)2. However, these figures appear at odds to research studies using anonymous athlete selfreports that put the estimate much higher at between 14.0% and 57.1%,3 with between 3.1% and 26.0% of dopers reporting a lifetime prevalence.4

    Therefore, there is clear discrepancy between the number of anti-doping rule violations (ADRV) and the estimated prevalence of doping. This is despite increases in both the financial resources being allocated to the fight against doping in sports, and number of samples analysed (7.1% increase in the overall number of samples analysed: 300,565 in 2016 to 322,050 in 20175).

    Consequently, questions can be raised about the efficiency of current anti-doping policy and testing strategies, and whether other types of data are required. In turn, this targeted approach to anti-doping would enhance the ability of anti-doping authorities to make more informed decisions on assigning athletes to registered testing pools, and target-testing individuals, and ultimately allow a more efficient distribution of anti-doping testing resources.

    One key piece of information available to anti-doping authorities is the performance of the athlete, which is currently seldom used in deciding testing strategy. As the primary reason for doping is improvement of athletic performance, it is reasonable to suggest that monitoring an individual's competition results on a longitudinal basis may reveal suspicious performance improvements. …

    The aim of this case report is to demonstrate the potential for mathematical modelling of individual career trajectories (i.e. the relationship between age and performance) to identify characteristics of performance evolution, which are able to distinguish athletes who have previously been convicted of doping, from others who are presumed clean.

    In this work, we acknowledge that monitoring athlete performance and identifying changes obviously does not prove doping, however extreme changes that are in excess of what is predicted based upon the population changes, may be sufficient to raise the level of suspicion of an athlete. …

    Hopker J, Griffin J, Brookhouse J, Peters J, Schumacher YO, Iljukov S. Performance profiling as an intelligence-led approach to anti-doping in sports. Drug testing and analysis 2019. Error - Cookies Turned Off
  5. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    [OA] Performance-Enhancing Medicines in Sports: Legal Discussion

    Morally speaking, employing Performance-Enhancing Medicines (PEMs) in sports is not acceptable because using these medicines in sports competitions is associated with negative legal consequences.

    However, due to rapid advances in the genetic modification technologies, there is a fear that these therapeutic technologies have been applied to athletes (e.g., to prevent Myostatin from incapacitating skeletal muscle groups).

    Additionally, taking and giving performance-enhancing medicines are not only unethical, but such activities could even be illegal because of the dangerous side effects of drugs associated with it.

    The main issue that this paper is going to discuss in the absence of criminal provisions addressing the actions of doping generally and gene doping in many existing legal systems around the world. Another issue that this paper deals with is the lack of laboratory screening methods that can discover the occurrence of gene modifications.

    In this regard, this study attempts to examine the legal theory of the development of disciplinary and criminal systems setting athletes’ responsibility which definitely arise as a result of utilizing PEMs and employing gene doping technologies in sports competitions. The study uses the analytic method to find out the exact terminologies of these substances which affect athletes and their rights to life - bodily integrity.

    Al-Dafrawi ASA, Abdullah MA, Zawawi M, Ismail Z. Performance-Enhancing Medicines in Sports: Legal Discussion. International Journal of Law, Government and Communication. 2019;4(17),48-60. http://www.ijlgc.com/PDF/IJLGC-2019-17-12-07.pdf
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  6. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Hypothalamic-Pituitary-Testicular Axis Effects and Urinary Detection Following clomiphene Administration

    Context: Clomiphene is a performance-enhancing drug commonly abused by males in sport, but the extent to which testosterone increases in healthy males following its use is unknown. In addition, evidence suggests that clomiphene, a mixture of cis- and trans-isomers zuclomiphene and enclomiphene, is detectable in urine for months following use; the isomer-specific urinary detection window has yet to be characterized in a controlled study.

    Objective: To determine the effect of once-daily, 30-day clomiphene treatment on serum testosterone and gonadotropin levels in the subject population studied and the urinary clearance and detection window of clomiphene isomers following administration for antidoping purposes.

    Participants and design: Twelve healthy males aged 25 to 38 years, representing a recreational athlete population, participated in this open-label, single-arm study.

    Intervention: Oral clomiphene citrate (50 mg) was self-administered once daily for 30 days. Serum and urine samples were collected at baseline and at days 7, 14, 21, 28, 30, 32, 35, 37, 44, 51, and 58; urine collections continued periodically up to day 261.

    Results: Mean testosterone, LH, and FSH levels increased 146% (SEM, ±23%), 177% (±34%), and 170% (±33%), respectively, during treatment compared with baseline. Serum drug concentrations and urinary excretion were nonuniform among individuals as isomeric concentrations varied. The zuclomiphene urinary detection window ranged from 121 to >261 days.

    Conclusions: Clomiphene significantly raised serum testosterone and gonadotropin levels in healthy men and thus can be abused as a performance-enhancing drug. Such abuse is detectable in urine for ≥4 months following short-term use.

    Miller GD, Moore C, Nair V, et al. Hypothalamic-Pituitary-Testicular Axis Effects and Urinary Detection Following Clomiphene Administration in Males. J Clin Endocrinol Metab. 2019;104(3):906–914. https://academic.oup.com/jcem/article-abstract/104/3/906/5115462?redirectedFrom=fulltext
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  7. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Tainted Toothpaste - Analytical Investigation Into An Unusual Adverse Finding

    In 1999, a German track and field athlete was tested positive twice following two out-of competition controls, on the 19th October 1999 analyzed by the IOC accredited doping control laboratory in Kreischa by Dresden, and on the 12th November 1999 analyzed by the IOC accredited doping control laboratory in Cologne (both Germany). In both cases, the laboratory reported an adverse analytical finding (AAF) for 19-norandrosterone. 19-Norandrosterone is the main metabolite of the banned anabolic androgenic steroids nandrolone and its prohormones norandrostenedione or norandrostenediol.

    Second investigation of products of the daily life of the athlete and identification of a contaminated toothpaste Based on the results of the first investigation, the DLV agreed that further products at the athlete’s home should be tested to probe for the presence of a source of the anabolic steroid leading to positive urine samples with 19-norandrosterone. The second investigation selected 74 products (food, skin cream, shower gel, tooth paste, etc.) for follow-up analyses. Results: On the 1st of December 1999, a toothpaste named Elmex sensitive was found to contain norandrostenedione, a prohormone of nandrolone. Overall, the amount of norandrostenedione contained in the complete toothpaste accounted for approximately 100mg of the steroid.

    Wrner Franke of the most respected anti-doping experts, stated 2006 in an interview with Der Spiegel: “I'm sure it was an attack [professionally altered/contaminated/sabotage]. Baumann was very committed to the fight against doping. His toothpaste tubes were contaminated, proven to be an old Stasi method”

    Schänzer W, Geyer H, Thevis M. Tainted toothpaste - analytical investigation into an unusual adverse finding [published online ahead of print, 2020 Jan 7]. Drug Test Anal. 2020;10.1002/dta.2761. Error - Cookies Turned Off
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  8. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Studies of Athlete Biological Passport Biomarkers and Clinical Parameters in Male and Female Users of Anabolic Androgenic Steroids and Other Doping Agents

    The use of anabolic androgenic steroids and other performance enhancing substances can change over time, so there is a need to constantly update what substances that are used and can be detected.

    We recruited 36 anabolic androgenic steroid users (women n=6, men n=30) who filled out an anonymous questionnaire about their use of performance enhancing substances during the past year.

    Sampling took place on a single occasion and included blood and urine collection. Our aim was to identify what doping agents that can be detected in men and women self‐reporting AAS‐use.

    The first choice of substances differed between men (testosterone) and women (oxandrolone). Use of growth hormones was reported among men (10 %) and women (50 %). Growth hormone releasing factors/secretagogues were reported by about ~ 20 % in both genders.

    Nandrolone was the most frequently detected anabolic androgenic steroid even in those who did not report use in the past year.

    Of the current male testosterone users, 82 % exhibited T/E ratios > 4. Men with current testosterone use displayed 4‐fold and 6‐fold higher median T/E, respectively, when compared with recent and previous testosterone users, (p= 0.0001).

    Dermal testosterone use in women (n=2) was not associated with T/E >4, but with supra‐physiological total serum testosterone concentrations.

    Changes in gonadotropins and hematological parameters were associated with time of last anabolic androgenic steroid intake in men, whereas in women these biomarkers were within the normal range.

    This highlights gender specific differences and indicates a need for additional biomarkers in female athletes.

    Börjesson A, Lehtihet M, Andersson A, et al. Studies of Athlete Biological Passport biomarkers and clinical parameters in male and female users of anabolic androgenic steroids and other doping agents [published online ahead of print, 2020 Jan 10]. Drug Test Anal. 2020;10.1002/dta.2763. Error - Cookies Turned Off
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  9. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    [OA] Steroidal Module of The Athlete Biological Passport

    Since 2014, testosterone doping can be targeted by the Steroidal Module of the Athlete Biological Passport. The steroidal module consists of the longitudinal monitoring of five ratios between urinary concentrations of endogenous anabolic androgenic steroids, measured by gas chromatography coupled to mass spectrometry (GC-MS).

    Although this longitudinal approach improved T doping detection capabilities in comparison with the former testosterone/epitestosterone threshold value of 4, it is still subjected to various drawbacks, mainly related to the nature of urinary matrix and the analytical technique employed for the analyses.

    For these reasons, several research projects are carried out in this context within the recent years to better understand the alterations of the steroidal module and to provide additional markers and novel approaches to improve antidoping performances.

    Ponzetto F, Baume N, Schweizer C, Saugy M, Kuuranne T. Steroidal module of the Athlete Biological Passport. Current Opinion in Endocrine and Metabolic Research 2019;9:14-21. Steroidal module of the Athlete Biological Passport - ScienceDirect
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  10. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Thevis M, Kuuranne T, Geyer H. Annual banned-substance review – Analytical approaches in human sports drug testing. Drug Testing and Analysis 2019. https://doi.org/10.1002/dta.2735

    Within the complex construct of today's antidoping work, continuously updated routine doping controls, as well as advancements in sampling and analysis have been of particular relevance and importance. New analytes of existing classes of prohibited substances are frequently included into sports drug testing assays, analytical approaches are optimized to allow for better sensitivities, selectivity, and/or faster turnaround times, and research dedicated to addressing analytical issues concerning scenarios of both (potentially) inadvertent doping and new emerging doping agents is constantly conducted. By way of reviewing and summarizing, this annual banned‐substance review evaluates the literature published between October 2018 and September 2019 offering an in‐depth evaluation of developments in these arenas and their potential application to substances reported in WADA's 2019 Prohibited List.
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  11. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Performance Profiling as An Intelligence-Led Approach to Antidoping In Sports

    The efficient use of testing resources is crucial in the fight against doping in sports. The athlete biological passport relies on the need to identify the right athletes to test, and the right time to test them. Here we present an approach to longitudinal tracking of athlete performance to provide an additional, more intelligence‐led approach to improve targeted antidoping testing.

    The performance results of athletes (male shot putters, male 100 m sprinters, and female 800 m runners) were obtained from a performance results database. Standardized performances, which adjust for average career performance, were calculated to determine the volatility in performance over an athlete's career.

    We then used a Bayesian spline model to statistically analyse changes within an athlete's standardized performance over the course of a career both for athletes who were presumed “clean” (not doped), and those previously convicted of doping offences. We used the model to investigate changes in the slope of each athlete's career performance trajectory and whether these changes can be linked to doping status.

    The model was able to identify differences in the standardized performance of clean and doped athletes, with the sign of the change able to provide some discrimination. Consistent patterns of standardized performance profile are seen across shot put, 100 m and 800 m for both the clean and doped athletes we investigated.

    This study demonstrates the potential for modeling athlete performance data to distinguish between the career trajectories of clean and doped athletes, and to enable the risk stratification of athletes on their risk of doping.

    Hopker J, Griffin J, Brookhouse J, Peters J, Schumacher YO, Iljukov S. Performance profiling as an intelligence-led approach to antidoping in sports. Drug Testing and Analysis 2019;n/a. https://doi.org/10.1002/dta.2748
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  12. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Saugy M, Leuenberger N. Anti-doping: from health tests to the athlete biological passport. Drug Testing and Analysis 2020. https://doi.org/10.1002/dta.2773

    Athlete biological passport (ABP) was implemented in International Cycling Union (UCI) in 2008. However, this improvement in the fight against doping was preceded with different milestones since 1996.

    In this paper, a detailed evolution of the ABP out of traditional direct (urine) testing for anti‐doping purposes is presented. Chronological overview of the ABP including earlier non‐disclosed information and contemporary documentation are shown and documented. The strategic development from on‐site competition blood testing, called “health tests”, to the structure of the ABP is explained in this historical overview which provide information to the anti‐doping community and general public regarding the beginning of blood doping tests.
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  13. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Hair testing for doping agents. What is known and what remains to do.

    · Hair testing is a complementary approach to document doping agent(s) use
    · All prohibited substances but hormones should be detectable in hair
    · Interest and limitations of hair testing for doping agents are reviewed based on the authors' experience
    · Although a lot of data are available for drugs of abuse, controlled studies are missing for anabolic steroids, diuretics and some unusual classes of substances

    Kintz P, Gheddar L, Ameline A, Arbouche N, Raul J-S. Hair testing for doping agents. What is known and what remains to do. Drug Testing and Analysis 2020;n/a. Error - Cookies Turned Off

    Attached Files:

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  14. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    [OA] Therapeutic Use Exemptions (Tues) Are Essential in Sport: But There Is Room for Improvement.

    What is the issue?

    Hacking of the World Anti-Doping Agency’s (WADA’s) Anti-Doping Administrative & Management System (ADAMS) by an alleged Russian cyber espionage group ‘Fancy Bear’ disclosed incomplete information about Therapeutic Use Exemptions (TUEs) granted to more than 100 Olympic athletes from over 20 countries1 including some high-profile athletes.

    These unethical and illegal leaks of personal medical information provoked some criticism of the TUE system, much of it is ill-informed.2 3 In this discussion, I briefly review the concept of TUEs and advise how the TUE system can and should be strengthened.

    Is there a problem? Yes and no

    The TUE concept is both sound and essential, and the four criteria that must be met to approve a TUE have changed only marginally in 25 years.

    Fitch K. Therapeutic Use Exemptions (TUEs) are essential in sport: but there is room for improvement. Br J Sports Med. 2020;54(3):191–192. Therapeutic Use Exemptions (TUEs) are essential in sport: but there is room for improvement
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  15. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    As a part of Global Athlete’s listening exercise, a survey was launched in September 2019. The survey resulted in 491 Athletes from 48 countries representing all continents from 40 summer and 16 winter sports providing feedback on national and international anti-doping programs. Of the athletes surveyed 44% were actively competing with sport as their primary profession, 31% competing but not as a primary profession and 25% of the athletes were retired, 31% were Olympic Athletes, 8% Paralympic, 46% International level, 15% competed nationally.

    Key outcomes of the survey included:

    • Athletes believe that National Anti-Doping Organizations are more independent than the World Anti-Doping Agency.
    • The majority of athletes feel that the World Anti-Doping Agency does not work transparently.
    • The majority of athletes feel that their National Anti-Doping Organization works transparently.
    • The majority of athletes feel that the World Anti-Doping Agency requires further governance reforms with athletes, and National Anti-Doping Organizations having an equal seat at the decision-making tables.
    • Athlete strongly believe that the WADA Charter of Athlete Rights should be fully embedded into the World Anti-Doping Code.
    • Athletes have more trust in anti-doping programs nationally than internationally.
    • The majority of athletes have trust in the efficiency of their National Anti-Doping Agency.
    • There is a need for more athlete representation within National Anti-Doping Organizations.

    Global Athlete would like to thank the athletes, researchers, FairSport and Play the Game for their contribution to the survey. Download the report here. https://static1.squarespace.com/sta...Global+Athlete+Survey+Results+Anti-Doping.pdf
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  16. master.on

    master.on Member

    Yeah right
    Now blame the WADA
    They had nothing to do with you prescribing steroids for no medical reason.
  17. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Sport-Specific Use of Doping Substances

    Background: In recent years, there has been a solid effort across all sports organizations to reduce the prevalence and incidence of doping in sport. However, the efficacy of current strategies to fight against doping might be improved by using anti-doping polices tailored to the features of doping in each sport.

    Objectives: The aim of this investigation was to analyze the substances more commonly found in doping control tests in individual and team sports. Material and Methods: The publicly accessible Testing Figures Reports made available by the World Anti-Doping Agency, were analyzed from 2014 to 2017.

    Results: The most commonly detected groups of banned substances were anabolic agents and stimulants but the distribution of adverse findings per drug class was very different depending on the sports discipline.

    Weightlifting, athletics, rugby, hockey and volleyball presented abnormally high proportions of anabolic agents (p = 2.8 × 10-11). Cycling, athletics and rugby presented atypically elevated proportions of peptide hormones and growth factors (p = 1.4 × 10-1). Diuretics and masking agents were more commonly found in boxing, wrestling, taekwondo, judo, shooting, and gymnastics than in other sports (p = 4.0 × 10-68). Cycling, rowing, aquatics, tennis, gymnastics and ice hockey presented abnormally high proportions of stimulants (p = 1.8 × 10-5).

    Conclusions: These results indicate that the groups of banned substances more commonly detected in anti-doping control tests were different depending on the sports discipline. These data suggest the prohibited substances used as doping agents might be substantially different depending on the type of sport and thus, sports-specific anti-doping policies should be implemented to enhance the efficacy of anti-doping testing.

    Aguilar-Navarro M, Salinero JJ, Muñoz-Guerra J, Plata MDM, Del Coso J. Sport-Specific Use of Doping Substances: Analysis of World Anti-Doping Agency Doping Control Tests between 2014 and 2017 [published online ahead of print, 2020 Mar 18]. Subst Use Misuse. 2020;1–9. doi:10.1080/10826084.2020.1741640 https://www.tandfonline.com/doi/abs/10.1080/10826084.2020.1741640?journalCode=isum20
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  18. ResearcherEssex

    ResearcherEssex Junior Member


    At the University of Essex (UK), we are conducting a World Anti-Doping Agency funded research project examining the experience and role of athlete support personnel in the pursuit of clean sport and doping prevention. This project has been approved by the Science and Health Ethics sub-committee at the University of Essex (Ethics ID: ETH1920-1217).

    As it stands there is limited research examining the experiences of athletes who have used prohibited forms of performance enhancement or of those in support roles around such athletes. Therefore, we would like to invite athletes, parents, and coaches of athletes to participate in an anonymous survey and instant messenger based interview, where they will be asked their views on doping and their reasons for taking or supporting the use of prohibited forms of performance-enhancing substances. We hope that our research project will shed light on why athletes may choose to dope and the opinions of their support network; subsequently informing the way the World Anti-doping Agency develops anti-doping education programmes.

    I would now like to invite you to assist us in conducting this research project. We need to recruit both athletes and the parents or coaches of athletes who have used prohibited performance-enhancing substances. As the whole process is completed anonymously, we would like to ask if you could pass on the following link to our study information to any individuals you think may meet the criteria or would be helpful to such a research project please DM me for the link to our anonymous survey.

    If you would like any more information please do not hesitate to contact me and I will be more than happy to answer any questions you may have.

    All the best and stay safe during these unprecedented times!
  19. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Prevalence of Therapeutic Use Exemptions at The Olympic Games and Association with Medals

    Objectives: The percentage of athletes with Therapeutic Use Exemptions (TUEs) competing in elite sport and the association with winning medals has been a matter of speculation in the absence of validated competitor numbers. We used International Olympic Committee (IOC) and World Anti-Doping Agency (WADA) data to identify athletes competing with TUEs at five Olympic Games (Games) and a possible association between having a TUE and winning an Olympic medal.

    Methods: We used the IOC's competition results and WADA's TUE database to identify the number of TUEs for athlete competitions (ACs, defined as one athlete competing in one event) and any associations with medals among athletes competing in individual competitions. We calculated risk ratios (RR) for the probability of winning a medal among athletes with a TUE compared with that of athletes without a TUE. We also reported adjusted RR (RRadj) controlling for country resources, which is a potential confounder.

    Results: During the Games from 2010 to 2018, there were 20 139 ACs and 2062 medals awarded. Athletes competed with a TUE in 0.9% (181/20 139) of ACs. There were 21/2062 medals won by athletes with a TUE. The RR for winning a medal with a TUE was 1.13 (95% CI: 0.73 to 1.65; p=0.54), and the RRadj was 1.07 (95% CI: 0.69 to 1.56; p=0.73).

    Conclusion: The number of athletes competing with valid TUEs at Games is <1%. Our results suggested that there is no meaningful association between being granted a TUE and the likelihood of winning a medal.

    Vernec A, Healy D. Prevalence of therapeutic use exemptions at the Olympic Games and association with medals: an analysis of data from 2010 to 2018 [published online ahead of print, 2020 May 6]. Br J Sports Med. 2020;bjsports-2020-102028. doi:10.1136/bjsports-2020-102028 Prevalence of therapeutic use exemptions at the Olympic Games and association with medals: an analysis of data from 2010 to 2018
  20. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Influence of Pain Killers on the Urinary Anabolic Steroid Profile

    Anabolic androgenic steroids (AAS) are prohibited as performance enhancing drugs in sports. Among them, testosterone and its precursors are often referred to as "pseudo-endogenous" AAS, that is, endogenous steroids that are prohibited when administered exogenously. To detect their misuse, among other methods, the World Antidoping Agency (WADA) accredited laboratories monitor the steroid profile (concentrations and concentration ratios of endogenous steroids, precursors and metabolites) in urine samples collected from athletes in and out of competition.

    Alterations in steroid profile markers are used as indicators for misuse of anabolic steroids in sports. Therefore, especially their metabolic pathways with possible interactions are crucial to elucidate. As steroid metabolism is very complex, and many enzymes are involved, certain non-prohibited drugs may influence steroid metabolite excretion. One important group of steroid metabolizing enzymes are aldo-keto-reductases (AKRs).

    An inhibition of them by non-steroidal anti-inflammatory drugs (NSAIDs), which are neither prohibited nor monitored, but frequently used drugs in sports, was demonstrated in vitro. Thus, this work aims to investigate the influence of NSAID intake on the urinary steroid profile. Kinetic and inhibitory studies were performed using 5α-dihydrotestosterone (5αDHT) as substrate. The results obtained from in vitro experiments show that ibuprofen inhibits AKR1C2 and thus influences steroid biotransformation.

    For in vivo investigations, urine samples prior, during and post administration of ibuprofen were analysed using routine methods to monitor the steroid profile. Changes in markers of the steroid profile of volunteers were observed. The combination of in vitro and in vivo results suggests that monitoring of ibuprofen may be useful in doping control analysis.

    The presented work illustrates the importance to consider co-administration of (non-prohibited) drugs during anti-doping analysis. Intake of multiple substances is likely leading to interfering effects. Divergent results in anti-doping analysis may therefore be observed and misinterpretation of analytical data may occur. Similar considerations may be appropriate for other fields of forensic applications.

    Stoll A, Iannone M, De Gregorio G, de la Torre X, Botre F, Parr M. Influence of Pain Killers on the Urinary Anabolic Steroid Profile [published online ahead of print, 2020 May 9]. J Anal Toxicol. 2020;bkaa049. doi:10.1093/jat/bkaa049 Influence of Pain Killers on the Urinary Anabolic Steroid Profile