Asthma Medication as Doping Agent?

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Study by Ulm University Medical Center examines effect of asthma medication on athletic performance / Cooperation with Freie Universität Berlin and German Sport University Cologne

No 265/2019 from Sep 12, 2019

A new study conducted this year by the Sports and Rehabilitation Medicine Unit at Ulm University Medical Center is examining how asthma medications affect athletic performance in professional athletes. The World Anti-Doping Agency (WADA) has provided 315,000 dollars in funding for the study.

"Asthma inhaler use is common among competitive athletes, which suggests that there may be performance-enhancing side effects," says Dr. Jürgen Steinacker, a professor and head of the Sports and Rehabilitation Medicine Unit at Ulm University Medical Center. For example, asthma inhalers could affect the muscles, stimulating their growth. However, there are also specific groups of athletes, such as cross-country skiers and bicyclists, who increasingly suffer from asthma due to frequently inhaling cold or dusty air, which can provoke respiratory problems.

So far, certain asthma sprays have not been banned in competitive sports, but their use is restricted. The studies on the use of asthma inhalers in competitive sports to date do not show that there are side effects on the muscles, Steinacker says. WADA wants certainty on this question, so after an international call for proposals, it is financing the study in Ulm with 315,000 dollars in funding. The cooperation partners involved in the study are the well-known working groups headed by Dr. Maria Parr (Freie Universität Berlin, Institute of Pharmacy) and Dr. Patrick Diel (German Sport University Cologne, Institute of Cardiology and Sports Medicine), which have also logged great successes in anti-doping research.

The Design of the Planned Study

24 test subjects in all - 12 male athletes and 12 female athletes ranging in age from 18 to 45 years - will pedal a bike for ten minutes at maximum force once a week under observation at the Sports and Rehabilitation Medicine Unit to see whether there is any difference between asthma medication and a placebo. Two medications, formoterol and albuterol, will be used in various combinations, along with a placebo. Subjects will have their blood pressure, cardiac output, and blood oxygen saturation checked. A thigh muscle biopsy will also be taken after exertion. "We will be looking at the molecular signatures under acute exertion," explains Steinacker. Maximum exertion with and without the medication will show whether or not the medications have beneficial effects on muscle, he explains.

In 2018, the German Federal Institute for Drugs and Medical Devices (BfArM) concluded the review of content required pursuant to Sec. 42 of the German Medicinal Products Act (AMG) for the study and gave its approval. The board of Ulm University Medical Center signed a sponsoring declaration for the study in February 2019, thereby agreeing to be the intellectual sponsor and employer for this project. The ethics committee of the University of Ulm gave its approval on May 21, 2019.

The study will take two years, one year to run the experiments and one year for analysis and interpretation. The results may affect doping checks for these substances and help advance the understanding of side effects.


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