Peroxisome Proliferator-Activated Receptor Delta Agonist (PPAR- δ) and Selective Androgen Receptor Modulator (SARM) Abuse

Peroxisome Proliferator-Activated Receptor Delta Agonist (PPAR- δ) and Selective Androgen Receptor Modulator (SARM) Abuse: Clinical, Analytical and Biological Data in a Case Involving a Poisonous Combination of GW1516 (Cardarine) and MK2866 (Ostarine) / Pascal Kintz, Laurie Gheddar, Camille Paradis, Mickael Chinellato, Alice Ameline, Jean-Sébastien Raul, Magali Oliva-Labadie. - (Toxics 9 (2021) 10 (7 October) 251)

  • PMID: 34678947
  • PMCID: PMC8538264
  • DOI: 10.3390/toxics9100251


A 43-year-old male, sport coach, presented him-self at the Emergency unit of a local hospital for epigastric pain, myalgia pain and severe headache. He claimed having used for some days a combination of GW1516 (cardarine), a peroxisome proliferator-activated receptor delta agonist (PPAR- δ) and MK2866 (ostarine), a selective androgen receptor modulator (SARM) to gain skeletal muscles. Cytolysis with marked increase of alanine aminotransferase or ALT (up to 922 UI/L) and aspartate aminotransferase or AST (up to 2558 UI/L) and massive rhabdomyolysis with elevated creatine phosphokinase or CPK (up to 86435 UI/L) were the main unusual biochemistry parameters. Using a specific liquid chromatography coupled to tandem mass spectrometry method, cardarine and ostarine tested positive in blood at 403 and 1 ng/mL, respectively. In urine, due to extensive metabolism, the parent GW1516 was not identified, while ostarine was at 88 ng/mL. Finally, both drugs were identified in hair (2 cm in length, brown in colour), at 146 and 1105 pg/mg for cardarine and ostarine, respectively. This clearly demonstrates repetitive abuse over the last 2 months. Asthenia was persistent for 2 weeks and 6 weeks after the admission, the subject fully recovered.

Original document


Case report
7 October 2021
Ameline, Alice
Chinellato, Mickael
Gheddar, Laurie
Kintz, Pascal
Oliva-Labadie, Magali
Paradis, Camile
Raul, Jean-Sébastien
Other organisations
Centre Hospitalier Intercommunal Marmande Tonneins
Groupe hospitalier Pellegrin
Institut de médecine légale de Strasbourg
Analytical aspects
Mass spectrometry analysis
Doping classes
S1. Anabolic Agents
S4. Hormone And Metabolic Modulators
Enobosarm (ostarine)
Peroxisome Proliferator Activated Receptor δ (PPARδ) agonists
Selective androgen receptor modulators (SARMs)
Medical terms
Health effects
Athlete support personnel
Document category
Scientific article
Document type
Pdf file
Date generated
3 November 2021
Date of last modification
12 November 2021
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