Can conditions of skeletal muscle loss be improved by combining exercise with anabolic-androgenic steroids? A systematic review and meta-analysis of testosterone-based interventions / Hugo Falqueto, Jorge L.R. Júnior, Mauro N.O. Silvério, Juliano C.H. Farias, Brad J. Schoenfeld, Leandro H. Manfredi. - (Reviews in endocrine & metabolic disorders (2020) 30 March)

• PMID: 33783694
• DOI: 10.1007/s11154-021-09634-4

Abstract

Sarcopenia, cachexia, and atrophy due to inactivity and disease states are characterized by a loss of skeletal muscle mass, often accompanied by reduced levels of anabolic hormones (e.g. testosterone). These conditions are associated with an increase in mortality, hospitalization and worsening in quality of life. Both physical exercise (EX) and anabolic-androgenic steroid (AAS) administration can improve the prognosis of patients as they increase physical functionality. However, there is a gap in the literature as to the impact of these therapies on the gains in strength and muscle mass and their implications for patient safety. Accordingly, we performed a random-effects meta-analysis to elucidate the effects of AAS and/or EX interventions on lean body mass (LBM) and muscle strength in conditions involving muscle loss. A systematic search for relevant clinical trials was conducted in MEDLINE, EMBASE, SCOPUS, Web of Science, and SPORTDiscus. Comparisons included AAS vs. Control, EX vs. Control, AAS vs. EX, AAS + EX vs. AAS and AAS + EX vs. EX. A total of 1114 individuals were analyzed. AAS increased LBM (effect size [ES]: 0.46; 95% CI: 0.25, 0.68, P = 0.00) and muscle strength (ES: 0.31; 95% CI: 0.08, 0.53, P = 0.01) when compared to a control group. EX promoted an increase in muscular strength (ES: 0.89; 95% CI: 0.53, 1.25, P = 0.00), with no effect on LBM when compared to the control group (ES: 0.15; 95% CI: -0.07, 0.38, P = 0.17). AAS did not demonstrate statistically significant differences when compared to EX for LBM and muscle strength. The combination of EX + AAS promoted a greater increase in LBM and muscular strength when compared to AAS or EX in isolation. Qualitatively, AAS administration had relatively few side effects. Significant heterogeneity was found in some analyses, which may be explained by the use of different AAS types and EX protocols. Our findings suggest that AAS administration in cachectic and sarcopenic conditions may be a viable interventional strategy to enhance muscle function when exercise is not a possible approach. Moreover, combining AAS with exercise may enhance positive outcomes in this population.

Complete Overview of Prohibited Substances and Prohibited Methods from the IOC Lists (1968-2003) & WADA Prohibited Lists (2004- ) / ed. M.C. Tuk, Olivier de Hon. - Doping Authority Netherlands (Dopingautoriteit); Anti-Doping Knowledge Center (ADKC), 2021

Jaresbericht 2020 / Natonale Anti-Doping Agentur Austria (NADA Austria). - Wien : NADA Austria, 2021

Contents:

NADA Austria

• Leitbild, Vision, Mission, Werte, Ziele, Qualitätsmanagement
• Kommissionen
• Mitarbeiterinnen und Mitarbeiter
• Nationale und internationale Kooperationen

DopingkontrollSystem

• Dopingkontrollprogramm 2020
• Dopingkontrollstatistik 2020

Medizin

• Medikamentenabfrage - MedApp
• Medizinische Ausnahmegenehmigungen

Recht

• Welt-Anti-Doping-Code
• Anti-Doping Bundesgesetz 2021
• "Operation Aderlass" (Update)
• Verstöße gegen die Anti-Doping Bestimmungen 2020

Information & Prävention

• International Standard for Education
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• Schulungsprogramme
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Ausblick NADA Austria
Anlagen

In July 2018 the International Cycling Union (UCI) has reported an anti-doping rule violation against the French cyclist Jérôme Pulidori after his sample tested positive for the prohibited substances Presnisolone and Prednisone without a valid TUE. After notification a provisional suspension was ordered and the Athlete was heard for the UCI Anti-Doping Tribunal.

The Athlete admitted the violation and denied the intentional use of the substances. With medical information he demonstrated that he had used prescribed medication as treatment for his condition.

The Athlete made an application for a retroactive TUE which was rejected by the AFLD in January 2019 and, when appealed by the Athlete, again rejected in April 2019.

The Athlete made several requests for extention of the proceedings while he rejected and Acceptance of Sanction with a proposed sanction of 12 months. Further he complained that the UCI had imposed moral harassment, psychological violence and financial blackmail, and any other form of pressure on him.

UCI accepted that the violation was not intentional, that the substances were used for medical treatment, and that the Athlete had established how these substances had entered his system.

The Sole Arbitrator agrees that the violation was not intentional but deems that the Athlete had acted negligently since he had failed to research his medication for prohibited substances before using.

The Tribunal considers that there were substantial delays in the proceedings and backdated the commencement of the sanction while the Athlete had in fact already served the sanction during the period of the provisional suspension.

Therefore the UCI Anti-Doping Tribunal decides on 31 March 2021 to impose a fine and a 2 year period of ineligibility on the Athlete starting backdated on the date of the sample collection, i.e. 29 March 2018.

Costs of the UCI for the results management, the sample analysis and the documentation packages shall be borne by the Athlete.

Identifying best-practice amongst health professionals who work with people using image and performance enhancing drugs (IPEDs) through participatory action research / Katinka van de Ven, Ian Boardley, Martin Chandler. - (Qualitative Research in Sport, Exercise and Health (2021) 1 April)

• DOI: 10.1080/2159676X.2021.1898457

Abstract

The use of image and performance enhancing drugs (IPEDs), such as anabolic-androgenic steroids to grow muscle mass, is a growing public health concern in the UK and across the globe. An important indicator is the rapid rise of people who inject steroids accessing needle and syringe programmes (NSPs). However, NSP workers and other health professionals often report having a lack of knowledge regarding IPEDs, and not feeling confident when engaging with this group. Adding to this is a lack of evidence-based educational/training materials, making it difficult for health professionals to improve their skills in this area. Using a participatory action research approach (PAR), we collaborated with health professionals who had experience in working with this client group (n=52), particularly NSP staff, to address this knowledge gap. Consistent with our PAR approach, health professionals were involved in all stages of this research, from establishing the research questions through to disseminating the findings. To identify current best practices, a workshop was organised to collaboratively determine approaches to improve professional development in this area and to ultimately facilitate better engagement with people who use IPEDs. The participating health professionals described issues and solutions in relation to the collection of clinical data, staff training, client contact and service provision – with community engagement being mentioned as a key element to improve and create awareness of health services, and to strengthen community partnerships. By adopting a PAR approach, we have co-produced guidance on effective engagement with consumers that is both evidence-based and experience-informed.

Tailor-Made Immunochromatographic Test for the Detection of Multiple 17α-Methylated Anabolics in Dietary Supplements / Barbora Holubová, Pavla Kubešová, Lukáš Huml, Miroslav Vlach, Oldřich Lapčík, Michal Jurášek, Ladislav Fukal. - (Foods 10 (2021) 4 (1 April); 741)

• PMID: 33915816
• PMCID: PMC8065520
• DOI: 10.3390/foods10040741

Abstract

In recent years, the undeclared presence of various anabolic androgenic steroids (AAS) in commercial supplements has been confirmed. This fact can be a potential threat to all athletes using these supplements, and therefore, there is of increased interest in the implementation of rapid methods for the detection of AAS. The presented study describes the development of an immunostrip test for the detection of multiple 17α-methylated AAS based on direct and indirect competitive principle using gold nanoparticles as a label. As a capture reagent on test lines conjugated stanazolol to rabbit serum albumin (RSA/ST-3) was used, the intensity of color formed in the test line of the AAS-positive sample was visually distinguishable from that of negative sample within 10 min. The optimized closed direct and indirect format of the test provided a similar visual detection limit (0.7 and 0.9 ng/mL, respectively). The most commonly orally abused AAS (17α-methyltestosterone, methandienone, methyldihydrotestosterone, oxandrolone and oxymetholone) showed a strong cross-reaction. Developed immunostrips were successfully applied to analysis of artificially contaminated dietary supplements with 17α-methylated AASs. The developed immunostrips offer potential as a useful user-friendly method for capturing suspicious dietary supplement samples with different contents of AAS at levels far below the usually used concentrations of AAS.

iNADO Update (2021) 04 (1 April)
Institute of National Anti-Doping Organisations (iNADO)

Contents:

Message from our Chair

• What did we learn in Anti-Doping from COVID-19?

iNADO Community

• NADA Germany publishes Research into the Use of Analgesics in German Football Leagues
• International Paralympic Committee launches Tokyo 2020 Anti-Doping Webpage
• World Rowing Partners with the International Testing Agency
• IADA Secretariat Handover

Bulletin Board

• Enhanced Independence and a stricter Separation of Powers: iNADO´s Suggestions for WADA Governance
• iNADO Annual General Assembly 2021
• Bye Bye Facebook
• Webinar Invitation by UK Anti-Doping
• Governance in anti-doping: How to meet the challenges
• Job Vacancy at AFLD

Athlete's Voice

• "Be a Person first, an Athlete second"

People

• Farewell to Jonas Hebchen

Science

• Helsinki Laboratory resumes its Anti-Doping Activities following Relocation

Practical Development in Anti-Doping

• The Anti-Doping Knowledge Centre adds a dedicated Category for CAS Anti-Doping Division Awards

Feature of the Month

• Be part of Play True Day 2021

iNADO Partners & Sponsors

• New at the Anti-Doping Knowledge Center

Anabolic steroids and extreme violence: a case of murder after chronic intake and under acute influence of metandienone and trenbolone / Frédéric Aknouche, Laurie Gheddar, Angeline Kernalléguen, Christophe Maruejouls, Pascal Kintz

• International Journal of Legal Medicine 135 (2021) 4; p. 1449-1453
• PMID: 33813613
• DOI: 10.1007/s00414-021-02587-y

Abstract

A 32-year-old male went to the police to claim he just killed his girlfriend by inflicting several stabs with a kitchen knife. He was very nervous and particularly aggressive. About 90 min after the assault, a blood specimen was collected with natrium fluoride as preservative. The blood was free of alcohol, pharmaceuticals and drugs of abuse, but tested positive by LC-MS/MS for metandienone (32 ng/mL) and trenbolone (9 ng/mL). The perpetrator admitted regular consumption of anabolic steroids to enhance his muscular mass, as he was a professional security agent. To document long-term steroid abuse, a hair specimen was collected 3 weeks after the assault, which tested positive for both drugs. Segmental analyses revealed in the proximal 1.5 cm segment, corresponding to the period of the assault, the simultaneous presence of metandienone (11 pg/mg) and trenbolone (14 pg/mg), while only metandienone (3 pg/mg) was identified in the distal 1.5 cm segment. As aggressiveness and violence can be associated with abuse of anabolic steroids, the aetiology of this domestic crime was listed to be due impulsive behaviour in a context of antisocial lifestyle.

Previously the CrossFit Games Organisation, as non-signatory of the World Anti-Doping Code, imposed a 4 year period of ineligibility on the Brazilian Athlete after he tested positive for the prohibited substances Enobosarm (ostarine), LGD-4033 (ligandrol) and Metandienone. 

The sanction was imposed by CrossFit without a hearing although the Athlete wanted to be heard. In October 2020 the Brazilian Doping Control Authority (ABCD) confirmed in a Decision that the Athlete’s participation in competitions would be a violation of the Brazilian Anti-Doping Code. 

Hereafter in October 2020 the Athlete filed a request with the Brazilian Sports Justice Anti-Doping Tribunal (TJD-AD). The Athlete disputed the validity of the imposed CrossFit sanction and the ABCD Decision and requested to lift the imposed suspension. 

The TJD-AD Rapporteur established that under the Rules the anti-doping decision from CrossFit, as Non-Signatory, and the ABCD Decision are only valid after confirmation by the TJD-AD.

Due to the TJD-AD had not approved the CrossFit Decision the TJD-AD Rapporteur deemed that the ABCD Decision was invalid. 

Therefore the TJD-AD Panel decides on 5 April 2021 to lift the imposed sanction on the Athlete.

Related case:

TJD-AD 2021-015 Appeal Decision - Cycling
June 30, 2021

In November 2019 the Brazilian Doping Control Authority (ABCD) reported an anti-doping rule violation against the cyclist after his sample tested positive for the prohibitied substance Erythropoietin (EPO).

After notification a provisional suspension was ordered. The Athlete filed a statement in his defence and the case was referred to the Brazilian Sports Justice Anti-Doping Tribunal (TJD-AD). 

The Athlete gave a prompt admission and declined an acceptance of sanction of 45 months proposed by ABCD with approval of WADA, whereas the Athlete sought a reduced sanction of 2 years. He acknowledged that he intentionally had injected the substance into his system. 

The TJD-AD Rapporteur finds that the presence of the prohibited substance had been established in the Athlete’s sample and accordingly that he had committed an anti-doping rule violation. The Rapporteur considers that the Athlete had admitted the intentional use of the substance, rejected an acceptance of sanction, and that there are no grounds for a reduced sanction. 

Therefore the TJD-AD Panel decides on 5 April 2021 to impose a 4 year period of ineligibility on the Athlete, starting on the date of the provisional suspension, i.e. on 13 November 2019.