iNADO Update #2022-01

10 Jan 2022

iNADO Update (2022) 1 (January)
Institute of National Anti-Doping Organisations (iNADO)


iNADO Community

  • iNADO Season's Greetings
  • iNADO Live Chat  - Nick Paterson

Bulletin Board

  • Annual Banned Substance Review 2020 / 2021
  • iNADO Member-only webinar
  • WADA: Anti-Doping Rule Violation Report for 2019


  • Jane Rumble - New CEO of UKAD


  • Study examines ligandrol to determine inadvertent or advertent doping
  • Psychological intervention as a powerful tool in doping prevention? 
  • 2022 Scientific Research Grant by WADA
  • Suggested minimum reporting level for diuretics

Practical Development in Anti-Doping

  • The Council of Europe Anti-Doping Monitoring Group
  • Move of the Analysis Department of the French-Anti-Doping Organization

Feature of the Month

  • INADO participate in the closing meeting of ERASMUS+ Programme Project IMPACT

iNADO Partners & Sponsors

  • New at the Anti-Doping Knowledge Center

Severity of anabolic steroid dependence, executive function, and personality traits in substance use disorder patients in Norway

10 Jan 2022

Severity of anabolic steroid dependence, executive function, and personality traits in substance use disorder patients in Norway / Morgan Scarth, Ingrid A. Havnes, Marie L. Jørstad, Jim McVeigh, Marie Claire Van Hout, Lars T. Westlye, Svenn Torgersen, Astrid Bjørnebekk

  • Drug and Alcohol Dependence 231 (1 February 2022), 109275
  • PMID: 35030506
  • DOI: 10.1016/j.drugalcdep.2022.109275


Introduction: Anabolic androgenic steroids (AAS), including testosterone and synthetic derivatives, are typically used to increase muscle mass. Many users develop a dependence on these substances, contributing to worsened physical and mental health outcomes. Aspects of personality and executive dysfunction may represent underlying vulnerabilities for developing dependence.

Objective: To identify levels of AAS dependence within substance use disorder (SUD) treatment patients and assess the relationship between dependence severity and personality traits and executive function (EF).

Methods: Data were collected from patients at 38 SUD treatment facilities in Norway. Questionnaires were completed for measures of personality and EF. Measures of symptoms of AAS dependence were used in latent class analysis to identify sub-groups of patients, which were evaluated for association with EF and personality traits, and compared with a group of non-AAS using SUD patients.

Results: Three classes were identified; largely reflecting low, moderate, and high symptoms of dependence. Multinomial regression analyses indicated that moderate and high symptoms were associated with several measures of EF and personality traits, particularly self-monitoring, antagonism, disinhibition, and rigid perfectionism while users with low symptoms exhibited higher capacities for emotional control and shift, and lower negative affectivity, relative to non-AAS using SUD patients. Backward stepwise regressions indicated antagonism, and decreased self-monitoring as key personality and cognitive characteristics of SUD patients with severe AAS dependence.

Conclusion: Our findings indicate that specific executive dysfunctions and personality features, particularly those associated with poor emotional control, reduced empathy, and impulsivity are associated with more severe AAS dependence in the SUD population.

Keywords: Anabolic androgenic steroids; Executive function; Latent class analysis; Personality; Substance use disorder.

UKAD 2021 UKAD vs Jamie Acton

27 Dec 2021

In April 2021 the United Kingdom Anti-Doping (UKAD) has reported an anti-doping rule violation against the rugby player Jamie Acton after reanalysis of his sample, provided in December 2014, revealed the presence of the prohibited substance GHRP-6. After notification a provisional suspension was ordered.

At first the Athlete stated that he was retired from rugby since April 2019, yet failed to provide an explanation for the positive test result. Hereafter in July 2021 the Athlete admitted the violation, waived his right for a hearing and accepted the sanction proposed by UKAD.

UKAD deems that the Athlete had committed one single first anti-doping rule violation pursuant to 2009 ADR without grounds for a reduced sanction.

Therefore UKAD decides on 27 Decemer 2021 to impose a 2 year period of ineligibility on the Athlete, starting on the date of the provisional suspension, i.e. on 30 April 2021.

CCES 2021 CCES vs Alexis Stevens

23 Dec 2021

In November 2021 the Canadian Centre for Ethics in Sport (CCES) has reported an anti-doping rule violation against the Athlete Alexis Stevens after his sample tested positive for the prohibited substance GW501516.

After notification the Athlete gave a prompt admission, waived his right for a hearing, accepted a provisional suspension and the sanction proposed by CCES.

Because the Athlete signed and submitted the Early Admission and Acceptance Form the Athlete received a 1 year reduction from CCES.

Therefore CCES decides on 23 December 2021 to impose a 3 year period of ineligibility on the Athlete, starting on the date of the provisional suspension, i.e. on 18 November 2021.

Clomiphene citrate for men with hypogonadism: a systematic review and meta-analysis

21 Dec 2021

Clomiphene citrate for men with hypogonadism : a systematic review and meta-analysis / Manou Huijben, M. Tycho W.T. Lock, Vincent F. de Kemp, Laetitia M.O. de Kort, H.M.K. van Breda

  • Andrology (21 December 2021), p. 1-19
  • PMID: 34933414
  • DOI: 10.1111/andr.13146


Background: Male hypogonadism is a clinical and biochemical androgen insufficiency syndrome, becoming more prevalent with age. Exogenous testosterone is first-choice therapy, with several side effects, including negative feedback of the hypothalamic-pituitary-gonadal axis, resulting in suppression of intratesticular testosterone production and spermatogenesis. To preserve these testicular functions while treating male hypogonadism, clomiphene citrate is used as off-label therapy. This systematic review and meta-analysis aimed to evaluate the effectiveness and safety of clomiphene citrate therapy for men with hypogonadism.

Methods: The EMBASE, PubMed, Cochrane databases were searched in May 2021, for effectiveness studies of men with hypogonadism treated with clomiphene citrate. Both intervention and observational studies were included. The Effective Public Health Practice Project Quality Assessment Tool, a validated instrument, was used to assess methodological study quality. The primary outcome measure was the evaluation of serum hormone concentration. Secondary outcomes were symptoms of hypogonadism, metabolic and lipid profile, side effects, safety aspects.

Results: We included 19 studies, comprising four randomized controlled trials and 15 observational studies, resulting in 1642 patients. Seventeen studies were included in the meta-analysis, with a total of 1279 patients. Therapy and follow-up duration varied between one and a half and 52 months. Total testosterone increased with 2.60 (95% CI 1.82-3.38) during clomiphene citrate treatment. An increase was also seen in free testosterone, luteinizing hormone, follicle stimulating hormone, sex hormone-binding globulin and estradiol. Different symptom scoring methods were used in the included studies. The most frequently used instrument was the Androgen Deficiency in Aging Males questionnaire, whose improved during treatment. Reported side effects were only prevalent in less than 10% of the study populations and no serious adverse events were reported.

Conclusion: Clomiphene citrate is an effective therapy for improving both biochemical as well as clinical symptoms of males suffering from hypogonadism. Clomiphene citrate has few reported side effects and good safety aspects.

ITF 2021 ITF vs Matilde Paoletti

17 Dec 2021

In August 2021 the International Tennis Federation (ITF) has reported an anti-doping rule violation against the Italian tennis player Matilde Paoletti (18) after her A and B samples tested positive for the prohibited substance Clostebol in a low concentration.

After notification the Athlete gave a prompt admission, waived her right for a hearing, accepted a provisional suspenson and the sanction proposed by the ITF.

The Athlete denied the intentional use of the subsance and at first she could not explain how the substance had entered her system. After investigations the Athlete produced witness statements and expert reports in her defence that established the source of the prohibited substance.

The Athlete asserted that the positive test results must have been caused by inadvertent transdermal absorption of Clostebol through prolonged close contact with the family dog. Without the Athlete's knowledge the dog's dermatitis had been treated by her mother at the relevant time with Veterabol, a veterinary medication in spray form that contains Clostebol.

After the ITF had received further specifical factual and scientific evidence from the Athlete it accepts that she had established that the it is more likely than not that the presence of Clostebol was due to inadvertent transdermal absorption of Clostebol at the relevant time following physical contact with her family dog, which was, unknown to the Athlete, being treated with Veterabol spray containing Clostebol.

Further the Montreal Lab confirmed that the repeated treatment with Clostebol administered by spray to the Athlete's dog on the dates and in the quantities asserted by the Athlete could explain the positive test result.

Based on the evidence the ITF concludes on 17 December 2021 that the violation was not intentional and that the Athlete acted with No Fault or Negligence. Therefore the Athlete's provisional suspension is lifted with immediate effect and she will not serve any period of ineligibility for her anti-doping rule violation.

iNADO Update #2021-12

7 Dec 2021

iNADO Update (2021) 12 (7 December)
Institute of National Anti-Doping Organisations (iNADO)


iNADO Community

  • iNADO Acknowledges the Approval of Further Governance Reforms by the WADA Foundation
  • AMADA Annual Report
  • iNADO Live Chat - Gobi Nair
  • Antidoping Switzerland Foundation to become the Swiss Sport Integrity Foundation in 2022
  • World Rugby's "Keep Rugby Clean" Campaign
  • Sport Integrity Australia – Victories and Challenges after 18 Months of Creation

Bulletin Board

  • INADO Intervention at the Foundation Board Meeting of Paris
  • INADO Live Member Only Teleconference:
    "Challenges and Opportunities for INADO in 2022" with Nick Paterson
  • iNADO Webinar: Delivering Education with the support of your country sport system with NADA Austria and
    Slovak Anti-Doping Agency
  • Update on iNADO Workshop 2022: New Possibilities to Use Anti-Doping Capacity

Athlete's Voice

  • Establishment of the Athlete Committee in Drug Free Sport New Zealand


  • Pavel Christian Balaj steps down


  • Study confirms Presence of Undeclared Prohibited Substances in Nutrition Supplements

Practical Development in Anti-Doping

  • Social Sciences Researchers Propose a Doping Prevention Research Agenda 

Feature of the Month

  • iNADO Live Chat Celebration
  • Visit to the Doping Authority Netherlands & Anti Doping Denmark

iNADO Partners & Sponsors

  • New at the Anti-Doping Knowledge Center

World Athletics 2021 WA vs Abeba-Tekulu Gebremeskel

6 Dec 2021

In February 2021 the Athletics Integrity Unit (AIU) of World Athletics reported an anti-doping rule violation against the Ethiopian Athlete Abeba-Tekulu Gebremeskel after an AIU Expert Panel concluded unanimously in October 2020 in their Joint Expert Opinion that the Athlete’s hematological profile “highly likely” showed that he used a prohibited substance or a prohibited method: the use of EPO or Blood doping. 

This conclusion of the AIU Expert Panel was based on assessment of blood samples, collected in the period from 30 November 2019 until 21 July 2020 reported in the Athlete’s Biological Passport (ABP). 

After notification the Athlete submitted an expert report to explain the values in her ABP. However after consideration the Expert Panel rejected the Athlete’s explanations in their 2nd Joint Expert Opinion in February 2021. A provisional suspension was ordered and the Athlete was heard for the World Athletics Disciplinary Tribunal. 

The AIU contended that the Athlete's ABP profile showed that the Athlete had committed and anti-doping rule violation, in particular to the extreme abnormality in Sample 1.

Supported by her expert witness the Athlete denied the violation and asserted that the abnormal values in her ABP were due to another reason than blood doping and that the use of prohibited substance or of a prohibited method was hightly unlikely. The Athlete's expert's report provided these explanations:

  • increased HGB caused by decreased plasma volume;
  • technical errors in the laboratory; and
  • other pathologies.

During the hearing the Athlete did not file any new explanations for the abnormalities in her ABP profile.

Based on the evidence the Panel finds that none of the Athlete's explanations could have caused the abnormal values detected in Sample 1. Also the value of HGB in Sample 1 was so high that in a normal evironment it would have been considered as a situation of emergency where immediate medical intervention would have been required.

The Panel concludes that the abnormalities observed in the Athlete's ABP fall within the scope of a doping scenario, thus, the Panel deems that the AIU succeeded in establishing, to the Panel's comfortable satisfaction, that the abnormal values of the ABP were caused by the use of a prohibited subsance or a prohibited method by the Athlete.

Therefore the Disciplinary Tribunal decides on 6 December 2021 to impose a 4 year period of ineligibility on the Athlete starting on the date of the provisional suspension, i.e. on 22 February 2021.

World Rugby 2021 WR vs Luxora Suarez Suarez

1 Dec 2021

In September 2021 World Rugby has reported an anti-doping rule violation against the Colombian ruby player after her A and B  samples tested positive for the prohibited substance 5-Methylhexan-2-amine (1,4-dimethylpentylamine).

After notification the Athlete admitted the violation, waived her right to be heard, accepted the provisional sanction and the sanction proposed by World Rugby.

World Rugby deems that the violation was not intentional and that there were no grounds for No Significant Fault or Negligence.

Therefore World Rugby decides on 1 December 2021 to impose a 2 year period of ineligibility on the Athlete, starting on the date of the provisional suspension, i.e. on 24 September 2021.

Gene therapy, genetic doping and sport: fundaments and implications for the future

1 Dec 2021

Gene therapy, genetic doping and sport : fundaments
and implications for the future / Guilherme Giannini Artioli, Rosário Dominguez Crespo Hirata, Antonio Herbert Lancha Junior

  • Revista Brasileira de Medicina do Esporte 13 (2007) 5; p. 349-354
  • DOI: 10.1590/s1517-86922007000500013


Optimal performance has been constantly sought for in high level competitive sport. To achieve this goal, many athletes use illicit drugs and methods, which could have important side effects. Gene therapy is a very recent therapeutic modality, whose results have shown to be efficient in the treatment of severe diseases so far. The basis of gene therapy is a vectorial transfer of genetic materials to target-cells in order to supply the products of an abnormal gene in the patient's genome. Recently, the potential for misuse of gene therapy among athletes has called attention of scientists and sports regulating organs. The transfer of genes that could improve athletic performance, a method prohibited by COI in 2003, was named gene doping. The most important candidate genes for gene doping are the ones which codify for the following proteins: GH, IGH-1, miostatin blockers, VEGF, endorfins and enkefalins, eritropoetin, leptin and PPAR-delta. Once inserted in the athlete genome, the gene would be expressed and produce an endogenous product capable of improving performance. Thus, current doping detection methods are not sensitive enough to detect gene doping, which in turn could stimulate its use among athletes. Moreover, gene therapy still presents known application problems, such as inflammatory response and lack of control of gene activation. It is probable that such problems would be even more important in healthy individuals, since there would be excessive product of the transferred gene. Moreover, other unknown risks specific for each gene are present. Therefore, debate on gene doping should be carried on in the academic as well as sports field, in order to study prevention, control and detection measures of gene doping, avoiding hence, future problems regarding the misuse of this promising therapy.

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