Allergy, Asthma & Sports Unit, Immunoallergology Department, Centro Hospitalar São João E.P.E., Porto, Portugal.
Clin J Sport Med. 2013 Jan;23(1):74-6. doi: 10.1097/JSM.0b013e31826869ef.
To investigate how changes to the World Anti-Doping Agency (WADA) guidelines on asthma medication requests have impacted the management of asthmatic athletes in Portugal.
Retrospective analysis of asthma medication requests submitted in 2008 to 2010.
Portuguese Anti-Doping Authority database.
Athletes requesting the use of inhaled corticosteroids and/or β2-agonists.
Demographic, therapeutic, and diagnostic test data.
Yearly changes in number of asthma medication requests and diagnostic procedures.
We analyzed 326 requests: 173 abbreviated Therapeutic Use Exemptions (TUEs) in 2008 (objective tests not required), 9 Declaration of Use (DoU) and 76 TUEs in 2009, and 39 DoU and 29 TUEs in 2010. Spirometry was performed in 87% and 37% of athletes in 2009 and 2010, respectively; the corresponding figures for bronchoprovocation were 59% and 16%, almost all positive in both years.
Applications for inhaler use have decreased by approximately half since objective asthma testing became mandatory. Our findings show that WADA guidelines have an impact on asthmatic athletes care: In 2009 a more rigorous screening was possible, leading to withdrawal of unnecessary medication. Constant changes, however, jeopardize this achievement and nowadays introduce safety issues stemming from the unsupervised use of inhaled β2-agonists.
调查世界反兴奋剂机构（WADA）关于哮喘药物申请指南的变化如何影响葡萄牙哮喘运动员的管理。
对 2008 年至 2010 年期间提交的哮喘药物申请进行回顾性分析。
葡萄牙反兴奋剂机构数据库。
申请使用吸入皮质类固醇和/或β2-激动剂的运动员。
人口统计学、治疗和诊断测试数据。
哮喘药物申请和诊断程序的年度变化。
我们分析了 326 份申请：2008 年有 173 份简短治疗用药豁免（TUE）（无需进行客观测试），2009 年有 9 份用药声明（DoU）和 76 份 TUE，2010 年有 39 份 DoU 和 29 份 TUE。2009 年和 2010 年分别有 87%和 37%的运动员进行了肺量测定，支气管激发试验的相应比例分别为 59%和 16%，这两年几乎都是阳性。
自从客观哮喘测试成为强制性要求以来，吸入器的使用申请减少了约一半。我们的发现表明，WADA 指南对哮喘运动员的护理产生了影响：2009 年可以进行更严格的筛选，导致不必要的药物停用。然而，不断的变化危及了这一成就，如今，由于吸入β2-激动剂的不受监管使用，带来了安全问题。
