Sports Medicine, Australian Institute of Sport, Bruce, Australian Capital Territory, Australia
Sports Medicine, Australian Institute of Sport, Bruce, Australian Capital Territory, Australia.
Br J Sports Med. 2020 Apr;54(7):402-407. doi: 10.1136/bjsports-2019-101175. Epub 2020 Feb 5.
Glucocorticoids are commonly prescribed in medicine. When administered via certain routes, glucocorticoids are prohibited for incompetition use by WADA. The glucocorticoid prescribing habits of sports medicine doctors have not been reported.
An online survey was distributed internationally to physicians working in high-performance sports. The survey queried the doctors about their use of glucocorticoids with athletes and their understanding of WADA's regulations regarding glucocorticoid use in competition.
603 sports medicine doctors from 30 different countries participated. The majority (>85%) routinely injected glucocorticoids and/or prescribed glucocorticoids by other routes. There were substantial differences in the common routes of injection as well as types of glucocorticoid used among the physicians from various countries. A relatively small percentage of sports doctors (<25%) accurately identified which routes of glucocorticoid administration are prohibited in competition by WADA. There was a great variation in how long before competition the use of glucocorticoids would cause the doctor to consider applying for a therapeutic use exemption (TUE). A better understanding of the clearance rates of glucocorticoids from athletes' bodies would greatly aid sports medicine doctors' decisions on how and when to apply for a TUE. A small number of doctors had observed side effects of glucocorticoid administration, with the majority of side effects being minor in nature.
Glucocorticoids are widely prescribed by sports physicians. There is a need to better educate sports physicians on the current WADA regulations in relation to glucocorticoid administration.
糖皮质激素在医学中被广泛应用。当通过某些途径给药时，世界反兴奋剂机构（WADA）禁止将糖皮质激素用于竞赛禁用。目前还没有报道过运动医学医生开具糖皮质激素处方的习惯。
国际上向从事高性能运动的医生分发了在线调查。该调查询问了医生在运动员中使用糖皮质激素的情况，以及他们对 WADA 关于竞赛中使用糖皮质激素规定的理解。
来自 30 个不同国家的 603 名运动医学医生参与了调查。大多数（>85%）医生经常注射糖皮质激素和/或通过其他途径开具糖皮质激素处方。各国医生常用的注射途径以及使用的糖皮质激素类型存在很大差异。只有一小部分（<25%）运动医生能准确识别出 WADA 禁止在竞赛中使用的糖皮质激素给药途径。在比赛前多久使用糖皮质激素会导致医生考虑申请治疗用药豁免（TUE），医生之间存在很大差异。如果运动员体内糖皮质激素的清除率有更清晰的了解，将极大地帮助运动医学医生做出如何以及何时申请 TUE 的决定。少数医生观察到了糖皮质激素给药的副作用，大多数副作用性质轻微。
运动医学医生广泛开具糖皮质激素处方。有必要更好地教育运动医学医生了解当前 WADA 关于糖皮质激素给药的规定。
