Ventura Rosa, Daley-Yates Peter, Mazzoni Irene, Collomp Katia, Saugy Martial, Buttgereit Frank, Rabin Olivier, Stuart Mark
Catalonian Antidoping Laboratory, IMIM, Hospital del Mar Institute for Medical Research, Barcelona, Catalunya, Spain.
Clinical Pharmacology & Experimental Medicine, GSK, Brentford, London, UK.
Br J Sports Med. 2021 Apr 20. doi: 10.1136/bjsports-2020-103512.
The systemic effect of glucocorticoids (GCs) following injectable routes of administration presents a potential risk to both improving performance and causing harm to health in athletes. This review evaluates the current GC antidoping regulations defined by the World Anti-Doping Agency and presents a novel approach for defining permitted and prohibited use of glucocorticoids in sport based on the pharmacological potential for performance enhancement (PE) and risk of adverse effects on health. Known performance-enhancing doses of glucocorticoids are expressed in terms of cortisol-equivalent doses and thereby the dose associated with a high potential for PE for any GC and route of administration can be derived. Consequently, revised and substance-specific laboratory reporting values are presented to better distinguish between prohibited and permitted use in sport. In addition, washout periods are presented to enable clinicians to prescribe glucocorticoids safely and to avoid the risk of athletes testing positive for a doping test.
注射途径给药后糖皮质激素（GCs）的全身效应，对运动员提高成绩和健康都存在潜在风险。本综述评估了世界反兴奋剂机构定义的当前GC反兴奋剂规定，并基于提高成绩的药理学潜力（PE）和对健康产生不良反应的风险，提出了一种在体育中定义GCs允许和禁止使用的新方法。已知的提高成绩的糖皮质激素剂量以皮质醇等效剂量表示，因此可以得出任何GC和给药途径与高PE潜力相关的剂量。因此，提出了修订后的特定物质实验室报告值，以更好地区分体育中的禁止和允许使用。此外，还给出了洗脱期，以使临床医生能够安全地开具糖皮质激素处方，并避免运动员兴奋剂检测呈阳性的风险。
