Article Text

PDF
β-2 Agonists in sport: are the anti-doping rules meeting the needs of asthmatic athletes?
  1. J Naranjo Orellana,
  2. M D Carranza Márquez
  1. Centro Andaluz de Medicina del Deporte, Sevilla, Spain
  1. Correspondence to José Naranjo Orellana, Centro Andaluz de Medicina del Deporte, Glorieta Beatriz Manchón s/n, 41092 Sevilla, Spain; jose.naranjo{at}juntadeandalucia.es

Abstract

Objectives (a) To review the methacholine tests performed in our laboratory up until 2008; (b) to compare them with previously reported data in 2006 and (c) to examine if the anti-doping rules are meeting the needs of asthmatic athletes who really need bronchodilator treatment.

Methods Between April 2004 and September 2008, 89 high-level athletes were examined in our laboratory in order to obtain an abbreviated therapeutic use exemption for β-2 agonists. Of these, 50 men (23.31 (7.05) years) and 23 women (20.68 (5.94) years) performed a methacholine inhalation test with increasing concentrations of methacholine (0.025, 0.25, 2.5, 5, 10 and 25 mg/ml) until a fall of 20% in forced expiratory volume in 1 s (FEV1) was achieved.

Results 31 candidates (42.5%) had a provocative concentration causing a 20% fall in FEV1 (PC20) <2 mg/ml; 12 (16.4%) were between 2 and 4 mg/ml; 8 (11%) between 4.1 and 8 mg/ml and 22 candidates (30.1%) had a PC20 >8 mg/ml. Seven of the 73 candidates had an obstructive pattern in the spirometry at rest, demonstrated by a FEV1% <70% but with a FEV1 >70% of the reference value.

Conclusions The anti-doping regulations with respect to β-2 agonists need to be reviewed, and measures should be adopted to include a fall of 70% in FEV1% as an obstruction criterion to indicate a bronchodilation test and to extend the criterion for a positive methacholine test to a PC20 of 8 mg/ml.

Statistics from Altmetric.com

Footnotes

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Ethics Committee of Centro Andaluz de Medicina del Deporte.

  • Provenance and peer review Not commissioned; not externally peer reviewed.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.