Objective To examine the effect of beta2-agonists on aerobic performance in healthy, non-asthmatic study participants.
Design Systematic review and meta-analysis.
Eligibility criteria We searched four databases (PubMed, Embase, SPORTDiscus and Web of Science) for randomised controlled trials published until December 2019. Studies examining the effect of beta2-agonists on maximal physical performance lasting longer than 1 min were included in the meta-analysis. Data are presented as standardised difference in mean (SDM) with 95% CI.
Results The present meta-analysis includes 47 studies. The studies comprise 607 participants in cross-over trials, including 99 participants in three-way cross-over trials and 27 participants in a four-way cross-over trial. Seventy-three participants were included in parallel trials. Beta2-agonists did not affect aerobic performance compared with placebo (SDM 0.051, 95% CI −0.020 to 0.122). The SDM for the included studies was not heterogeneous (I2=0%, p=0.893), and the effect was not related to type of beta2-agonist, dose, administration route, duration of treatment or performance level of participants. Beta2-agonists had no effect on time trial performance, time to exhaustion or maximal oxygen consumption (p<0.218).
Conclusion/implication The present study shows that beta2-agonists do not affect aerobic performance in non-asthmatic subjects regardless of type, dose, administration route, duration of treatment or performance level of participants. The results of the present study should be of interest to WADA and to anyone who is interested in equal opportunities in competitive sports.
Systematic review registration PROSPERO CRD42018109223.
- elite performance
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Contributors All authors reviewed the report. AR generated the hypotheses, did the literature search, analysed the data and wrote the first draft of the manuscript. AR, TS, JS and LBA revised the manuscript critically for important intellectual content. All authors, external and internal, had full access to all of the data (including statistical reports and tables) in the study and can take responsibility for the integrity of the data and the accuracy of the data analysis. AR and TS extracted the data. JS and AR assessed bias. AR and LBA evaluated the studies for inclusion.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
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