PT - JOURNAL ARTICLE AU - Rosa Ventura AU - Peter Daley-Yates AU - Irene Mazzoni AU - Katia Collomp AU - Martial Saugy AU - Frank Buttgereit AU - Olivier Rabin AU - Mark Stuart TI - A novel approach to improve detection of glucocorticoid doping in sport with new guidance for physicians prescribing for athletes AID - 10.1136/bjsports-2020-103512 DP - 2021 Jun 01 TA - British Journal of Sports Medicine PG - 631--642 VI - 55 IP - 11 4099 - http://bjsm.bmj.com/content/55/11/631.short 4100 - http://bjsm.bmj.com/content/55/11/631.full SO - Br J Sports Med2021 Jun 01; 55 AB - 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.