BUDESONIDE TREATMENT OF PROFESSIONAL ATHLETES AND ANTI-DOPING TESTING--CASE STUDIES.

According to the World Anti-Doping Agency (WADA) Prohibited List, glucocorticosteroids are prohibited in competition and only when administered by oral, intravenous, intramuscular or rectal routes. Up to now, in order to differentiate whether glucocorticosteroids were administered by one of the prohibited routes or not, a specific reporting limit for urinary concentrations of parent compounds and their metabolites was established at 30 ng/mL. Additionally, the new specific regulation starting from 1 September 2014 for budesonide have been introduced that the 6ß-hydroxybudesonide shall be targeted. Budesonide is a glucocorticosteroid used mainly by inhalation for asthma management. Interestingly, anti-doping laboratory statistics show that budesonide adverse analytical findings (AAF) constitute almost 50% of all reported glucocorticosteroid AAFs, even though budesonide possesses a very low systemic activity which may cause performance enhance effects. This work presents the results of five studies of controlled budesonide administration carried out on professional athletes. The samples were analyzed by using a quantitative HPLC/MS/MS method for 16α-hydroxy-prednisolone, the most abundant budesonide metabolite in urine. Our data clearly show that inhalation of budesonide at least 12 h before a competition at therapeutic doses leads to appearance of the main budesonide metabolite in concentrations exceeding prior reporting limit for this compound. Therefore, our work strongly supports recent WADA decision not to target the main budesonide metabolite using the same reporting limit as for other glucocorticosteroids.

The prevalence of trimetazidine use in athletes in Poland: excretion study after oral drug administration.

Stimulants, together with anabolic androgenic steroids, are regarded as one of the most popular doping substances in sport. Owing to a great variety of these substances and new designer drugs being introduced to the market, each year the World Anti-Doping Agency (WADA) updates the list of substances and methods prohibited in sport. On 1 January 2014, a new doping agent - trimetazidine (TMZ) - was added to the WADA Prohibited List. TMZ, a substance prohibited in competition, is classified in the S6b Specified Stimulant Group. TMZ is used as a well-known cardiologic drug with confirmed biochemical and clinical activity. According to knowledge of the pharmacology and mechanism of TMZ action, TMZ can be used by athletes to improve physical efficiency, especially in the case of endurance sports. This study presents the phenomena of TMZ use by Polish athletes involved in anti-doping control in the WADA-accredited laboratory in Warsaw (Poland) between 2008 and 2013. Samples were taken from the athletes of such disciplines as cycling, athletics, and triathlon. Moreover, the elimination study of TMZ has been conducted to establish the change of TMZ concentration in urine sample after oral administration of a single or double (during the long-term therapy) dose. TMZ was monitored in urine samples by gas chromatography-mass spectrometry-nitrogen phosphorus detection (GC-MS-NPD).