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Annual Banned-Substance Review 17th Edition - Analytical Approaches in Human Sports Drug Testing 2023/2024 / Mario Thevis, Tiia Kuuranne, Hans Geyer

• Drug Testing and Analysis (28 December 2024), p. 1-26
• PMID: 39731401
• DOI: 10.1002/dta.3835

Contents:

• Introduction
• Non-Approved Substances
• Anabolic Agent
  • Anabolic-androgenic steroids 
  • Initial testing procedures and Studies on Metabolism
  • Steroid profiling in urine and blood
  • Other Anabolic Agents
• Peptide Hormones, Growth Factors, Related Substances, and Mimetics
  • EPO-receptor agonists (ERAs) and hypoxia-inducible
    factor (HIF) activating agents
  • Peptide hormones and their releasing factors

• Β2-Agonists, Hormone, And Metabolic Modulators, and diuretics

  • β2-Agonists
  • Hormone and metabolic modulators
  • Diuretics
• Stimulants And Glucocorticoids
  • Stimulants
  • Glucocorticoids
• Manipulation Of Blood And Blood Components
• Chemical and Physical Manipulation
• Gene and Cell doping
• Conclusion And Perspectives

Abstract

The 17th edition of the annual banned-substance review on analytical approaches in human sports drug testing is dedicated to literature published between October 2023 and September 2024. As in previous years, focus is put particularly on new or enhanced analytical options in human doping controls as well as investigations into the metabolism and elimination of compounds of interest, which represent central (while not exclusive) cornerstones of the global anti-doping mission. New information published within the past 12 months on established doping agents as well as new potentially relevant substances are reviewed and discussed in the context of the World Anti-Doping Agency's 2024 Prohibited List. Thereby, analytical challenges, especially with regard to the continuously growing number of target compounds and potentially relevant drug classes as well as the exigency (and consequences) of utmost analytical retrospectivity, are thematized and contextualized. Investigations especially into anabolic agents, peptide hormones, and strategies for the detection of gene doping were identified as core areas of anti-doping research in the reviewed period.

Trends in the Detection of Erythropoietin Receptor
Agonists (ERAs) in Anti-Doping: An Analysis of Recent
Adverse Analytical Findings (AAFs) / Tristan Equey, Julian Broséus, Norbert Baume, Reid Aikin

• Drug Testing and Analysis (25 November 2024), p. 1-6 
• DOI: 10.1002/dta.3828

ABSTRACT

Anti-doping efforts aim to reduce the prevalence of doping through a combination of education, deterrence, and detection. Detection of doping practices, for example through testing and/or investigations, aims both to catch committed dopers and deter potential dopers. To date, little empirical evidence is available examining the ability of detection strategies to deter athletes from doping. Here, trends in adverse analytical findings (AAFs) for EPO or other EPO-Receptor Agonists (ERAs) were examined over an 8-year period in order to assess the impact of ERA testing and detection on athlete behavior. It was observed that the majority (62.8%) of ERA AAFs occur on samples collected on the day of a competition. Evidence is also presented that the largest fraction of ERA AAFs occurs on the first sample ever taken from an athlete (43.2%), and that the ERA AAF rates decline steadily as athletes continue to be tested. These findings provide evidence of a deterrent effect of testing on ERA use in sport.

In December 2024 the Athletics Integrity Unit (AIU), on behalf on World Athletics, reported an anti-doping rule violation against the Kenyan Athlete Ezekiel Kipkorir after his sample tested positive for the prohibited substance Testosterone and its metabolites.

Following notification the Athlete timely admitted the violation, waived his right for a hearing, accepted a provisional suspension and the sanction proposed by the AIU.

The AIU deems that the Athlete failed to establish that the violation was not intentional. Because he had signed and submitted the Admission of Anti-Doping Rule Violations and Acceptance of Consequences Form he received a 1 year reduction from the AIU.

Therefore the AIU decides on 18 December 2024 to impose a 3 year period of ineligibility on the Athlete, starting on the date of the provisional suspension, i.e. on 5 December 2024.

In April 2024 the Athletics Integrity Unit (AIU), on behalf of World Athletics, reported an anti-doping rule violation against the South Sudanese Athlete Anjelina Nadai Lohalith after her sample tested positive for the prohibited substance Trimetazidine.

Following notification a provisional suspension was ordered. The Athlete accepted the test result and filed a statement in her defence.

The Athlete denied the intentional use of the substance and argued that she was tested before without issues. She assumed that sabotage or her treatment had caused the positive test result.

She explained that she underwent medical treatment for her health problems and had used prescribed medication. In support she produced medical documents of the medical facilities in Kenya were she was treated.

In view of the evidence the AIU concluded that the Athlete failed to establish how the prohibited substance had entered her system, nor that the violation was not intentional. Accordingly in November 2024 the AIU issued the Athlete a Notice of Charge. 

Hereafter in December 2024 the Athlete admitted the violation, waived her right for a hearing and accepted the sanction proposed by the AIU. She also signed and submitted the Admission of Anti-Doping Rule Violations and Acceptance of Consequences Form.

Therefore the AIU decides on 20 December 2024 to impose a 3 year period of ineligibility on the Athlete, starting on the date of the provisional suspension, i.e. on 30 April 2024.

In October 2024 the Athletics Integrity Unit (AIU), on behalf on World Athletics, reported an anti-doping rule violation against the Ethiopian Athlete Aberash Mutala Amena after her A and B samples tested positive for the prohibited substance Testosterone and its metabolites.

Following notification the Athlete timely admitted the violation, waived her right for a hearing, accepted a provisional suspension and the sanction proposed by the AIU. She could not explain how the substance had entered her system.

The AIU deems that the Athlete failed to establish that the violation was not intentional. Because she had signed and submitted the Admission of Anti-Doping Rule Violations and Acceptance of Consequences Form she received a 1 year reduction from the AIU.

Therefore the AIU decides on 10 December 2024 to impose a 3 year period of ineligibility on the Athlete, starting on the date of the provisional suspension, i.e. on 14 October 2024.

Study of long-acting vs daily growth hormone : peak levels, AUC, action duration, and IGF-1 / Ashraf Soliman, Fawzia Alyafei, Nada Alaaraj, Noor Hamed, Shayma Mohamed, Ahmed Elawwa, Vincenzo De Sanctis

• Academia Biology 2 (2024) 4, p. 1-16
• doi.org/10.20935/AcadBiol7439

Abstract

Introduction: Long-acting growth hormone (LAGH) therapy was developed to improve adherence by reducing injection frequency compared to daily growth hormone (GH) therapy. Objectives: This review assesses the impact of LAGH therapy on serum levels of GH and insulin-like growth factor-1 (IGF-1) and evaluates the potential metabolic and safety risks compared to the natural pulsatile secretion of GH and daily GH injections in normal children.
Methods: A comprehensive literature search identified studies examining the effects of LAGH therapy on serum GH and IGF-1 levels.
Results: Studies from 2010 to 2024 were included. LAGH formulations maintain elevated IGF-1 levels for extended periods, in contrast to the episodic peaks and troughs of natural GH secretion. These formulations demonstrate efficacy in promoting growth and maintaining IGF-1 levels but are associated with sustained nonpulsatile GH exposure. Significant intra- and interindividual variability in GH uptake after injection has been observed, with higher GH concentrations correlating with increased IGF-1 levels and growth response. Concerns have been raised about adverse metabolic outcomes, including decreased insulin sensitivity. Sustained high IGF-1 levels with LAGH therapy may also increase risks for certain cancers and proliferative disorders, although evidence remains inconclusive.
Discussion: While LAGH therapy offers improved adherence, it leads to non physiological, sustained high levels of GH and IGF-1, raising concerns about long-term metabolic effects. Conclusions: LAGH therapy presents a viable alternative to daily GH injections, providing improved adherence and convenience. However, continuous monitoring of long-term metabolic and safety risks and performing long-term studies are crucial to ensuring safe and effective use in clinical practice.

CAS 2023/A/10022 Carina Horn v. World Athletics - Athletics Integrity Unit

Related cases:

• World Athletics 2019 WA vs Carina Horn
  September 10, 2021
• World Athletics 2023 WA vs Carina Horn
  August 2, 2023
  
  

In June 2022 the Basque Anti-Doping Agency (BADA) reported an anti-doping rule violation against the South African Athlete Carina Horn after her A and B samples tested positive for the prohibited substance Clenbuterol in a low concentration.

Consequently on 13 March 2023 the Basque public authorities decided to impose a 6 year period of ineligibility on the Athlete for her second anti-doping rule violation. Thereupon the Athlete's appeals against this decision were dismissed by the Basque Minister of Culture and Language Policy.

Although the Basque public authorities are not a Signatory of the WADA Code the Athletics Integrity Unit (AIU) established that the Basque Anti-Doping Act is consistent with the WADA Code in all its material aspects. Accordingly the AIU decided on 2 August 2023 for implementation of the imposed 6 year period of ineligibility for the Athlete's second anti-doping rule violation, starting on 13 March 2023.

Hereafter in September 2023 the Athlete appealed the AIU decision with the Court of Arbitration for Sport (CAS). The Athlete requested the Panel to set aside the Appealed Decision and the test results.

The Athlete denied the intentional use of the substance and claimed that meat contamination had caused the positive test results. Moreover she disputed the validity of the Appealed Decision.

• the AIU failed to undertake a comparison between the WADA Code and the Basque Anti-Doping Law;
• the Basque Anti-Doping Law is inconsistent with the WADA Code;
• the BADA failed to comply with the Stakeholder Notice; and
• the sanction is disproportionately severe.

By contrast the AIU contended that the Athlete's arguments are misguided and must be rejected. The AIU requested the Panel to confirm the Appealed Decision of 28 July 2023.

The Panel assessed and addressed the evidence and arguments presented by the Parties and determines that:

• The applicable Basque Law is consistent with the WADA Code and consistent in all its material aspects.
• The Basque Resolution in question followed the material principles of the WADA Code and the proper rules have been applied.
• BADA has the burden of establishing an anti-doping rule violation, not a duty to investigate the source of the alleged meat contamination.
• The question of proportionality of the sanction is outside the scope of this appeal.

Therefore the Court of Arbitration for Sport decides on 4 December 2024 that:

1.) The appeal filed by Ms Carina Horn on 27 September 2023 against the Implementation Decision is dismissed

2.) The Implementation Decision is upheld.

3.) The present proceedings shall be free, except for the CAS Court Office fee, which was paid by the Appellant and is retained by the Court of Arbitration for Sport.

4.) Mrs Carina Horn is ordered to pay to World Athletics a total amount of CHF 2,000 (two thousand Swiss Francs) as contribution towards the expenses in connection with this arbitration proceeding.

5.) All other motions or prayers for relief are dismissed.

iNADO Update (2024) 11/12 (20 December)
Institute of National Anti-Doping Organisations (iNADO)

Contents:

Special Feature

• The legal analysis: how should an Anti-Doping Organisation assess a case involving a Contaminated Product?

News & Updates

• Leadership Update: Dr. Peter Van de Vliet Assumes Role as CEO
• Dr. Andrea Gotzmann Honoured by the DOSB
• UKAD Celebrates 15 Years This December
• iNADO Welcomes New CEOs to its Global Community

Building a Supportive Community

• AMADA Hosts Conference on Olympic Games, AMADA and NADA Germany Sign MoU
• Anti-doping Experts Meet in Amsterdam
• UKAD and SIA Host November Data Analytics Workshop
• NADA Germany Welcomes Testing Experts in Bonn
• We Want Your Thoughts on Our Basecamp!
• Update Your NADO Contact Details for iNADO BaseCamp

Improving Practice Everywhere

• 2025 iNADO Annual Workshop
• WADA Opens Registration for 2025 Annual Symposium

Speaking Up for NADOs & RADO Globally

• iNADO Chair Anders Solheim Presents at WADA Foundation Board

Guiding Principles

• Join Our Commitment: Become a Signatory to the Guiding Principles for Clean Sport

iNADO Sponsors & Partners

• MODOC: A Comprehensive Solution for Anti-Doping Management
• A Message from Berlinger
• Reminder: iNADO Members Have an Offer with Bird & Bird

Prohibited List January 2025 : The World Anti-Doping Code International Standard / World Anti-Doping Agency (WADA). - Montreal : WADA, 2024

The Prohibited List is a mandatory International Standard as part of the World Anti-Doping Program.
The List is updated annually following an extensive consultation process facilitated by WADA. The effective date of the List is 1 January 2025.

Working Group Cottier Report Implementation - Report / WADA Working Group. - Montreal : World Anti-Doping Agency (WADA), 2024

The WADA Executive Committee (ExCo) at a meeting in Riyadh, Kingdom of Saudi Arabia, unanimously approved a range of recommendations presented by a Working Group, which was set up by the ExCo in September 2024. 

The Working Group was tasked with turning the findings of Independent Prosecutor, Eric Cottier, who carried out a review of WADA’s handling of the no-fault contamination cases involving 23 swimmers from China in 2021 and those of the Anti-Doping Audit Review Committee of World Aquatics on the same topic, into concrete recommendations that could be reviewed and approved by the ExCo. 

The Working Group’s recommendations cover the following five areas with established corresponding timelines: 

1. Results Management Filing System   
2. WADA Intelligence & Investigations (I&I) Department Triage and Prioritization Framework   
3. Alarm setup in WADA’s Anti-Doping Administration and Management System [ADAMS] and Results Management Process Review   
4. World Anti-Doping Code Update Process Issues   
5. Out-of-competition Testing Independent from National Anti-Doping Organizations and Local Laboratories  

In his review, Mr. Cottier concluded that WADA showed no bias towards China, that its decision not to appeal the cases to the Court of Arbitration for Sport (CAS) was reasonable, and that it followed the rules at all times. Through his final report, which was presented to the ExCo in September, Mr. Cottier also made a number of observations as to how anti-doping rules and WADA’s administrative processes could be further strengthened in light of these cases.