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Erythropoietin doping in cycling: lack of evidence for efficacy and a negative risk–benefit
Author(s) -
Heuberger Jules A. A. C.,
Cohen Tervaert Joost M.,
Schepers Femke M. L.,
Vliegenthart Adriaan D. B.,
Rotmans Joris I.,
Daniels Johannes M. A.,
Burggraaf Jacobus,
Cohen Adam F.
Publication year - 2013
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/bcp.12034
Subject(s) - medicine , intensive care medicine , population , erythropoietin , clinical trial , environmental health
Imagine a medicine that is expected to have very limited effects based upon knowledge of its pharmacology and (patho)physiology and that is studied in the wrong population, with low‐quality studies that use a surrogate end‐point that relates to the clinical end‐point in a partial manner at most. Such a medicine would surely not be recommended. The use of recombinant human erythropoietin (rHuEPO) to enhance performance in cycling is very common. A qualitative systematic review of the available literature was performed to examine the evidence for the ergogenic properties of this drug, which is normally used to treat anaemia in chronic renal failure patients. The results of this literature search show that there is no scientific basis from which to conclude that rHuEPO has performance‐enhancing properties in elite cyclists. The reported studies have many shortcomings regarding translation of the results to professional cycling endurance performance. Additionally, the possibly harmful side‐effects have not been adequately researched for this population but appear to be worrying, at least. The use of rHuEPO in cycling is rife but scientifically unsupported by evidence, and its use in sports is medical malpractice. What its use would have been, if the involved team physicians had been trained in clinical pharmacology and had investigated this properly, remains a matter of speculation. A single well‐controlled trial in athletes in real‐life circumstances would give a better indication of the real advantages and risk factors of rHuEPO use, but it would be an oversimplification to suggest that this would eradicate its use.