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Clinical Journal of Sport Medicine:
doi: 10.1097/JSM.0b013e31826869ef
Brief Report

Impact of Changes in Anti-doping Regulations (WADA Guidelines) on Asthma Care in Athletes

Couto, Mariana MD*,†; Horta, Luís MD, PhD; Delgado, Luís MD, PhD*,†; Capão-Filipe, Miguel MD*,§; Moreira, André MD, PhD*,†

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Objective: To investigate how changes to the World Anti-Doping Agency (WADA) guidelines on asthma medication requests have impacted the management of asthmatic athletes in Portugal.

Design: Retrospective analysis of asthma medication requests submitted in 2008 to 2010.

Setting: Portuguese Anti-Doping Authority database.

Participants: Athletes requesting the use of inhaled corticosteroids and/or β2-agonists.

Independent Variables: Demographic, therapeutic, and diagnostic test data.

Main Outcome Measures: Yearly changes in number of asthma medication requests and diagnostic procedures.

Results: We analyzed 326 requests: 173 abbreviated Therapeutic Use Exemptions (TUEs) in 2008 (objective tests not required), 9 Declaration of Use (DoU) and 76 TUEs in 2009, and 39 DoU and 29 TUEs in 2010. Spirometry was performed in 87% and 37% of athletes in 2009 and 2010, respectively; the corresponding figures for bronchoprovocation were 59% and 16%, almost all positive in both years.

Conclusions: Applications for inhaler use have decreased by approximately half since objective asthma testing became mandatory. Our findings show that WADA guidelines have an impact on asthmatic athletes care: In 2009 a more rigorous screening was possible, leading to withdrawal of unnecessary medication. Constant changes, however, jeopardize this achievement and nowadays introduce safety issues stemming from the unsupervised use of inhaled β2-agonists.

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.

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