β2‐adrenergic agonists and doping: Where do we stand?

Annual banned‐substance review: Analytical approaches in human sports drug testing 2020/2021

“…Asthma medication, more specifically the use of β 2 ‐agonists, has required distinct considerations in anti‐doping due to the prevalence of asthma‐related conditions within the general as well as the elite athletic population and the necessity of maintaining respiratory health while protecting the integrity of sport 138 . Agreement appears to exist among scientists about the performance‐enhancing potential of β 2 ‐agonists, particularly concerning short and largely anaerobically conducted athletic performance, and anabolic as well as lipolytic activities 88 . In 2020/2021, especially, salmeterol was the subject of in‐depth anti‐doping investigations as the drug's permissive use is limited to 200 μg per 24 h, 24 but, in contrast to salbutamol and formoterol, no urinary threshold or reporting level has been defined.…”

“…138 Agreement appears to exist among scientists about the performance-enhancing potential of β 2 -agonists, particularly concerning short and largely anaerobically conducted athletic performance, and anabolic as well as lipolytic activities. 88 In 2020/2021, especially, salmeterol was the subject of indepth anti-doping investigations as the drug's permissive use is limited to 200 μg per 24 h, 24 but, in contrast to salbutamol and formoterol, no urinary threshold or reporting level has been defined. In order to provide critical information on urinary concentrations of salmeterol and its hydroxylated main metabolite, adequate quantitative test methods and controlled elimination studies are required.…”

Beyond bronchodilation: Illuminating the performance benefits of inhaled beta2‐agonists in sports

“…More than half the athletes in some endurance sports, such as swimming and cross‐country skiing, report a variable degree of asthma and EIB 3,5–8 . Given the widespread use of inhaled beta 2 ‐agonists and the fact that systemically administered beta 2 ‐agonists exert performance enhancing and anabolic effects, this has raised concerns as to whether inhaled beta 2 ‐agonists exhibit a similar performance‐enhancing potential 9–15 . The topic sparked considerable attention in light of anti‐doping inquiries involving the use of a short‐acting beta 2 ‐agonist (SABA), salbutamol, by a four‐time Tour de France winner 16 and a Tour de Ski winner, 17 prompting the director of the World Anti‐Doping Agency (WADA) to hint that the regulations had been too lenient 18 .…”

“…3,[5][6][7][8] Given the widespread use of inhaled beta 2 -agonists and the fact that systemically administered beta 2 -agonists exert performance enhancing and anabolic effects, this has raised concerns as to whether inhaled beta 2 -agonists exhibit a similar performance-enhancing potential. [9][10][11][12][13][14][15] The topic sparked considerable attention in light of anti-doping inquiries involving the use of a short-acting beta 2 -agonist (SABA), salbutamol, by a four-time Tour de France winner 16 and a Tour de Ski winner, 17 prompting the director of the World Anti-Doping Agency (WADA) to hint that the regulations had been too lenient. 18 This naturally raises the question of the circumstances under which inhaled beta 2 -agonists can impose a performanceenhancing effect.…”