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Glucocorticoids in elite sport: current status, controversies and innovative management strategies—a narrative review
The use of systemic glucocorticoids (GCs), as well as local injections, continues to be a controversial issue in the sport/anti-doping community. There is widespread and legitimate use of GCs for numerous health conditions, yet there are concerns about side effects and the possibility of enhanced at...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6923944/ https://www.ncbi.nlm.nih.gov/pubmed/31326919 http://dx.doi.org/10.1136/bjsports-2018-100196 |
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author | Vernec, Alan Slack, Andrew Harcourt, Peter Rex Budgett, Richard Duclos, Martine Kinahan, Audrey Mjøsund, Katja Strasburger, Christian J |
author_facet | Vernec, Alan Slack, Andrew Harcourt, Peter Rex Budgett, Richard Duclos, Martine Kinahan, Audrey Mjøsund, Katja Strasburger, Christian J |
author_sort | Vernec, Alan |
collection | PubMed |
description | The use of systemic glucocorticoids (GCs), as well as local injections, continues to be a controversial issue in the sport/anti-doping community. There is widespread and legitimate use of GCs for numerous health conditions, yet there are concerns about side effects and the possibility of enhanced athletic performance in limited settings. This is compounded by the uncertainty regarding the prevalence of GC use, mechanisms underlying physiological effects and complex pharmacokinetics of different formulations. While WADA continues to promote research in this complex area, some international sporting federations, major event organisers and professional sports leagues have introduced innovative rules such as needle policies, mandatory rest periods and precompetition guidelines to promote judicious use of GCs, focusing on athlete health and supervision of medical personnel. These complementary sport-specific rules are helping to ensure the appropriate use of GCs in athletes where overuse is a particular concern. Where systemic GCs are medically necessary, Therapeutic Use Exemptions (TUEs) may be granted after careful evaluation by TUE Committees based on specific and strict criteria. Continued vigilance and cooperation between physicians, scientists and anti-doping organisations is essential to ensure that GC use in sport respects not only principles of fairness and adherence to the rules but also promotes athlete health and well-being. The purpose of this narrative review is to summarise the use and management of GCs in sport illustrating several innovative programmes by sport leagues and federations. |
format | Online Article Text |
id | pubmed-6923944 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-69239442020-01-02 Glucocorticoids in elite sport: current status, controversies and innovative management strategies—a narrative review Vernec, Alan Slack, Andrew Harcourt, Peter Rex Budgett, Richard Duclos, Martine Kinahan, Audrey Mjøsund, Katja Strasburger, Christian J Br J Sports Med Review The use of systemic glucocorticoids (GCs), as well as local injections, continues to be a controversial issue in the sport/anti-doping community. There is widespread and legitimate use of GCs for numerous health conditions, yet there are concerns about side effects and the possibility of enhanced athletic performance in limited settings. This is compounded by the uncertainty regarding the prevalence of GC use, mechanisms underlying physiological effects and complex pharmacokinetics of different formulations. While WADA continues to promote research in this complex area, some international sporting federations, major event organisers and professional sports leagues have introduced innovative rules such as needle policies, mandatory rest periods and precompetition guidelines to promote judicious use of GCs, focusing on athlete health and supervision of medical personnel. These complementary sport-specific rules are helping to ensure the appropriate use of GCs in athletes where overuse is a particular concern. Where systemic GCs are medically necessary, Therapeutic Use Exemptions (TUEs) may be granted after careful evaluation by TUE Committees based on specific and strict criteria. Continued vigilance and cooperation between physicians, scientists and anti-doping organisations is essential to ensure that GC use in sport respects not only principles of fairness and adherence to the rules but also promotes athlete health and well-being. The purpose of this narrative review is to summarise the use and management of GCs in sport illustrating several innovative programmes by sport leagues and federations. BMJ Publishing Group 2020-01 2019-07-20 /pmc/articles/PMC6923944/ /pubmed/31326919 http://dx.doi.org/10.1136/bjsports-2018-100196 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Review Vernec, Alan Slack, Andrew Harcourt, Peter Rex Budgett, Richard Duclos, Martine Kinahan, Audrey Mjøsund, Katja Strasburger, Christian J Glucocorticoids in elite sport: current status, controversies and innovative management strategies—a narrative review |
title | Glucocorticoids in elite sport: current status, controversies and innovative management strategies—a narrative review |
title_full | Glucocorticoids in elite sport: current status, controversies and innovative management strategies—a narrative review |
title_fullStr | Glucocorticoids in elite sport: current status, controversies and innovative management strategies—a narrative review |
title_full_unstemmed | Glucocorticoids in elite sport: current status, controversies and innovative management strategies—a narrative review |
title_short | Glucocorticoids in elite sport: current status, controversies and innovative management strategies—a narrative review |
title_sort | glucocorticoids in elite sport: current status, controversies and innovative management strategies—a narrative review |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6923944/ https://www.ncbi.nlm.nih.gov/pubmed/31326919 http://dx.doi.org/10.1136/bjsports-2018-100196 |
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