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The asthmatic athlete, inhaled beta agonists, and performance
Donald C McKenzie1, Ian B Stewart, Kenneth D Fitch
1Division of Sports Medicine, The University of British Columbia, Vancouver, British Columbia, Canada. kari@interchange.ubc.ca
Summary
The use of inhaled beta agonists (IBAs) by asthmatic athletes at the Olympics has increased significantly, with no performance-enhancing effects at therapeutic doses. New IOC guidelines require clinical evidence for IBA use, assessed via tests like eucapnic voluntary hyperpnea.
Area of Science:
- Sports Medicine
- Exercise Physiology
- Pharmacology
Background:
- Rising use of inhaled beta agonists (IBAs) among Olympic athletes raises medical concerns.
- Significant geographical and sport-specific variations exist in IBA prescriptions.
Purpose of the Study:
- To review IBA use in asthmatic athletes.
- To examine international and sport-specific prescribing trends.
- To propose a framework for justifying IBA use.
Main Methods:
- Analysis of International Olympic Committee (IOC) data on IBA use.
- Review of published literature on asthma, elite athletes, and ergogenic aids.
- Consultation with the IOC Medical Commission.
Main Results:
- Substantial increase in IBA use at Olympic Games since 1984.
- Marked geographical and sport-based disparities in IBA requests.
- No ergogenic benefits observed for IOC-approved IBAs at therapeutic doses.
Conclusions:
- Many IBA prescriptions for athletes lack robust clinical justification.
- New IOC regulations (effective 2002 Winter Games) mandate evidence of medical necessity.
- The eucapnic voluntary hyperpnea test will be a key diagnostic tool for assessing IBA need.