Asthma is more prevalent in high performance athletes than in the general population, especially in endurance athletes and swimmers. Asthma in athletes who practice winter sports such as cross-country skiing is particularly common, possibly due to the inhalation of cold, dry air into the upper respiratory tract.
Treatment with beta(2)-agonists by using an inhaler has been the most common treatment for athletes thus far. Beta(2)-agonists are known as bronchodilators, drugs that help control the symptoms of asthma by relaxing the muscles lining the bronchial tubes of the lungs which constrict during an asthma attack.
However, the World Anti Doping Agency (WADA) has prohibited their use unless the athlete has been granted an exemption for therapeutic use. In these cases salbutamol, salmeterol, formoterol and terbutaline can be used. Nevertheless, there is still some controversy regarding this treatment, with many sports administrators believing this treatment may still offer an unfair advantage to asthmatic athletes.
However, a meta-study conducted by Wilfried Kindermann and researchers at the Institute of Sports and Preventive Medicine at the University of Saarland in Saarbrucken, Germany, has concluded that beta(2)-agonists used to treat asthma do not confer any performance advantage in athletes.
Researchers evaluated the studies of 19 randomised placebo-controlled trials in non-asthmatic competitive athletes. In 17 of these studies, no performance-enhancing effects could be found from the inhalation of the beta(2)-agonists formoterol, salbutamol, salmeterol and terbutaline, particularly among athletes specialising in endurance performance, strength performance and anaerobic power.
In three out of four studies there was still no evidence of performance enhancement even with supratherapeutic doses of 800-1200 micrograms of salbutamol. While the inhaled beta(2)-agonists provided no performance advantage, the oral administration of salbutamol did appear to improve endurance performance and muscle strength.
Based upon the evidence of their study, researchers concluded that -there appears to be no justification to prohibit inhaled beta(2)-agonists on the basis of any ergogenic effects they might confer'.
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