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by Shane Stokes
June 17, 2014
The World Anti Doping Agency has said that it doesn’t have an issue with the UCI’s decision to grant Chris Froome a therapeutic use exemption for the corticosteroid prednisolone, believing that the regulations were followed as required.
“WADA is satisfied that the UCI’s decision to grant a Therapeutic Use Exemption (TUE) to Chris Froome was conducted according to the rules of the International Standard for Therapeutic Use Exemptions (ISTUE), and therefore will not be reviewing this case any further,” stated the agency, responding to questions on the matter from CyclingTips.
“WADA monitors the applications for, and approvals of, Therapeutic Use Exemptions (TUEs) and has the ability to review TUE decisions in line with the ISTUE.”
On Sunday French newspaper Le Journal du Dimanche claimed that the UCI had not followed the correct protocol in relation to the TUE, which was requested by Froome after a chest infection. He was ill heading into the Tour de Romandie at the end of April and team doctor Allan Farrell sought a TUE from the UCI in relation to the corticosteroid prednisolone.
Le Journal du Dimanche claimed that the governing body’s scientific advisor Dr. Mario Zorzoli granted the request without submitting Froome’s medical dossier to a TUE committee. Froome went on to win the race for the second consecutive year.
The UCI responded by denying anything untoward had happened. “Christopher Froome’s TUE for oral use of glucocorticosteroids was granted on April 29, 2014 based on duly documented medical history and in compliance with the applicable UCI Regulations and the relevant WADA guidelines,” it said in a statement. “The TUE was granted for a limited period, following the usual procedure.
“The process was fully transparent as it is UCI’s policy to systematically record all TUEs on ADAMS. WADA was therefore informed throughout the process.”
It added that under the current rules, any rider with the same symptoms as Froome would have received a similar TUE.
Irish GP Conor McGrane, who has also acted as Cycling Ireland’s doctor for several years – said that he didn’t fault Froome in this situation. “It is more about whether or not the UCI followed the correct procedures in the matter,” he told CyclingTips, speaking prior to WADA’s clarification that the regulations were indeed followed.
McGrane played down suggestions that the amount prescribed was excessive. “As regards the dosage…the amount specified is pretty standard in Ireland and the UK for when people are prescribed steroids for flareup of asthma. It would be 40mg per day for seven days.”
He pointed out that when he had to prescribe oral corticosteroids to ill athletes in the past, the TUE committee of the Irish Sports Council insisted on a 14 day break before competition. This was double the seven day break in place at the time under the WADA regulations.
As today’s WADA statement shows, the agency is satisfied that the current rules were followed by Froome, Team Sky and the UCI in the matter.
Even if the matter has been put to rest, the story has turned the focus on what happens when athletes are ill, and raises the question about whether it is wise for them to compete under such circumstances.
McGrane and two other medical professionals expressed concerns about the wisdom of allowing athletes to compete when they need to take such corticosteroids.
“I would be personally be uncomfortable to have someone on steroids in competition. If they are so sick, I’d question if they competing,” said McGrane.
An informed medical source, who did not want to be publicly identified, also expressed similar concerns. “Using prednisolone, a glucocorticosteroid, for the entire duration of a competition – why would one even attempt to race?” he told CyclingTips.
“This is [usually] banned in competition for good reason – it is a potent stimulant and it is catabolic, not anabolic. It basically deregulates energy metabolism so that appetite is increased and more energy is burnt with much less fatigue.
“If intake does not match increased output, rapid fat loss ensues. If this goes on for more than a few weeks, muscle starts getting chewed up when the fat runs out. It’s been a mainstay of doping for at least 50 years.”
The individual was not accusing Froome of improper use, but rather raised concerns about the current regulations permitting a rider to seek a TUE to take the substance during competition.
“Can anyone dope up for a whole stage race if they complain of a cough? The tablets have a much more potent systemic effect, that’s why they are banned,” he said. “Suggesting it is okay to race rather then recover in this situation would be medically unusual.”
He pointed out an earlier statement by Team Sky’s former medical chief Dr. Steve Peters, which said that the squad had a policy against using TUEs to get riders through races.
“We agreed as a team that if a rider, suffering from asthma, got into trouble with pollen we would pull him out of the race rather than apply for a therapeutic use exemption on his behalf,” Peters told the Sunday Times last year.
A third medical professional, the former Cofidis doctor Jean-Jacques Menuet, wrote about the TUE matter on the Medecinedusportconseils website and said he personally had concerns about ill athletes using medication to continue racing.
“Reflection is needed, in a spirit of ‘good medicine’: if the use of oral corticosteroids is required, the athlete needs rest and should have nothing to do with competition. So I can only think that this requirement of an oral corticosteroid for this rider preceded or followed the competition period concerned; it is not otherwise possible.”
Menuet called for a rapid refinement of the regulations on the matter.
It remains to be seen if WADA will decide at some future point to look again at the permitted use of corticosteroids by athletes holding a TUE. In this particular case, though, it seems the agency is satisfied that there is no case for Froome, Team Sky and the UCI itself to answer.
As for Le Journal du Dimanche and the claims of improper actions by the UCI, the governing body made clear that it could pursue the matter further. On Sunday it rejected suggestions by the paper that president Brian Cookson’s son Oli’s role with Team Sky had led to any favouritism.
“The UCI President and the UCI Administration have absolutely no involvement with decisions on TUEs. Insinuating that Brian Cookson’s son’s employment with Team Sky could have something to do with the decision to grant the TUE is an unfounded allegation which will be dealt with seriously.”
Cookson himself communicated on the matter Sunday evening via his Twitter account. “I recognise the legacy I have inherited is an atmosphere of distrust around our sport. You should (and you will) judge me on my actions,” he wrote. “But smears and innuendoes are one thing, and facts are another. UCI and I will be commenting more on this matter over the next few days.”
Attempts to reach the UCI about this subject on Monday were unsuccessful.
Jonathan Lovelock also contributed to this article.