Academic study claims no evidence that EPO boosts performance of elite cyclists

Notion that EPO helps win races "rather naïve," says academic... but what if everyone else is on it?

by Simon_MacMichael   December 6, 2012  

Syringe

A new study analysing existing research on EPO claim that there is no evidence that it boosts performance among elite cylists, with the academic who led the study saying that believing a rider could win races solely as a result of taking the banned substance as “rather naïve.”

The startling assertion is made in a study published in the British Journal of Pharmacology, which is based on the findings of 13 previous studies carried out between 1991 and 2010, reports Bloomberg Business Week.

It comes at a time when EPO use within the peloton has once again been under the spotlight as a result of the United States Anti-Doping Agency’s investigation that resulted in Lance Armstrong being banned from sport for life and stripped of the seven Tour de France titles he won between 1999 and 2005.

The study’s authors, led by Adam Cohen, professor in clinical pharmacology at the Centre for Human Drug Research in Leiden, state that there is “no scientific evidence that it does enhance performance, but there is evidence that using it in sport could place a user’s health and life at risk.”

Banned by the International Olympic Committee in 1990, although a test for the substance was only introduced at the 2000 Olympic Games in Sydney, EPO – in full, erythropoietin – boosts the production of red blood cells within the body, which in turn can help boost the supply of oxygen to muscles.

The drug has been at the centre of a succession of doping scandals within cycling from the Festina affair of 1998 onwards, and suggestions that there is no proof that it has an effect on a rider’s performance is bound to be treated with scepticism within the sport and among anti-doping agencies.

“An elite cyclist runs on technique, on muscle power which is supplied by oxygen and glucose and amino acids and foods, on team tactics, on weather, on millions of things,” insisted Cohen. “To assume that one of these factors, which is delivery of oxygen to tissue, is going to clinch the whole thing, is rather naïve.”

To an extent, he has a point. Taking EPO isn’t going to turn a Monday to Friday commuter into a Tour de France winner. But he also acknowledges that “most of the research has been done on people who aren’t actually elite cyclists.”

He went on: “If you assume that Mr. X. was actually a mediocre cyclist and became very good just by injecting stuff, that seems premature. Once you start explaining that to people, and they believe you on the basis of data, they are probably less willing to do these sorts of things.

“So in the prevention, it is better than trying to chase these people to their homes, extract urine at unexpected moments and hope that you find something. It costs an enormous amount of money.”

The big question that doesn’t appear to have been addressed is whether it can make a difference to the performance of two top cyclists of equal ability. There’s plenty of examples of riders, not least those who provided evidence to USADA, insisting that EPO did make a difference.

To put it another way that several of those USADA witnesses touched upon - if everyone else is taking it, the rider who isn't will be at a disadvantage.

26 user comments

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Without being a huge tit, who is suggesting that EPO use is the sole reason for anyone winning races?

posted by hoski [61 posts]
6th December 2012 - 13:39

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The reason Lance won over other EPO users is that he trained harder, was more driven and had a superb team who were (some of them) also on EPO. Yes it wasn't the EPO alone but could he have won 7 tours given every other factor in his favour but no EPO use. I would suggest not, at least not all of the 7.

This seems to be yet another scientific report that states the bleeding obvious. Hey and I have been a scientist/technologist all my working life so I haven't got an axe to grind of the "typical scientists" bent.

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posted by bikeandy61 [361 posts]
6th December 2012 - 13:49

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Good points both. You do have to wonder exactly who is being "rather naive."

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posted by Simon_MacMichael [7480 posts]
6th December 2012 - 14:03

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You have to question the politics of this report/announcement.

We know that EPO on its own doesn't transform a mediocre athlete into a superhero. But in the world of elite competition, marginal gains make all the difference. So a team who are all boosting their red cell production by taking EPO illegally could quite conceivably be at an advantage, all other things being equal.

posted by Campag_10 [153 posts]
6th December 2012 - 14:13

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From reading the USADA evidence and a few other things, then here is a postulate ( Smile )

Given a max haemocrit of 50% (doping control limit), which can be reached naturally, then the use of synthetic EPO by a rider with a high hameocrit would be pointless. However if the haemocrit drops then EPO can help to boost it again, thereby allowing a rider to peak more often and for longer during a season. Assuming haemocrit is a valid measure of the effect of EPO and a valid indicator of blood oxygen transport capability, and assuming blood oxygen transport capability is a good indicator of a rider's physical fitness.

If all of that is true then the difference between a doping rider and a rider who uses legal boosting methods such as hyperbaric chambers and the like, as well as being monitored by his team and prepared optimally for specific races is unlikely to be very much at all on a given day. In fact a rider who relies on EPO may be worse. Over a grand tour however use of testosterone. EPO, HGH, transfusions etc seem to aid recovery and may well provide an edge, not on headline performance but on ability to maintain a higher level than otherwise possible.
Look at say Vino's stage win when he was busted for blood doping in the Tour. Hands up anyone who saw Kloeden pulling him up the previous stage and didn't wonder. Same with Floyd Landis, one bad day followed by perfect performance the next.

Anyone know if there's any data on clean riders being good in Classics, especially when they don't race all of them? Could be interesting to see if the Classics are a better target for a clean rider historically which would support the above hypothesising.

posted by robdaykin [153 posts]
6th December 2012 - 14:39

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Let's get one thing straight, there is nothing marginal about the gain derived by a full-time athlete taking EPO. This report is a load of bullsh*t, made up by some bullsh*t pseudo-scientist who thinks that testing 100 fat tea-ladies half of whom are on the juice and half of whom aren't, is relevant to people who are all at the extreme edge of what is physically possible. Probably if one of the tea-ladies or fat kids he tested had had 1 less Big Mac meal on the morning of the test it would have made more difference to their ability, true. But that does not make the results applicable to sportsmen and women. Do you know how many illness' and conditions we have managed to cure in rats and mice and yet how few of the results are applicable to humans? Same thing. Why are we even giving this jockey the time of day.

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posted by theclaw [75 posts]
6th December 2012 - 14:47

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robdaykin wrote:
From reading the USADA evidence and a few other things, then here is a postulate ( Smile )

Given a max haemocrit of 50% (doping control limit), which can be reached naturally, then the use of synthetic EPO by a rider with a high hameocrit would be pointless. However if the haemocrit drops then EPO can help to boost it again, thereby allowing a rider to peak more often and for longer during a season. Assuming haemocrit is a valid measure of the effect of EPO and a valid indicator of blood oxygen transport capability, and assuming blood oxygen transport capability is a good indicator of a rider's physical fitness.

If all of that is true then the difference between a doping rider and a rider who uses legal boosting methods such as hyperbaric chambers and the like, as well as being monitored by his team and prepared optimally for specific races is unlikely to be very much at all on a given day. In fact a rider who relies on EPO may be worse. Over a grand tour however use of testosterone. EPO, HGH, transfusions etc seem to aid recovery and may well provide an edge, not on headline performance but on ability to maintain a higher level than otherwise possible.
Look at say Vino's stage win when he was busted for blood doping in the Tour. Hands up anyone who saw Kloeden pulling him up the previous stage and didn't wonder. Same with Floyd Landis, one bad day followed by perfect performance the next.

Anyone know if there's any data on clean riders being good in Classics, especially when they don't race all of them? Could be interesting to see if the Classics are a better target for a clean rider historically which would support the above hypothesising.

What may be interesting is to find the top riders VAM figures for a Tour climb, when climbed 'stand alone'. It's clear that these figures have dropped dramatically in the GT's since the heyday of EPO.
Having said that, if you look outside cycling at athletics, you'll see a whole cluster of WR/close to WR times in the distance events from that era. Those are 'one day' performances, so you'd have to think that the conclusions of this study are erroneous (and that cycling gets a bad rap when it comes to doping).

posted by pwake [237 posts]
6th December 2012 - 15:02

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No, the study says that there is no EVIDENCE, not that there is no effect.

It simply says that nobody has conducted a SCIENTIFIC study on the effects of EPO on elite athletes undergoing elite level exercise stress, no surprise there.

The headline is somewhat misleading.

posted by mythbuster [31 posts]
6th December 2012 - 15:08

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Rollocks! It's a fact, blood doping and blood transfusions work, Viren the athlete proved it beyond doubt when it wasn't illegal and he's the reason it is illegal.

antonio

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posted by antonio [899 posts]
6th December 2012 - 15:12

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theclaw is smack on the money!

Tripod16

posted by Tripod16 [107 posts]
6th December 2012 - 15:37

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theclaw is spot on. Typical scientific view that does not apply to the real world.

Yes if an EPO juiced tour winning rider was on a 12" kids trike, infected with the ebola virus, had lead weights in his shoes and his tadger tied to the spokes then clearly he would not beat a clean 3rd cat rider up a mountain......but that really does not require a scientific study.

nob jockey in lab coat.

posted by Simmo72 [210 posts]
6th December 2012 - 16:09

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“Most of the research has been done on people who aren’t actually elite cyclists,” Cohen said so to use a statistics term there is no direct correlation between the results and elite cyclists so why mention them?

Paul W

posted by PaulVWatts [111 posts]
6th December 2012 - 16:17

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theclaw wrote:
Let's get one thing straight, there is nothing marginal about the gain derived by a full-time athlete taking EPO. This report is a load of bullsh*t, made up by some bullsh*t pseudo-scientist who thinks that testing 100 fat tea-ladies half of whom are on the juice and half of whom aren't, is relevant to people who are all at the extreme edge of what is physically possible. Probably if one of the tea-ladies or fat kids he tested had had 1 less Big Mac meal on the morning of the test it would have made more difference to their ability, true. But that does not make the results applicable to sportsmen and women. Do you know how many illness' and conditions we have managed to cure in rats and mice and yet how few of the results are applicable to humans? Same thing. Why are we even giving this jockey the time of day.

I'm not sure I totally agree, but you did make me laugh.

Smile

The bit about fat tea ladies is particularly good.

OldRidgeback

posted by OldRidgeback [1941 posts]
6th December 2012 - 16:31

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I was involved in peer reviewing a paper looking at the effects of EPO on an inflammatory Optic Neuritis dues to Multiple Sclerosis. Nobody got my "we should tap up the US Postal team from the late 90's as controls - pretty sure they arent so busy now" comment Sad

There are a million factors involved in winning on a bike. If you have a level playing field (as much as individual genetics/kit/training can allow) then the simple fact is that doping can give you the 1% benefit when you most need it. There is a huge amount, of course about the placebo effect of jabbing yourself with something that you are told will make you last longer at your threshold. The mind is our biggest weapon.

Right, back to my "pseudo sceince" im afraid, these mouse brains arent going to dissect themselves (JOKE!)

posted by jonnycondor [6 posts]
6th December 2012 - 18:23

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theclaw wrote:
Let's get one thing straight, there is nothing marginal about the gain derived by a full-time athlete taking EPO. This report is a load of bullsh*t, made up by some bullsh*t pseudo-scientist who thinks that testing 100 fat tea-ladies half of whom are on the juice and half of whom aren't, is relevant to people who are all at the extreme edge of what is physically possible. Probably if one of the tea-ladies or fat kids he tested had had 1 less Big Mac meal on the morning of the test it would have made more difference to their ability, true. But that does not make the results applicable to sportsmen and women. Do you know how many illness' and conditions we have managed to cure in rats and mice and yet how few of the results are applicable to humans? Same thing. Why are we even giving this jockey the time of day.

I'd like to defend the scientist involved in this study from the point of view of someone who currently works in research

For starters I'd go easy on the pseudo scientist part theclaw, Adam Cohen is a professor at pretty influential research institute in holland and the report is published in the British Journal of Pharmacology which is peer reviewed by other scientists.

Whats at fault here isn't so much the science being done (its pretty common to do a meta study where you combine data from several large studies) but rather the media interpretation of something said in the report.

He's entirely fair to say that EPO alone cant win you a tour and to think that would be naive (I think everybody would agree on that). He's also entirely fair to say that there is currently no evidence that proves EPO boosts performance in elite athletes (as several people have pointed out, the studies are done mostly done on individuals who are not elite athletes). If you read either the report or the bloomberg article, you'll notice that he actually calls for more research on the effects of EPO on elite athletes.

Whats happening here is a fairly typical example of a researcher setting up the background for his next line of research. Do a study, show that the research you want to do needs doing, and then try and sell that to a funding body. Having this data published should, in theory, make it easier for him to get the grant money. You can object all you want to this but its how evidence based research works, you actually cant go round saying something is true if there isn't any properly controlled lab based research to back it up, no matter how much anecdotal evidence there is.

To be fair, as there isn't much published showing the effects on elite athletes, he is actually right to question it, and by doing a proper trial you could measure the physiological effects and benefits of EPO usage, gaining valuable data to make the biological passport testing more secure.

Anyway, sorry to rant but, but genuine science getting jumped on and sensationalised by the media really hacks me off.

Oh and if anybody wants to actually read the report in context without all the media bollocks layered on top the feel free to get the summary here.

http://onlinelibrary.wiley.com/doi/10.1111/bcp.12034/abstract

posted by edf242 [36 posts]
6th December 2012 - 18:39

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Seems to revolve around one's view of what is evidence.

onward ever onward

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posted by bikecellar [218 posts]
6th December 2012 - 18:50

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We should ask the doping 'pentiti' what kind of edge EPO gave them. Tyler, Floyd, David, Jonathan et al, over to you.

posted by izzi green [12 posts]
6th December 2012 - 19:42

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applause for edf242 from a fellow researcher. Unfortunately the tabloid version always wins with the masses...

posted by andyp [633 posts]
6th December 2012 - 20:06

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Unfortunately this will now be seized on by Lance Armstrong and his apologists. The fact is that the USADA evidence shows he used it religiously knowing it was illegal and lying about his use. Effective or non-effective his attitude to EPO was that of a liar and a cheat.

posted by LeDomestique [34 posts]
6th December 2012 - 20:26

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Who was the report commissioned by - Hein Verbruggen?

Make mine an Italian with Campagnolo on the side

posted by monty dog [343 posts]
6th December 2012 - 20:43

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NEWS FLASH: New Study says that being fit won't guarantee that you'll marry a British prince.

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posted by pedalpowerDC [188 posts]
6th December 2012 - 21:44

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Two things jump out of the article and comments for me:

1. maybe the coverage has skewed the actual report, but I'm not surprised that there isn't any evidence that EPO boosts the performance of elite cyclists if no-one has actually looked for any evidence amongst that group - as others have said, they seem to have used a random collection of punters instead; and

2. in relation to the difference between an athlete with a naturally high haematocrit level and one who is juicing, I understood that one of the benefits of EPO for elite cycling is that it helps to keep haematocrit levels constant when they would otherwise drop fairly markedly during the course of a 3 week grand tour.

posted by Sadly Biggins [261 posts]
7th December 2012 - 11:41

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How on earth are they going to do studies on the effect of EPO on elite athletes? Any elite athlete taking it will be immediately banned?

Boardman CX Team '14 | Cannondale CAAD8 '12 (written off, SMIDSY) | Scott Sportster '08

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posted by Gizmo_ [642 posts]
7th December 2012 - 12:17

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In cycling alone there's a few recently retired candidates for this, I'm sure I don't need to name names....Assuming they've not just hit the cream cakes straight off. I'm sure some of them would be keen to partake in such a study to help cycling long term.
Plus you need a control group not taking EPO, and there's supposed to be lots of those...

posted by robdaykin [153 posts]
7th December 2012 - 12:29

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Simmo72 wrote:
Yes if an EPO juiced tour winning rider was on a 12" kids trike, infected with the ebola virus, had lead weights in his shoes and his tadger tied to the spokes then clearly he would not beat a clean 3rd cat rider up a mountain......but that really does not require a scientific study.

You're right, it doesn't require a scientific study, but I would love to see it carried out!

Now if I can just secure the funding....

posted by lows100 [21 posts]
7th December 2012 - 21:36

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pedalpowerDC wrote:
NEWS FLASH: New Study says that being fit won't guarantee that you'll marry a British prince.

This made me laugh. Sounds like a headline from the Daily Mash

posted by Rvizzle [97 posts]
10th December 2012 - 10:57

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