I recently read about the UCI’s decision to strip Davide Rebellin of the silver medal he “won” at the 2008 Olympics in Beijing because he tested positive for CERA. As my kid would say, “big whoop.”
It’s now November of 2009! The race was in August of 2008. What the (heck)? So more than a year later Fabian Cancellara finds out he actually won a silver medal and the bronze medal goes to a guy – Alexander Kolobnev – who never even got the chance to stand on a podium at the Olympics. How is any of this fair?
What is CERA? Why wasn’t there testing done before the race and why did it take them so long to figure out that Rebellin, (Stefan) Schumacher and a bunch of others were doped to the gills when they competed in China?
I have to agree … to a point. It is really unfortunate that testing for CERA wasn’t already in place at the Olympics by the time more than 11,000 athletes rolled into Beijing. It really sucks, in fact.
That said, there is still a degree of justice achieved by the retroactive testing of samples to check for new substances and techniques or to apply new testing methods for old tricks of the trade.
As you probably know, most of us learned about a new test for CERA during the 2008 Tour de France, barely a month in advance of the Beijing Games. The drug – known as a Continuous Erythropoiesis Receptor Activator – was developed by the Swiss pharmaceutical giant Roche. It is generally regarded as the “third generation” of drugs designed to promote the growth of red blood cells in the human body.
Our old friend EPO – first developed and marketed by the U.S. company Amgen – has, of course, had its own impact on endurance sports in general and cycling in particular. While it seems that every time we mention EPO it’s in the context of doping and cheaters, the development of erythropoiesis-stimulating agents (ESAs) marked a medical breakthrough for countless kidney and cancer patients who suffered from the debilitating effects of chronic anemia – a dangerously low level of red blood cells in the body.
That “first generation” of an effective ESA was developed back in the late ‘80s and endurance athletes with normal red-blood-cell (but low moral cell) counts immediately recognized its potential. Since EPO was quite similar to the erythropoietin naturally produced in the body, it was for a while at least, largely undetectable. The UCI and other governing bodies took some steps to control its use by establishing the 50-percent hematocrit level, which did some good in that it kept dopers from jacking up their red blood cell counts to ridiculous – and perhaps fatal – levels. You might recall that 1996 Tour de France winner, Bjarne Riis, was nicknamed “Mr. 60 percent” by some riders in the peloton. (We really doubt that had much to do with the rapid growth of his investment portfolio, even in those halcyon days of the 1990s economy.)
So, we finally flash forward to 2000 when researchers at the France’s Laboratoire National de Depistage du Dopage (LNDD), at Châtenay-Malabry, developed the first direct method of detecting EPO isoforms in urine samples. By then, of course, the doping crowd had its eyes pointed elsewhere and a new drug, Darbepoetin (Aranesp), was making its way onto the market in Europe. Well, that “second generation” drug didn’t last too long in sports circles, because a few cross-country skiers at the 2002 Winter Games in Salt Lake City found that the drug wasn’t quite as undetectable as they thought. D’oh!!!!
So driven solely by their overwhelming interest in the advancement of science, we’re sure, coaches, doctors and athletes began to scour research journals for new developments in the field of anemia management. Word was already getting out that Roche was in the process of developing its own version of an ESA, but one with a twist. Marketed under the trade name Mircera, the drug required fewer injections (13 or so over the course of a year, as opposed to more than 100) to increase and then maintain higher hemoglobin levels. It was approved for use by the European Commission in September of 2007 and received FDA approval here in the U.S. in November of that year. (While available in Europe, Mircera is still not for sale in the U.S. because of a patent dispute with Amgen.)
Anyway, so now that the drug was available, the “smart” guys in the peloton figured that since it was new, it was also undetectable for the foreseeable future. The cool thing, though, was that the manufacturer had actually been contacted by researchers at the LNDD and they cooperated in designing test protocols while the drug was still in development. We – and Ricardo Riccò – learned of the test on the morning of July 17, 2008, about an hour before the start of the 12th stage of the Tour de France. D’oh!!!!
It later turned out that his teammate, Leonardo Piepoli, also had made assumptions about the efficacy of testing. Double D’oh!!!! We have, of course, learned that other riders – including Bernhard Kohl, the man who had apparently won the KOM jersey – tested positive for the same drug. We’re happy to have heard that Roche lent a hand in the development of testing protocols. We’re just a little disappointed that the LNDD, the UCI, WADA and the IOC weren’t all on the same page when it came to prepping for the Olympics.
Now look back at the calendar for 2008. The CERA test was revealed at the Tour on July 17. The Olympic road race was less than a month later on August 9. Should the International Olympic Committee and its anti-doping program have had a CERA test in place in time for the Beijing Games? In retrospect, yes. Should the failure to have done so given Rebellin, Schumacher and others a free pass? No way.
Christiane Ayotte, the director of the anti-doping laboratory in Montreal and a respected member of the WADA testing commission said that she had no real explanation for why there was no CERA test in place in Beijing. She also noted that WADA rules have established an eight-year statute of limitations, meaning that samples can be re-tested at any time within that limit and sanctions can be imposed retroactively if the results turn up positive.
As we said, there were more than 11,000 athletes participating in the Beijing Games. There were nearly 5,000 blood and urine samples taken at the Olympics in 2008 and, for better or for worse, it wasn’t until October that the IOC decided to re-examine some of the 970+ blood samples for evidence of CERA.
What bothers us about the whole thing is that the testing then took until April of 2009 to complete. It was then another seven months before the IOC ruled that those who were caught should be stripped of their medals. Sure, the wheels of justice turn slowly and the accused do have rights that need to be protected, but compare that to the treatment handed out to Spanish cyclist Maria Isobel Moreno, who tripped the Dopo-meter for EPO before she even got settled into her room at the Olympic village. She was gone before she had a chance to even toe the line. Sure, it’s great if she’s guilty and odds are that she probably was, but it seems a bit different than the protections afforded Rebellin and ol’ “Schumy,” whose penalties came more than 15 months after they cheated.
Anyway, slow or not, the Rebellin, Riccò, Kohl et. al. CERA story may have an important lesson for other “cutting edge” dopers in the future, namely that the lab guys are reading the same journals you are. In case you’re wondering, there is progress being made in the development of a “fourth generation” ESA. This time, it’s a California company working on the development of a synthetic peptide-based ESA and, yes, a spokesman for the company says it’s already been working with WADA to develop new testing protocols. D’oh!