Table 1.
Overview of all substance classes and evidence for performance enhancement
| Substance class | Well-designed studies? | Studies with trained athletes? | Relevant performance parameters showing improvement | No. of trained athletes in studies with relevant performance parameters |
|---|---|---|---|---|
| S0: Non-approved substances | No | NA | NA | NA |
| S1: Anabolic agents | Yes | Yes | Muscle strength when combined with strength training + 10–20% bench-press and squatting power [24] + 12% bench press power [25] + 23% and + 12% elbow flexion and knee extension [26] |
Total: 91 40 [24] 21 [25] 30 [26] |
| S2: Peptide hormones, growth factors, related substances and mimetics | ||||
| Erythropoietin-receptor agonists | Yes | Yes | No evidence for effects on relevant endurance parameters, only on VO2max, maximal power output and time to exhaustion | Total: 161 20 [32] 11 [34] 27 [35] 16 [36] 40 [37] 47 [39] |
| Hypoxia-inducible factor activating agents | No | NA | NA | NA |
| GATA inhibitors | No | NA | NA | NA |
| TGFβ inhibitors | No | NA | NA | NA |
| Innate repair receptor agonists | No | NA | NA | NA |
| Chorionic gonadotrophin and luteinizing hormones and their releasing factors | No | NA | NA | NA |
| Corticotrophins and their releasing factors | Yes | Yes | No | Total: 24 16 [54] 8 [55] |
| Growth hormone, its fragments and releasing factors | Yes | No | Sprint performance + 3.9% Wingate sprint capacity [62] in untrained subjects |
Total: 123 22 [59] 30 [60] 7 [61] 64 untrained [62] |
| Growth factors and growth factor modulators | Yes | No | NA | NA |
| S3: β2-Agonists | Yes | Yes | Peak sprint power, muscle strength + 6% maximal voluntary isometric contraction, + 11% peak twitch force [70] + 8.4% quadriceps muscle strength, + 2.2% and + 3.3% Wingate peak and mean power, + 3% Wingate total work [71] + 4% (single dose) and + 6% (multiple dose) Wingate peak power [72] |
Total: 39 10 [70] 9 [71] 20 [72] |
| S4: Hormone and metabolic modulators | ||||
| Aromatase inhibitors | No | NA | NA | NA |
| Selective estrogen receptor modulators | No | NA | NA | NA |
| Other anti-estrogenic substances | No | NA | NA | NA |
| Agents modifying myostatin function(s) | No | NA | NA | NA |
| Metabolic modulators | No | NA | NA | NA |
| S5: Diuretics and masking agents | Yes | Yes | No | Total: 70 62 [89] 8 [90] |
| S6: Stimulants | Yes | Yes | Muscle strength, sprint performance, 1500 m run time + 9% knee extension strength, + 3% peak Wingate sprint performance [101] 2% decrease 1500 m run time [104] |
Total: 58 9 [97] 22 [101] 9 [102] 11 [103] 7 [104] |
| S7: Narcotics | Yes | Yes | No | Total: 8 8 [105] |
| S8: Cannabinoids | Yes | No | NA | NA |
| S9: Glucocorticoids | Yes | Yes | One-legged hopping force + 11% one-legged hopping maximal force [118] |
Total: 10 10 [118] |
| P1: β-Blockers (prohibited in particular sports) | Yes | Yes | Shooting performance + 13.4% shooting performance [124] |
Total: 33 33 [124] |
NA not applicable, TGF transforming growth factor, VO2max maximal oxygen consumption