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Performance-enhancing drugs pose challenge in endocrinology
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There is a lack of high-quality studies on performing-enhancing drugs because of ethical and societal concerns, posing difficulties to the endocrinologists who encounter the complications of these drugs, according to a statement from The Endocrine Society.
“The use of performance-enhancing drugs (PEDs) is far more prevalent than is generally believed and deserves substantially greater investigation of its medical consequences, mechanisms, prevention and treatment,” Harrison G. Pope Jr., MD, MPH, of McLean Hospital at the Harvard Medical School in Belmont, Mass., and an author of the statement, said in a press release. “Long-term observational studies (registries) to determine the health risks associated with PED use are a public health imperative.”
The statement, however, includes reasons that randomized, prospective studies have not been pursued because the long-term effects of PEDs — such cardiometabolic, neuroendocrine, neuropsychotic, hepatic, musculoskeletal, metabolic and kidney — are well-known and detrimental to the health of users.
“And it’s likely that some of the long-term effects of PEDs will only now start to become visible as the older members of the PED-using population reach the age of risk for these phenomena,” the authors wrote.
The statement covers androgenic-anabolic steroids, human growth hormone and erythropoiesis-stimulating agents, explaining their clinical pharmacology, adverse effects and methods of detection.
“There is a widespread misperception that PED use is safe or that adverse effects are manageable,” Shalender Bhasin, MD, director of the research program in Men’s Health: Aging and Metabolism at the Brigham and Women’s Hospital and chair of the task force that developed the statement, said in a press release. “The truth is, PED use has been linked to increased risk of death and a wide variety of cardiovascular, psychiatric, metabolic, renal and musculoskeletal disorders.”
The task force recommended the establishment of prospective observational cohort studies; epidemiologic surveys to determine the prevalence of PED use in the general population; human and animal studies to determine the mechanisms by which PEDs exert their adverse effects on the health of users; and randomized trials of various therapeutic strategies to treat androgenic-anabolic steroids withdrawal syndrome and to treat the complications of PED use.
Disclosure: The authors report no relevant financial disclosures.
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