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All About Salbutamol

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What will the verdict in Froome's salbutamol case?

He will be cleared
43
34%
3 month ban
4
3%
6 month ban
15
12%
9 month ban
24
19%
1 year ban
16
13%
2 year ban
21
17%
4 year ban
3
2%
 
Total votes : 126

Re: All About Salbutamol

08 Jul 2018 07:09

The enigma of inhaled salbutamol and sport: unresolved after 45 years was one of the first things I read on Froome's 'cas'e that really convinced me WADA threshold is simply not fit for purpose.
I assume it formed the core of Fitch's statement/report for Froomes defence anyway given it was submitted Jan 2017 so long before Froome's AFF. I assume carries no bias anyway other than Fitch believes WADA rules are flawed for the last 11 years.
It's interesting that WADA's own Physician Guildelines for Asthma even reference this paper too.
https://www.wada-ama.org/sites/default/files/resources/files/tpg_-_asthma_-_version_6.0_-_december_2017.pdf
samhocking
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Re:

08 Jul 2018 07:42

topcat wrote:We didn't ask you Sam. It has been an unbelievable sequence of events. We were already skeptical about CF. We're more skeptical now.
1. Did wada take CF's word on what doses of Sal he took during each of the stages?
2. We need to see the data, the 'unpublished research' to see if it stands up or not.
3. It appears wada did not want a lengthy expensive legal case.
4. From what we know so far it's extremely likely he exceeded the maximum allowable dose and should have been punished.


It sounds like glaxo's pharmocology director took Froomes inhalation record throughout La Vuelta, took his known urine specific gravity from each days WADA sample, ran it through various virtual simulations on what one can only imagine is bespoke glaxo supecomputer/simulations and proved statistically that Froomes own statement of how many puffs he said he took caused the AAF actually triggered up to 10% false positives during the period he was using maximum allowed dose.

There's clearly little research that simulates salbutomol use in a grand tour over 3 weeks with all the other physiological events that are going on in the body and with nutrition and whatever interaction there might have been with Froomes antibiotics at that time. It would seem simply, Fitch has proved why the urine test is flawed and WADA have publicly accepted that now and glaxo have demonstrated it flawed with Froomes own data and medical record.

Given WADA's recent comments they've finally accepted that a PCKS study is not practical in asserting that salbutamol levels in urine at above its permitted limit are consistent with inhalation at below its limit due to the testing's false premise, it would seem that what Fitch told them in 2007 is part of their decision making before Froome's case, for AAFs, even though the rules are not yet written that way explicitly. As Rabin says, Froomes case has happened before and they are well aware the PCKS is not workable for every case, but because it is Froome and because it was leaked, it now seems to be a unique case with Froome. The only thing unique, is Froome's was leaked and no other salbutomol cases like it have been, they all got resolved privately as it should and are not part of any AAF statistics that would have to be confirmed AAFs, not presumed ones.
samhocking
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08 Jul 2018 08:50

For Pettachi fans, not sure if this has been published. But this is one of Fitch's case studies off the Enigma paper. Also says Pettachi had documented asthma and a positive methacholine challenge in 2005 which is a test to determine how reactive or responsive your lungs are to things in the environment.

A 33-year-old cyclist with documented asthma and a positive methacholine challenge in 2005 won five stage s of the 2007 Giro d’Italia and was tested post-race on each occasion. After stage 11 that took more than five hours in hot humid conditions, his urinary SG was reported as 1.033 and the concentration of salbutamol reported as 1352 ng/mL with an expanded uncertainty of 45 ng/mL(Table 2). Recently, he had ceased an extemporaneously prepared betamethasone solution prescribed for him to be administered by inhalation as he considered it was ineffective. From information provided, it probably was of limited if any benefit.
Image
samhocking
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08 Jul 2018 10:30

1. There is an official record of the amount of Salbutomol that CF excreted after each of the stages.
2. We have Sky's version of how much CF inhaled (assuming he didn't take it illegally) each day.
3. It would have been easy for Sky to invent a list of values inhaled each day which would then imply there was huge variance in the excreted values.
4. This huge variance then implies the 10% chance of a false positive.
5. Unless a detailed scientific explanation is released, the whole process stinks.
topcat
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08 Jul 2018 10:46

I don't think it does at all. The leak at such an early stage of results management against the very low pre-existing opinion of Sky has simply distorted opinion. I agree more data needs to come out to confirm WADA's 27 other cases like Froome's they now have though. This is the thing, if that's true, there are 27 others cases like Froomes that support the theory of simple distorted opinion due to the leak coming so early in the process.

As more an more people come forward and more facts come out, everything seems to suggest a serious flaw in how 'positives' are decided for Salbutomol over long periods of time at maximum and high allowed doses.

The problem with demanding transparency is you then enable dopers. The best we can hope for is semi-transparency where anything of use to dopers gets omitted, but then that will generate more speculation and doubt. It's not winnable by anywone to want transparency, it does not work like that in anti-doping because it just can't.
samhocking
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Re: All About Salbutamol

08 Jul 2018 10:53

Mamil wrote:GSK are notoriously corrupt and unscrupulous. I wouldn't be pushing anything they do as an example of virtuous, impartial involvement in the case.

Learning that they played a part makes me more suspicious of how Froome got off, not less.


Daren Austin is a really keen amateur cyclist. It would seem, he probably offered his services to Froome for free perhaps? Remember Froome, British Cycling & Team Sky all have worked at GSK's Human Performance Lab, so the relationship already existed for 20 years or so.
samhocking
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08 Jul 2018 13:46

https://twitter.com/Huyskens/status/1015919187653545985

Dylan van Baarle van Team Sky zegt zojuist op @NPORadio1 dat hij ook salbutamol-pufjes gebruikt. Omdat de longen van een wielrenner zwaar belast worden. NIET omdat 'ie astma heeft dus...

Dylan van Baarle from Team Sky just said @NPORadio1 that he also used salbutamol-puffs. Because the lungs of a cyclist are heavily taxed. Not because ' IE has asthma so...



So Sky use it as a PED.

Claudio Corti, who was DS at Barloworld, said Froome did not have asthma and had no power.

Not hard to see the doping, really, it isn't.
User avatar Benotti69
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Re: All About Salbutamol

08 Jul 2018 14:27

Been used like this in peloton for years, same as every team uses flumicil too. Crikey we used to have a couple of puffs off mates inhaler coming off a crit in the morning and RR in afternoon and chest is fubar. It's hardly dopeing lol!
samhocking
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08 Jul 2018 14:47

Hardly doping? but when you are taking 500% more than the average asthma user it is doping. It is doping when you dont have asthma. It is a lot more than a few puffs. This stuff is not being puffed. It is taken orally or injected along with other stuff no doubt.

If you are going to lie about being asthmatic, what else are you lying about!
User avatar Benotti69
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Re:

08 Jul 2018 16:09

Benotti69 wrote:https://twitter.com/Huyskens/status/1015919187653545985

Dylan van Baarle van Team Sky zegt zojuist op @NPORadio1 dat hij ook salbutamol-pufjes gebruikt. Omdat de longen van een wielrenner zwaar belast worden. NIET omdat 'ie astma heeft dus...

Dylan van Baarle from Team Sky just said @NPORadio1 that he also used salbutamol-puffs. Because the lungs of a cyclist are heavily taxed. Not because ' IE has asthma so...



So Sky use it as a PED.

Claudio Corti, who was DS at Barloworld, said Froome did not have asthma and had no power.

Not hard to see the doping, really, it isn't.


Van barle has tweeted a different story.

https://twitter.com/DylanvanBaarle/status/1015977904025501696
I’m using the salbutamol because I have exercise induced asthma. Since I’m 10 years old I use my inhaler only when I’m exercising.


Sky are obviously as big into controlling the message as public strategies were for Armstrong.

:D
User avatar Benotti69
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08 Jul 2018 16:17

Fitch’s two papers (there was another on asthma that was relevant) were discussed on this thread a long time ago. There’s nothing in them that makes a case against the salbutamol limit that wasn’t well known to WADA—a few cases of athletes exceeding the limit, and a couple of studies showing great variability. I dissected his claims on this thread at that time. The notion that this destroys the old salbutamol level is way over the top. As I said before, out of maybe 10-15,000 tests of asthmatic athletes per year, there appear to be only half a dozen who exceed the limit without a TUE and aren't exonerated. There's no reason to think those half a dozen were not in fact doping.

I’m not going to go into details on simulations, particularly since I don’t know exactly what they did. I will say that the simplest type of simulation that could have been run was probably one in which various salbutamol doses were associated with various urine levels with weighted probabilities. E.g., 100 ug would have, say, 20% chance of returning 50 ng/ml, 30% chance of 100 ng/ml, and so on. This would assume the sample was given a certain time after inhalation. For other times, for multiple doses at different times, and for urination in between dose and sample, the weights would have to be adjusted to different values. Presumably the effect of inhaling one day on the next day was also accounted for.

But there are all kinds of problems with this. Even if you trust that Froome not only knows how much he took every day, and when, and is honest about it (he could definitely have an interest not to be) there is going to be a large error or uncertainty in assigning these weights, particularly with the relatively small number available from the Vuelta (twenty or so is not a lot, given that each one would have different conditions associated with it, which would have to be factored in, resulting in more uncertainty). When you run the simulation, to determine the probability that a high dose exceeds the limit, these cumulative uncertainties would probably make it fairly easy to exceed the limit just by manipulating the weights a little. There is much, much more to this than I can say here, but again, unless/until I see what they actually did, not much point in discussing it further.

What Froome’s team was trying to do, in other words, is turn this into a passport case, where a baseline is created based on the rider’s own previous values, then estimate the odds that his values in one questionable sample exceeded certain limits above that baseline. This is a good strategy, because the passport probably catches even fewer dopers than the EPO test does. But there are several complicating factors applying this to salbutamol cases that don’t exist in a passport case.

Obviously, every scientific advisor says his client has been proven innocent. Floyd’s thought he should have gotten off. Do you think Contador’s team (which included Martin) didn’t think they had proven it was meat? If we’re going by what’s reported in the media, it’s also been reported that the decision to drop the case was not made by Rabin, but from higher up. They no doubt realized that even if they won at the Tribunal, the case would have been appealed to CAS, meaning more time and more money. All for maybe a nine month’s suspension, and all the time the case was dragging out, Froome in the Tour was a huge problem.

Did WADA’s own scientific experts think they should have dropped the case? I haven’t heard that they did. This sounds like when the feds initially dropped their case against LA, and all the lawyers who actually worked on the case were appalled.
Merckx index
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08 Jul 2018 18:21

You still haven't learned the difference between Salbutamol and Clenbuterol? For all we know his advisors could have invented the perpetuum mobile and it wouldn't have gotten him off.
hazaran
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08 Jul 2018 19:34

The Times of London has 2 seperate articles on Froome giving different information about his Salbutamol intake.

One article claims Froome never exceeded 8 puffs a day.

https://ton.twitter.com/1.1/ton/data/dm/1016041138678128644/1016041078061924352/lcbF3J-j.jpg:large


The other claims he was taking it up to 10 times a day.


https://ton.twitter.com/1.1/ton/data/dm/1016041359659192327/1016041322174730242/e0RBhtUb.jpg:large

So much misinformation out there, and that appears to be part of Sky's mantra. Keep people guessing and misinformed.

Sky do not want anyone looking at the big picture. How did this guy from the Grupetto get to be the biggest modern day cycling star? A guy who stares at his screen and crashes lots is leaving everyone behind while apparently being a walking hospital patient.
User avatar Benotti69
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08 Jul 2018 19:58

As an aside - from 2017 - Inhalers raise an asthma patient's risk of pneumonia hospitalisation by 83%
http://www.dailymail.co.uk/health/article-4429066/Asthma-inhalers-cause-pneumonia.html
"Are you going to believe me or what you see with your own eyes?"

“It doesn’t matter what I do. People need to hear what I have to say. There’s no one else who can say what I can say. It doesn’t matter what I live.”
User avatar Robert5091
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08 Jul 2018 21:00

In this interview published in february 2018, Van Baarle said the he was already using Salbutamol before he joined Sky. At the radio, it wasn't a scoop.

https://www.nrc.nl/nieuws/2018/02/23/ik-voel-me-nog-net-geen-koning-a1593446
CTQ
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Re:

08 Jul 2018 22:34

CTQ wrote:In this interview published in february 2018, Van Baarle said the he was already using Salbutamol before he joined Sky. At the radio, it wasn't a scoop.

https://www.nrc.nl/nieuws/2018/02/23/ik-voel-me-nog-net-geen-koning-a1593446


Vaughters silence again another red flag.
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Re: Re:

08 Jul 2018 22:46

Benotti69 wrote:
CTQ wrote:In this interview published in february 2018, Van Baarle said the he was already using Salbutamol before he joined Sky. At the radio, it wasn't a scoop.

https://www.nrc.nl/nieuws/2018/02/23/ik-voel-me-nog-net-geen-koning-a1593446


Vaughters silence again another red flag.



not really, listen this podcast, he said that he had riders who use it.

https://twitter.com/cycling_podcast/status/1014577946651226117
CTQ
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Re: Re:

08 Jul 2018 22:51

CTQ wrote:
Benotti69 wrote:
CTQ wrote:In this interview published in february 2018, Van Baarle said the he was already using Salbutamol before he joined Sky. At the radio, it wasn't a scoop.

https://www.nrc.nl/nieuws/2018/02/23/ik-voel-me-nog-net-geen-koning-a1593446


Vaughters silence again another red flag.



not really, listen this podcast, he said that he had riders who use it.

https://twitter.com/cycling_podcast/status/1014577946651226117


Did he ask them to produce evdence from GPs they had it from an early age or did he look them in the eye....
User avatar Benotti69
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Re: Re:

09 Jul 2018 02:06

Benotti69 wrote:
CTQ wrote:
Benotti69 wrote:
CTQ wrote:In this interview published in february 2018, Van Baarle said the he was already using Salbutamol before he joined Sky. At the radio, it wasn't a scoop.

https://www.nrc.nl/nieuws/2018/02/23/ik-voel-me-nog-net-geen-koning-a1593446


Vaughters silence again another red flag.



not really, listen this podcast, he said that he had riders who use it.

https://twitter.com/cycling_podcast/status/1014577946651226117


Did he ask them to produce evdence from GPs they had it from an early age or did he look them in the eye....


do the effort to listen yourself if ever you are really interested by the answers
CTQ
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09 Jul 2018 09:10

If we go with what Van Baarle reports we can be pretty sure that Dawg continued routine Salbutamol
without asthmatic symptoms during the Giro as well as the Vuelta.

One might have thought Sky might have cut back - but no?
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