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Mar 11, 2009
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Please could you help me with a question regarding Hematide. Apologies if this has been asked/posted before.

Hematide, an erythropoietin stimulating agent, for the proposed treatment of anaemia associated with chronic renal failure (CRF) is currently non-approved for commercial use. I understand that the drug is at phase 3 (possibly 4) of the development stage for patients with CRF.

Patients with CRF are being tested with Hematide, to see whether the drug can raise and maintain haemoglobin levels, which would be within a range of 10-12 or 11-12 g/dl.

If an athlete with no previous record of CRF, but wanting to artificially increase their red blood cell count use Hematide, what would be the effect on the following: -

a) Hematacrit levels?
b) Haemoglobin levels?
c) Haematological parameters in a blood sample (would they rise, fall or stay at the same level?)

As you already know, the biological passport looks for manipulation of blood through r-EPO use. The first is the Haemoglobin variable of the concentration and percentage of reticulocytes (or immature red blood cells). The second (known as Off Score) takes into account the relationship between haemoglobin and reticulocyte concentration. As reticulocytes tend to decrease when haemoglobin is artificially high, the combination of high haemoglobin and a low reticulocyte raises the off score. I understand that the upper limit for the Off Score is 134.

Therefore, can the use of Hematide cause no change in Haemoglobin variable and Off Score?
Jun 23, 2009
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Should be very similar to CERA, that is, a slow acting EPO that can be dosed once a week or so in renal patients instead of daily.

It should still lift the reticulocyte count, haemoglobin, and 'on' score. It won't show up in the 'off' score (which is more useful for detecting blood transfusions).

So it should still affect the biological passport, maybe not enough for a positive if the rider is smart, but will still identify which riders to target.

I was under the impression CERA still affected the biological passport, but as I said, most users won't show up as a full-blown positive, rather just as a flagged rider. This interview indicated the biol passport team knew CERA was being used in the 2008 Giro by Ricco and co, but they weren't aware other labs had an accredited test for it.