EPOwer or PlacEPO?
An interesting recent study published in 2017 by the prestigious scientific journal Lancet Haematology (Effects of erythropoietin on cycling performance of well trained cyclists: a double-blind, randomised, placebo-controlled trial) has generated quite a stir (and embarrassment), calling into question the doping effectiveness of rhEPO on REAL road cycling performances.
All the numerous previous studies had in fact evaluated the effects of rhEPO inside laboratory tests (short incremental tests, mostly).
The Dutch, randomized, double-blind, placebo-controlled study selected 48 mid-level cyclists who would then take part in a 110 km cycling competition (with a total climbing of 1524 m), complemented by the ascent to Mount Ventoux (an additional 20 km or racing with 1690 m of difference in height).
24 cyclists were given rhEPO (epoietin beta) subcutaneously for a period of 8 weeks (on average 6000 IU/week). The other 24 cyclists were injected with a placebo (0.9% NaCl) during the same period prior to the race.
All 48 cyclists took 200 mg of iron fumarate and 50 mg of ascorbic acid, orally per diem.
Therapies and placebo were interrupted 12 days before the competition.
The rhEPO group showed an average increase of 16% in Hct and 12% in Hb; the two values remained unchanged in the placebo group.
On the day of the race the cyclists covered the first 110 km all together in a group, then faced the climb to the top of Ventoux to the best of their ability.
Weather conditions were interesting: a temperature of 20° C at the bottom of the climb and of 5° C at the summit, with strong wind from the north (up to 85 km/h).
4 cyclists (2 of each group) did not finish the race due to physical fatigue.
The average climbing time within the rhEPO group was 1h40'32", while in the Placebo group the average time was 1h40'15".
NO significant difference therefore between the two groups, both having expressed rather remarkable performances, considering the hard route and the strong wind, with a VAM = 1010m/h on average for the climb to Ventoux.
At the end of the competition all the participants were asked if they thought they had been treated with rhEPO or placebo: only 39% of those cyclists treated with rhEPO were able to recognize it (61% of them thought they had been treated with placebo!), while 25% of the placebo group believed they had received rhEPO.
Hb and Hct showed no correlation with the climbing times of the Ventoux.
The rhEPO group showed no side effects superior to placebo administration. Blood pressure, heart rate and coagulation factors were similar among the two groups.
Considering the "five-star doping substance" myth attributed to EPO by the media, anti-doping organizations and the stories of the athletes themselves, it is hard to believe that rhEPO actually has no effect on road cycling performances.
This study, original and well structured, strongly suggests that the possible effect of rhEPO on real road racing performances has been intensely OVERESTIMATED and EXPLOITED over the years, just like the majority of the so-called performance enhancing substances, whose effects have never really been demonstrated by independent studies (i.e. not directly involved in the Fight Against Doping™).