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October 3, 1990

The Abuse of Erythropoietin to Enhance Athletic Performance

JAMA. 1990;264(13):1660. doi:10.1001/jama.1990.03450130030017

To the Editor.—  Epoetin is a recombinant DNA-derived preparation of the human hematopoietic hormone erythropoietin, which stimulates production of red blood cells from bone marrow progenitors.1 Epoetin is indicated for treating the anemia of chronic renal failure. It is also under investigation as therapy for other anemias. The Council on Scientific Affairs has been asked to respond to recent accounts that describe the misuse of epoetin by endurance athletes who seek to increase the oxygen-carrying capacity of the blood and thus to enhance performance (Business Week. December 1989:123).2,3 The American Medical Association opposes the use of drugs to enhance athletic performance or to sustain athletic achievement,4 which clearly includes the abuse of epoetin as an alternative to erythrocyte reinfusion, or "blood doping."In patients given epoetin for anemia, hematocrit and blood pressure must be monitored frequently to adjust dosage and frequency and thus avoid toxic reactions. Hematocrits above