The New Era of Performance Enhancing Drugs Lyrics

Research intended to help people with muscle-wasting diseases could be about to launch a new era in performance-enhancing drugs.

The research has produced several muscle-building drugs now being tested in people with medical problems, including muscular dystrophy, cancer and kidney disease. The drugs all work by blocking a substance called myostatin that the body normally produces to keep muscles from getting too big.

It's likely that at least one of the drugs will receive FDA approval in the next few years, researchers say.

"When the myostatin inhibitors come along, they'll be abused," says Carlon Colker, a bodybuilder and a physician in Greenwich, Conn., who works with professional athletes. "There's no question in my mind."

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If myostatin inhibitors do catch on as performance-enhancing drugs, they will become part of a larger trend in sports doping. A decade ago, performance-enhancing drugs often came from rogue chemists in unregulated labs. These days, athletes are using FDA-approved products from major pharmaceutical companies.

Lance Armstrong and many other cyclists relied on the anemia drug known as EPO. Baseball players including Alex Rodriguez of the New York Yankees have been linked to another FDA-approved product, human growth hormone.

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Athletes and bodybuilders have been fascinated by myostatin ever since it was discovered in the 1990s by a researcher at Johns Hopkins named Se-Jin Lee. If you visit Lee's mouse lab, you can see why the discovery got so much attention.

The secured facility is filled with rows of plastic cages containing some very muscular mice. "They look bulked up," he says, and they are. Lee gestures toward the cages on one shelf. "Those mice," he says, "have about twice the muscle mass of normal mice."


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If myostatin drugs do reach the market, they could help tens of thousands of patients with genetic diseases like muscular dystrophy. The drugs also might help a much larger number of people with muscle wasting associated with cancer or kidney disease or even old age.

And myostatin inhibitors could do a lot for otherwise healthy people who simply suffer an injury like a blown-out knee, says Chris Mendias, a researcher who works with orthopedic patients at the University of Michigan.
"We have to put you in a brace. You have to be non-weight-bearing for a time," he says. "The muscle will atrophy. And in a lot of cases as hard as we try, the muscle mass never comes back."


Myostatin appears to contribute to this atrophy, Mendias says. Studies show that levels of the protein rise dramatically when people stop using a particular muscle. And you can see the result in patients who have torn the knee's anterior cruciate ligament.

"It literally looks like the muscle has kind of melted away," he says. "So [we think] that if you used a myostatin inhibitor for a short period that might actually be beneficial in preventing the atrophy later on."

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Another researcher with high hopes for myostatin is physiologist Lee Sweeney, who studies muscle diseases at the University of Pennsylvania. But Sweeney's optimism about new treatments is tempered by his concern about doping.

Sweeney fears that myostatin drugs will become notorious doping agents. Then, he says, doctors may hesitate to prescribe them for legitimate uses, like helping patients with cancer or kidney disease who can no longer walk because they have lost so much muscle.

"The sort of unmet need in all these diseases far outweighs whether somebody wins a bicycle race or a sprinting event because they cheated," he says.

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"EPO is a wonderful drug," says Jerry Avorn. "It does fantastic things to increase the red blood cell count and to treat anemia. And when used appropriately it's one of the best drugs that's been discovered in the last 50 years."

But no one expected this costly and potentially dangerous drug to be used by millions and millions of people, Avorn says.

"When EPO was first approved, it was approved as an orphan drug — a drug that was supposed to be used by under 200,000 people total in the U.S.," he says. "It turned out to be used by enormously greater numbers of people, partly for good reasons, partly for bad reasons."

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So now the question is, will drugs that inhibit myostatin become the next EPO?
"It's possible," says Colker, the physician and bodybuilder. Athletes and bodybuilders are constantly looking to medical research for the next product that will give them an edge, he says. And once a new product is widely used, people start looking for the next new thing.

The doping arms race is a bit like a cartoon, Colker says. "Daffy Duck comes out with a slingshot. And then Bugs Bunny comes back with a bat. And then Daffy Duck goes off and comes back with a gun, and then Bugs Bunny goes off and comes back with a bazooka, and then Daffy Duck goes off and comes back with an Army tank," he says. "It just keeps going and going and going."

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The following is an excerpt from an August 12, 2013 report from NPR regarding a new class of pharmaceuticals, called myostatin inhibitors, which are likely to usher in a new era of performance enhancing drugs after the fruitful years of EPO.

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