Poster 390: Systematic Review of SARMs Abuse in Athletes

Objectives: Selective Androgen Receptor Modulators (SARMs) are small-molecule compounds that exert agonist and antagonist effects on androgen receptors in a tissue-specific fashion. SARMs not FDA approved the USA, but readily available for purchase online. Increasingly, athletes have turned to recent years as means of augmenting lean muscle mass, evidenced by positive tests across multiple athletic organizations including NFL, NBA, UFC, NCAA, Olympics. The safety anabolic has been established, case reports associate with deleterious effects, drug-induced liver injury (DILI), myocarditis, tendon rupture. purpose this novel systematic review is provide comprehensive synthesis literature, order help sports medicine clinicians understand clinical treatment protocols, banned substance implications, potential contamination athlete-consumed SARMs. Methods: A English-language literature from PubMed, Cochrane, Embase was performed according PRISMA guidelines. Articles relevant outcomes, reports, profiles, doping control were included. Reviews, meta-analyses, editorials, conference abstracts excluded. Ostarine (Enobosarm, GTx-027, MK-2886, S-22), Ligandrol (LGD- 4033, VK5211), RAD-140 (Testolone), Andarine (S-4, GTx-007) primary focus, given reported widespread recreational abuse these specific Results: search yielded 1382 abstracts, total 23 articles 2011 2022 identified inclusion. Three five trials significant increases body mass (LBM) (Table 1). Five studies drug testing screening methods designed human-use 2). liquid chromatography tandem spectrometry urine method demonstrated lowest limit detection detecting all four analyzed purchased 3). Forty-nine samples Ostarine, Ligandrol, RAD-140, assessed: 26 out 49 (55%) varied substantially label dosing, purity, or type compound. Eight described 10 cases use treatment, published last 2 4). All included patients male, half athletes, ingested orally an average course 6 weeks. SARM consumed (4/10), (2/10). Several presented jaundice (5/10), pruritus icteric sclera (4/10). 8 diagnosed DILI, 1 acute sustained bilateral Achilles ruptures following two courses Conclusions: Athletes most commonly online, majority contaminated other substances. appear be frequently abused compounds. modalities include urine, hair, nail detection. Although may increase LBM at low doses, suggest users consume much higher doses than studied, which risk harmful side such injury, cardiovascular events, damage (perhaps akin androgenic steroids). Further basic science warranted validate early findings regarding [Table: see text][Table: text]