February 17, 2017
USADA announced today that UFC® athlete Cristiane Justino, of Curitiba, Brazil, has been granted a retroactive Therapeutic Use Exemption (TUE) and will therefore not face an anti-doping policy violation after testing positive for a prohibited substance in December of 2016. With this announcement, USADA is providing a public notice of the case’s resolution following the announcement of the potential anti-doping violation by the UFC on December 22, 2016.
Justino, 31, tested positive for Spironolactone, following an out-of-competition urine test conducted on December 5, 2016. Spironolactone is a prohibited substance in the category of Diuretics and Masking Agents and is prohibited at all times under the UFC Anti-Doping Policy, which has adopted the World Anti-Doping Agency (WADA) Prohibited List.
Upon notice of her positive test, Justino immediately identified a medication prescribed by her physician for the treatment of a common endocrine disorder as the source of the prohibited substance detected in her sample. She also participated in multiple interviews with USADA’s investigative team and consented to USADA interviewing her physician as well.
After a thorough investigation of the circumstances that preceded her positive test, which included a comprehensive review of Justino’s documented medical history, USADA accepted Justino’s explanation that her use of Spironolactone began in late September, following her bout at UFC Fight Night Brasilia, and was in accordance with her physician’s recommendation for the treatment of a legitimate medical condition. Nonetheless, because Spironolactone is prohibited at all times under the UFC Anti-Doping Policy, USADA advised Justino that her use of the medication without a valid TUE violated the UFC Anti-Doping Policy. Accordingly, Justino applied for a TUE to authorize her use of the medication, with retroactive effect.
USADA recognizes that over the course of a career, athletes may experience illnesses or medical conditions that require the use of a particular medication for proper treatment. While athletes are educated and encouraged to apply for a TUE in advance of using a prohibited substance or method, the UFC Anti-Doping Policy permits athletes to file for retroactive TUEs where the use of a prohibited substance or method was medically justified. Athletes are cautioned, however, that applying retroactively is at their own risk and the only guaranteed way to avoid an anti-doping policy violation for using a prohibited substance or method is by obtaining a TUE prior to the use of a prohibited substance or method.
Under the UFC TUE Policy, to receive approval of a TUE, athletes must submit medical records demonstrating a verifiable medical diagnosis and legitimate medical need for the requested medication in accordance with the applicable WADA guidelines. At least two members of USADA’s independent TUE Committee (TUEC) – comprised of medical experts with various areas of expertise from around the U.S. – must individually review the TUE application, after which a recommendation is made to USADA as to whether the TUE should be granted or denied.
In the case of Justino, the application for a TUE was granted because the athlete had an unequivocally diagnosed chronic medical condition for which the use of Spironolactone is the appropriate standard of care. Further, it was determined that the athlete and her medical team pursued and exhausted all non-prohibited alternatives and that the low dose of the medication is consistent with best medical practice to treat her condition and would return the athlete to a normal state of health without providing a performance-enhancing benefit.
Because Justino’s TUE application was granted retroactively, her provisional suspension has been lifted with immediate effect and her positive test will not result in an anti-doping policy violation. However, as a condition of the TUE approval, Justino will be required to continue to carefully document her medical care and must apply for a TUE renewal in advance of TUE expiry should she wish to maintain compliance with the UFC Anti-Doping Policy.
USADA conducts the year-round, independent anti-doping program for all UFC athletes. USADA is an independent, non-profit, non-governmental agency whose sole mission is to preserve the integrity of competition, inspire true sport, and protect the rights of clean athletes. In an effort to aid UFC athletes, as well as their support team members, in understanding the rules applicable to them, USADA provides comprehensive instruction on the UFC Anti-Doping Program website (UFC.USADA.org) regarding the testing process and prohibited substances, how to obtain permission to use a necessary medication, and the risks and dangers of taking supplements as well as performance-enhancing and recreational drugs. In addition, the agency manages a drug reference hotline, Drug Reference Online (UFC.GlobalDRO.com), conducts educational sessions, and proactively distributes a multitude of educational materials, such as the Prohibited List, easy-reference wallet cards, and periodic athlete alerts.