As the field of regenerative medicine has advanced in recent years, athletes have increasingly turned to therapies that utilize biological substances, such as stem cells, to heal sports injuries faster.
While researchers are still investigating the use of biological treatments and their potential efficacy, the questions below address some of the most common questions athletes subject to the UFC Anti-Doping Program have about stem cell therapies.
Are stem cell treatments prohibited?
In most cases, stem cell therapy is allowed if no prohibited substances are added to the material and the stem cells are locally applied only to the injury with no intent to enhance performance. The sole outcome of stem cell therapy should be the return to pre-injury level of function, or a normal state of health.
However, stem cell injections are prohibited if the product is modified in a way that can offer performance-enhancing benefits. According to World Anti-Doping Agency (WADA) regulations, “stem cell injections may or may not be prohibited, depending on how the cellular material is manipulated or modified for use.”
WADA further clarifies that it’s prohibited to use both normal and genetically modified cells in any way if the process causes performance enhancement. Based on these regulations, athletes should be aware that the use of stem cell products cannot justify a positive doping test if any prohibited substances are identified in a sample.
Any athlete considering stem cell treatments should get a detailed description of the treatment plan, including the source of the stem cells, and the use of any other growth factors or hormones from their doctor, and provide that information to USADA for review.
Is a TUE required for stem cell therapy?
You do not need a TUE for stem cell therapy as long as all of the following are true:
- You are donating and then receiving your own stem cells and no other growth factors, hormones, or other prohibited substances will be added to the preparation. Or, for commercial stem cell preparations, there are no growth factors or other hormones contained within.
- The stem cell preparation will be injected directly into the injured site, and there is no reason to expect that it will enter the circulatory system in meaningful quantities (e.g. the stem cells stay local to the site, and the administration of the stem cells will not ultimately be systemic).
- The stem cell preparation is a small volume (for example, a 1-3 mL local injection).
- There are no intravenous infusions or drips of in excess of 100mL per 12-hour period required during the clinical visit. If there is, you need a TUE for the IV Infusion.
- The expected outcome of the treatment is that the tissue will return to its normal strength and function.
If there is any chance or expectation that the stem cell therapy will make a tissue perform beyond the normal state (bigger, better, faster, stronger) than it was prior to the injury, or if the plan is to augment strength or ability of otherwise normal tissue through the use of stem cells, then this is a prohibited use of stem cells and requires a Therapeutic Use Exemption in advance.
When considering stem cell therapy, athletes should also discuss these guidelines with their physician and contact UFC Athlete Express at (866) 601-2632, or our Drug Reference team at drugreference@USADA.org, with any questions.