gms | German Medical Science

7th EFSMA – European Congress of Sports Medicine, 3rd Central European Congress of Physical Medicine and Rehabilitation, Annual Assembly of the German and the Austrian Society of Physical Medicine and Rehabilitation

Austrian Society of Physical Medicine and Rehabilitation

26.-29.10.2011, Salzburg, Austria

Analysis of one hundred therapeutical use exemptions of elite athletes in Serbia

Meeting Abstract

7th EFSMA – European Congress of Sports Medicine, 3rd Central European Congress of Physical Medicine and Rehabilitation. Salzburg, 26.-29.10.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11esm109

doi: 10.3205/11esm109, urn:nbn:de:0183-11esm1092

Published: October 24, 2011

© 2011 Antic et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: TUE (Therapeutical Use Exemption) is required when an athlete wants to use the substances from Prohibited List because he is injured or ill. Athletes have obligation to apply and get approval for TUE before using any medication that can lead to positive doping result. One of criteria for granting a TUE points that there is no reasonable therapeutic alternative to use of listed prohibited substance or prohibited method.

Material/Methods: In this cross sectional study, one hundred TUE applications from elite athletes of Serbia, were analyzed in last four years by using official data of Anti-doping agency of Serbia. These applications had been processed by national and international sports federations.

Results: This research has included all variations of Therapeutic Use Exemptiones in last period which resulted in the proportion: TUE/DoU/ATUE – 31/37/32. No longer existing, ATUE (Abbreviated TUE) and DoU (Declaration of Use), were required for beta-2-agonist taken by inhalation and glucocorticosteroids administered by non-systemic routes. Frequency of application has been raising during the observed period, from 14 in 2007. up to 29 in 2010. Third of all TUE were forward to international sports federations and were approved by them. Basic statistic had shown that men/women ratio was 70:30. Glucocorticosterodes, betamethasone (26%) and triamcinolon (20%), were the most commonly administered medicines. Considering beta 2 agonists, salbutamol was the most used substance in treatment represented by 14%. The musculosceletal disorders (64%) and asthma (20%) were the main reason for applying TUE. Only 5% applications were related to chronicle diseases. Both inhalation and intraarticular routs of drug administration were equally represented in treatment of athletes. Also, Athletic Federation of Serbia, followed by Basketball and Football Associations had reported the highest number of TUE in Serbia.

Conclusion: This study can be useful for perceiving medical conditions regarding one hundred elite athletes. The significant low number of TUE in Serbia implies that the education of athletes and sports federations should be on a higher level. Frequent non-systemic use of glucocorticosteroids without valid medical indication can cause severe side effects leading to decreased sports performance. Since illegitimate consumption of these medicines can cause doping positive result, the importance of reporting TUE should be stressed out.


World Anti-doping Agency. International standard for TUE (ISTUE). 2011.
Andjelkovic M, Dikic N. TUE in Serbia – with special emphasis on the application of glucocorticosteroids. Dikic, N. 2008. Team doctor – missing link. Sports Medicine Association of Serbia. Belgrade; 2008.