HISA Puts Provisional Suspensions on Hold for Metformin

The Horse Racing Integrity and Safety Authority is taking a step back on the penalties for trainers associated with positive test results for the diabetes medication metformin, announcing June 4 it will defer active provisional suspensions until a thorough scientific review can be conducted. The policy change, effective immediately, was recommended by HISA's Anti-Doping and Medication Control Standing Committee. "In line with HISA's Anti-Doping and Medication Control requirements, metformin is included in the Prohibited Substances List because there is no recognized therapeutic use for the substance in horses involved in Thoroughbred racing," said Charles Scheeler, chairman of the HISA board. "In addition, HIWU has intelligence that some horsemen may be using metformin to try and gain a performance advantage. However, there is limited scientific information available regarding the substance's use in horses. The HISA board feels that further expert analysis on the topic is necessary to determine if any refinement of HISA's rules is appropriate." Metformin is a drug that has been used to control diabetes since the 1950s in Europe and was approved by the U.S. Food and Drug Administration in 1995. The drug is the first-line treatment for type 2 diabetes, when the body is not producing enough insulin (the hormone that lets sugar into cells to fuel muscle and other tissues) or is not responding to insulin properly. Studies in humans have looked at how metformin affects exercise, with several of these studies showing no effect on oxygen uptake or lactate concentrations but a significantly longer time to reach exhaustion and a higher rate of recovery from high-intensity exercise compared with subjects taking a placebo. Metformin also has a following in the health and fitness community because preliminary studies have suggested the drug may slow age-related disease, according to a blog written by Dr. Robert Shmerling, senior faculty editor for Harvard Health Publishing. The medication has shown up in a number of racehorse blood and urine tests since last June, including the filly Heaven and Earth, whose positive test led to a two-year suspension and $25,000 fine for trainer Jonathan Wong, who is seeking to challenge his penalties in court. Trainer Mike Lauer also had a metformin positive for his stakes winner Mowins, but received a 75-day suspension and a $2,600 fine after providing documentation that the horse's groom had been taking the drug twice a day, that Lauer had policies and procedures in place in order to avoid contamination between his employees and the horses in his care, and that these procedures had been relayed to the groom. Neither Lauer nor his assistant trainer was aware the groom was taking metformin when he was hired, according to a summary of the case resolution and final decision from HIWU. HISA and its Horseracing Integrity and Welfare Unit have asked the Racing Medication & Testing Consortium's Scientific Advisory Committee to conduct a review of the available science relating to metformin. Following RMTC's board of directors' approval, any conclusions drawn, and guidance produced regarding the SAC's review will be shared with the ADMC committee. Once the RMTC Scientific Advisory Committee completes its work, which is expected to take a few months, the ADMC committee and the HISA board will determine whether any policy changes regarding metformin should be submitted to the Federal Trade Commission for approval. In this interim period, metformin remains a prohibited substance. A positive test result for metformin—regardless of the source and/or the existence of any mitigating circumstances, such as proof that a groom is taking metformin to control diabetes—will result in the automatic disqualification of race results of the relevant Covered Horse. The deferral of provisional suspensions is only applicable to the Responsible Person; Covered Horses that test positive for metformin are still subject to a provisional suspension. HISA said it continues to receive valuable feedback from all industry constituents, especially the Horsemen's Advisory Group, as it continues to refine its regulatory program to make horse racing safer and fairer.