SporTRIA study-a multicentre trial protocol for excretion kinetics of triamcinolone acetonide following sport-related intra-articular injections in knees: definitions of the washout periods.

INTRODUCTION: Intra-articular (IA) and peri-articular glucocorticoid (GC) injections are common in sports medicine. However, from 1 January 2022, all injectable GC routes (including IA administration) will be prohibited in-competition by World Anti-Doping Agency (WADA). Owing to these rules, an IA GC treatment out-of-competition could result in an adverse analytical finding in-competition if the washout period is not clearly defined. The aim of this study is to determine the urinary excretion profile of triamcinolone acetonide following IA injection to strengthen the definition of the washout periods. METHODS AND ANALYSIS: This is a prospective multicentre trial to include 20 subjects who practice sports for at least 4 hours/week and present a knee disorder requiring IA injection of triamcinolone acetonide for therapeutic purposes. To determine the excretion profile of triamcinolone acetonide in both urine and blood following IA injection of the drug, We will perform 20 urinary tests and 20 dried blood spot tests, two prior to GC injection (baseline) and the last one at 35 days. Analyses will be performed by the French antidoping agency laboratory in accordance with WADA standards and regulations. ETHICS AND DISSEMINATION: The study protocol was approved by the French ethics committee (CPP Sud Est III-Lyon-2020-070B on 06 October 2020). All subjects will provide written informed consent. The results of this study will be accessible in peer-reviewed publication and be presented at academic conference. TRIAL REGISTRATION NUMBER: NCT04574232.

Apolipoprotein E in apolipoprotein B (apo B)- and non-apo B-containing lipoproteins in 3523 participants in the Stanislas cohort: biological variation and genotype-specific reference limits.

BACKGROUND: Apolipoprotein (apo) E is a component of two major classes of plasma lipoproteins, apo B- (apo E-LpB) and non-apo B-containing (apo E-Lp-non-B) lipoproteins. The factors that affect total apo E in particles [lipoprotein E (LpE), apo E-Lp-non-B, and apo E-LpB], are incompletely characterized. METHODS: We studied the determinants of these lipoparticles in a sample population of presumably healthy individuals: 1784 children (age range, 8-18 years) and 1739 adults (age range, 19-50 years). Serum concentrations of LpE and apo E-Lp-non-B were measured by electroimmunoassays, and the concentration of apo E-LpB was calculated by a difference method. RESULTS: Serum LpE and apo E-Lp-non-B were higher in females than in males. Their concentrations decreased with age until 20-25 years and then increased in men but not in women. apo E-LpB concentrations increased up to 20-25 years and were similar in both sexes. Thereafter, adult men had higher values than women. Individuals carrying the epsilon2 allele had higher mean apo E-Lp-non-B concentrations and lower apo E-LpB concentrations than did individuals carrying the epsilon3 allele. Individuals with the epsilon4 allele showed an inverse profile compared with those with the epsilon2 allele. Age, gender, the common apo E polymorphism, puberty, serum lipid concentrations, and alcohol consumption were significantly associated with total LpE, apo E-Lp-non-B, and apo E-LpB concentrations. Reference limits were established according to age, gender, and the common apo E polymorphism. CONCLUSIONS: Because measurements of LpE, apo E-Lp-non-B, and apo E-LpB concentrations may improve cardiovascular risk assessment, the proposed reference limits will aid interpretation of the results in clinical or therapeutic trials.