Sir Bradley Wiggins: Former team doctor 'surprised' at drug prescription
A former team doctor of Sir Bradley Wiggins has questioned the decision to allow him to use a banned steroid just days before major races.
Prentice Steffen said he was "surprised" he was prescribed the drug.
He told BBC Newsnight the sport's governing body was wrong to give the cyclist permission to use a powerful corticosteroid before major races.
Sir Bradley Wiggins said his use of the drug was for legitimate medical reasons and that no rules had been broken.
BBC Newsnight also spoke to the convicted doper Michael Rasmussen, who said that, taken in isolation, the pattern of Wiggins's use of the corticosteroid triamcinolone ahead of major races seemed "suspicious".
The issue of Therapeutic Use Exemptions (TUEs), which allows athletes to use banned substances if they have genuine medical need, has been in the news since dozens of Olympic athletes had their private data stolen from a World Anti-Doping Agency (Wada) database by a group of hackers calling themselves The Fancy Bears.
Dozens of athletes have been affected and there is no suggestion they have broken anti-doping rules.
But focus has centred on five-time Olympic champion and Tour de France winner Wiggins, because of the nature and apparent timing of his TUE applications.
The stolen data revealed Wiggins, an asthma and allergy sufferer, was given permission to inject the banned drug triamcinolone, a powerful corticosteroid, just days before three major races, including the 2012 Tour de France, which he won, becoming the first Briton to do so.
He also received similar permission to use 40mg of the drug before the 2011 Tour and the 2013 Tour of Italy.
But questions have been raised over why Wiggins apparently did not need the drug before 2011, or after 2013.
In 2009, Sir Bradley's only TUEs were for standard asthma inhalers.
Dr Prentice Steffen was team doctor at Wiggins's former team Garmin Slipstream that year, when Wiggins had his breakthrough in road racing, finishing a surprise fourth in the Tour de France.
Though he could not comment on Wiggins's private medical records, he was said he was "surprised" he needed this sort of intervention.
"I was surprised to see there were TUEs documented for intramuscular triamcinolone just before three major events - two Tours de France and one Tour d'Italia.
"You do have to think it is kind of coincidental that a big dose of intramuscular long-acting corticosteroids would be needed at that… exact time before the most important race of the season.
"I would say certainly now in retrospect it doesn't look good, it doesn't look right from a health or sporting perspective."
Sir Bradley's TUEs applications are understood to have been made by the then team doctor Dr Richard Freeman, who is now team doctor at British Cycling.
In each of them it states that Wiggins underwent a nasal endoscopy in 2011, suggesting he needed more serious intervention to control his allergies.
Dr Freeman did not respond to a request for comment.
In Sir Bradley's 2012 autobiography, My Time, there is no mention of asthma or allergies. Referring specifically to 2012, he states how he was "only ill once or twice with minor colds" and "barely lost a day's training from it".
What are therapeutic use exemptions?
A TUE allows an athlete, for medical reasons, to take a banned substance or have treatment that is otherwise prohibited.
The Wada rules for obtaining TUEs include:
- the banned drug can only be used to treat an acute or chronic medical condition
- it must be highly unlikely to produce any additional enhancement of performance
- and that there's no reasonable therapeutic alternative.
Dr John Dickinson, of Kent University, who has worked with more than 1,000 athletes with breathing problems, said he had never prescribed triamcinolone to an athlete.
He said: "That sort of medication [is] typically reserved for individuals who are in a very severe asthma response and are in need of emergency care which would suggest... that particular individual may be not fit and well to compete in a race at that point in time.
"I've never been myself involved with an athlete that's needed to go that far in terms of that sort of treatment for an asthmatic condition.
"We really concentrate on working with our athletes to make sure... they are on the optimal inhaler therapy so that they never need to go to that level of needing to go above or into the TUE world really."
Earlier this week, some experts said that, while they would not prescribe triamcinolone to an athlete for allergies, it would have little or no performance-enhancing effect.
But other experts as well as many cyclists, including convicted dopers David Millar and Michael Rasmussen, claim it is an extremely potent drug.
Rasmussen had been just four stages away from winning the Tour de France in 2007 when he was thrown out of the race for avoiding doping controls. He later blew the whistle on his own doping and the doping culture within the sport at that time.
He told BBC Newsnight: "There is no doubt in my mind that corticosteroids [are] very, very strong and performance enhancing.
"It would postpone this sensation fatigue, increase your recovery speed and most importantly and quite easily I would drop one or two kg which is very important when you want to climb mountains.
"It will drain the body from all excess fat in a quite short period of time. It's a very fast and very effective drug in that sense."
Asked specifically about Wiggins' TUEs he said: "Just looking at the drugs and looking at the dates of the injections it looks very much like something that could have happened 10 years ago when I was riding for general classification in the Tour de France."
"If you look solely at the pattern of the TUEs of Bradley Wiggins then you would say that this looks very suspicious. It's something that a rider would do if he wants to perform well in a grand tour, something that I would do, something that I did."
Rasmussen's doctor then at Team Rabobobank, was Geert Leinders, who was also at Sky for periods during 2011 and 2012, though Team Sky has said Leinders had no involvement in Wiggins's TUEs.
Leinders was sacked by Team Sky in 2012 and banned for life for doping practices in 2015.
Triamcinolone is a corticosteroid, which is an anti-inflammatory medicine prescribed for a range of issues including asthma and allergies. Corticosteroids are banned in competition under Wada rules, unless a TUE is approved.
Dr Jeroen Swart is a sport scientist who last year carried out physiological tests on Team Sky Tour de France champion Chris Froome.
He told Newsnight earlier this week: "The substance that was used - triamcinolone asetonate - is quite a strong, long-acting corticosteroid. It's not used frequently in the control of asthma and allergic conditions. It's used as a last resort.
"The other problem with that substance is it's the same substance that's been used by athletes, specifically in cycling, for a fairly long time with a lot of testimonials from ex-professional cyclists, some who have been caught using prohibited substances and they all happen to have used coincidentally the exact same drug - Kenalog or triamcinolone.
"Some of them have reported to have used it exactly the same way and so there's that unfortunate coincidence there, in terms of the drug, that dosage, the method used which is intramuscular.
"The TUE system exists to support the welfare of athletes by enabling them to receive appropriate treatment for medical conditions."
Sir Bradley Wiggins's representatives did not respond to questions from Newsnight.
They previously said in a statement: "There's nothing new here. Everyone knows Brad suffers from asthma, his medical treatment is British Cycling and International Cycling Union approved and like all Team GB athletes he follows Wada regulations to the letter."
A spokesman for Team Sky said: "TUEs for Team Sky riders have been granted by the appropriate authorities and in complete accordance with the rules.
"This is a complex area given the obvious issues around medical confidentiality. There is a legitimate debate across sport on where best to draw the line on transparency.
"It is very rare that a rider needs a TUE and we have robust internal processes in place that we are confident in and which we constantly review.
"Team Sky's approach to anti-doping and our commitment to clean competition are well known."
Dr Steffen called on the sports governing body, the UCI, to tighten up the TUE process.
He added: "I would say that Bradley is probably at the bottom of the list to be held personally responsible.
"I think his doctor and his team, to make the decision to apply for that TUE is questionable and then I think for the UCI or UK Cycling or Wada to sign off on that application, all things considered, really that is the end point where the TUE committee should have looked at that and said no, this is not acceptable, so we are not going to approve it."
A spokesman for the UCI said: "The management of Therapeutic Use Exemptions in cycling is robust and fully safeguarded. The UCI TUE committee is composed of independent experts in the fields of clinical, sports and exercise medicine and the coordination of the committee is handled by the Cycling Anti-Doping Foundation, the independent body mandated by the UCI to carry out anti-doping in the sport."
More on this story on BBC Newsnight at 22:30 on BBC Two - or catch up afterwards on iPlayer http://www.bbc.co.uk/programmes/b07wgh4v