What is efaproxiral or RSR-13?

Answer 1

A cholesterol drug bezafibrate from the 1970's, slightly modified and attempted to be re-branded as a new drug for treatment of depression, traumatic brain injury, ischemia, stroke, myocardial infarction, Diabetes, hypoxia, sickle cell disease, hypercholesterolemia and as a radio sensitizer. It failed phase 3 clinical trials. Sports Medicine Scientific researchers also received funding to study and place Efaproxiral and RSR-13 on the World Anti-Doping Agency list as a potential new method of abuse. As of 2012, there is no evidence in existence that RSR-13 or Efaproxiral can enhance athletic performance in any way in human athletes. Ironically there are a dozen similarly modified bezafibrate compounds with the same theoretical allosteric modification effects, which are not mentioned by WADA or banned as a method. Any athletic benefit of efaproxiral (or the other dozen similar compounds) would theoretically come from a large IV infusion, which are dangerous and has the potential to harm an athlete. However, IV infusions are strictly banned by WADA and it is redundant to also ban Efaproxiral as an IV method. There is no way to determined from a urine test if an IV method was used or if simple absorption from skin or mouth occurred. Many argue for the complete removal of any mention of Efaproxiral by sporting governing bodies or establishing a cut-off value to determine between abuse as a method and simple oral or topical contamination. The United States Anti-Doping Agency erroneously lists Efaproxiral as a Banned Substance on it's website. The rules set forth by the World Anti-Doping Agency explicitly exclude Efaproxiral from the Banned Substance List. However, enforcing Efaproxiral as a simple banned substance is a cost cutting technique by USADA, which relies on limited government funding for its scientific research and employee salaries. (The science is enormously expensive to enforce a substance as an allosteric modifier of hemoglobin.) This shifts the financial burden onto an individual athlete of scientifically establishing a urine cut-off value for determining when efaproxiral has allosterically modified hemoglobin.