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Doping & Anti-Doping

What is CERA (Continuous Erythropoietin Receptor Activator)?

A third-generation EPO variant designed to evade detection but eventually caught multiple high-profile cyclists in 2008.

What You Need to Know

CERA (Continuous Erythropoietin Receptor Activator), marketed as Mircera, is a long-acting EPO analogue developed for anemia treatment. It became a major doping scandal in cycling when athletes switched to it believing it was undetectable.

WHAT MAKES CERA DIFFERENT

Chemical Modifications

• Larger molecular structure than standard EPO • PEGylated (polyethylene glycol attached) • Longer half-life in the body • Reduced dosing frequency required

Pharmacological Advantages for Dopers

• Longer action means less frequent injections • Smaller total doses needed • More stable blood values • Initially thought to be undetectable • Different molecular structure from traditional EPO

Performance Effects

• Same benefits as standard EPO • Increased red blood cell production • Enhanced oxygen-carrying capacity • VO2 Max improvements • Better endurance performance

THE 2008 SCANDAL

Retroactive Testing

• New CERA test developed by WADA labs • Applied to stored samples from 2008 Tour de France • Multiple positive results emerged • Samples tested months after the race

Key Positive Tests

Riccardo Riccò (2008 Tour de France): • Positive during the race • Suspended immediately • Later admitted to EPO and CERA use • Career effectively ended

Bernhard Kohl (2008 Tour de France): • Third place finisher • Tested positive in retroactive analysis • Stripped of podium finish • Received two-year ban • Later became anti-doping advocate

Stefan Schumacher

• Double time trial winner at 2008 Tour • CERA detected in retests • Two-year ban • Results annulled

Leonardo Piepoli

• Stage winner 2008 Tour de France • Positive for CERA • Retired from cycling

IMPACT ON CYCLING

Why CERA Was Significant

• Showed athletes still seeking new doping methods • Demonstrated retroactive testing works • Proved no substance stays undetectable forever • Led to increased research funding for detection • Reinforced value of sample storage

DETECTION METHODS

CERA-Specific Testing

• Isoelectric focusing (IEF) method • Detects unique molecular structure • Can identify CERA use weeks after administration • Blood and urine testing both effective

Biological Passport

• Abnormal blood values trigger suspicion • Combined with direct CERA testing • Longitudinal monitoring catches patterns • Makes timing of use more difficult

SAMPLE STORAGE POLICY

Why Stored Samples Matter

• Samples kept for 10 years • Retroactive testing as new methods develop • No statute of limitations on cheating • Deterrent effect on current athletes • Justice delayed but not denied

Detection & Regulation

MODERN TESTING PROTOCOL

During Competition

• Podium finishers tested • Random selections throughout peloton • Stage winners and jersey holders • Suspicious performances targeted

Out-of-Competition

• Unannounced testing year-round • Targeted based on intelligence • Biological Passport monitoring • Whereabouts system enables testing

Sample Management

• All samples stored frozen • 10-year retention period • Regular retesting as methods improve • Results can lead to retroactive bans

ANTI-DOPING SCIENCE

Ongoing Research

• Detection methods for new EPO variants • Reducing detection windows • Improving sensitivity of tests • Developing biomarker approaches • Integration with genetic profiling

LESSONS LEARNED

For Athletes

• No substance remains undetectable • Retroactive testing means old cheating can be caught • Stored samples are time bombs • Risk far outweighs reward

For Anti-Doping

• Keep samples for extended periods • Invest in detection research • Retroactive sanctioning sends strong message • Cooperation between labs crucial

Why It Matters

CERA represents the cat-and-mouse game between dopers and anti-doping scientists. Athletes thought they'd found an undetectable substance, but retroactive testing caught them. This reinforces that cheating is always risky and detection methods constantly improve.

⚠️ Common Mistakes

The main misconception is that CERA was widely used. In reality, its detection was developed quickly, and only a relatively small window existed where athletes thought it was safe. Another myth is that all EPO variants are equally detectable - new variants still pose detection challenges, though none remain undetectable for long.

What is CERA (Continuous Erythropoietin Receptor Activator)? | Pedaloom