Martin Maes Tests Positive to Prohibited Substance

Martin Maes is the third Enduro World Series athlete to test positive for a banned substance in the last 12 months. The announcement comes just days after Richie Rude announced that his eight-month suspension had been retroactively served and he would return to racing this week in Italy. Now just days from practice at round four in Val Di Fassa, Maes, the current series leader, and his team GT Factory Racing have announced he will be sidelined with a 90-day ban from competition.

During anti-doping tests performed at both the Rotorua (March 24) and Tasmania (March 31) 2019 EWS rounds, Maes tested positive for the drug Probenecid. The drug itself is not a performance enhancer but the World Anti-Doping Agency includes it under their “Diuretics and Masking Agents” prohibited list. He returned a negative test result sometime later in Madeira.

Maes was prescribed Probenecid a couple of days after sustaining a bad cut during the NZ Enduro. It had become badly infected and with racing ongoing, event doctors put Maes on the drug in conjunction with antibiotics to help him heal. This isn't an uncommon method for doctors to take in the event of a bad infection. But it can also mask the release of performance-enhancing drugs at the time of testing which is why it is banned. NZ Enduro doctors weren’t aware the drug was on WADA’s prohibited list and were unable to confirm due to the remoteness of the race location during the assessment.

GT Factory Racing applied for a TUE (Therapeutic Use Exemption) after the team received the news on May 21st. The UCI denied the TUE request despite acknowledging that the Probenecid was for medical reasons and "provided no additional enhancement to Martin’s performance.” Similar sentences for trace amounts that were accepted as therapeutic use have been dished out to Olympic athletes in the past, including Australian swimmer Richard Upton.

It’s clear the UCI is playing hardball with athletes in the EWS, and maybe they need to? While the punishment for Maes sounds like overkill, it shows that any athlete testing positive to any banned substance will be penalized. It completely sucks as a fan, but if this is what it takes to keep enduro clean, then so be it. It's certainly going to have competitors on their toes, checking supplements and treatments carefully in the future.

Maes is understandably upset by the finding. Especially after his great start to the season and what looked like an overall title coming his way. Now his results from round one and two are no more, leaving him with only the win in Madeira where he tested clean.

There are heaps more questions to ask and be answered and I’m chasing down the relevant parties for their opinions. Look for more on the topic soon.

GT Factory Racing's Public Statement

On May 21, 2019, GT Factory Racing athlete Martin Maes was notified by the Cycling Anti-doping Federation (CADF) of an Adverse Analytical Finding (AAF) for a prohibited substance. There was a high level of Probenecid in his test samples from EWS Round 1 in New Zealand and EWS Round 2 in Tasmania in March 2019. Probenecid is on the UCI’s List of Prohibited Substances and Methods. The Probenecid and a related antibiotic were prescribed by an official race doctor at the New Zealand Enduro to help treat a serious infection in Martin’s leg.

According to the official race doctor:

“Martin sustained a lower leg laceration which developed a serious infection while racing the New Zealand Enduro (March 8-10, 2019). The infection was worsening despite standard doses of antibiotics, and it had the potential to become life threatening. The doctors at the New Zealand Enduro elected to add Probenecid, which is commonly used to boost blood levels of penicillin-type antibiotics, and it was effective in treating Martin’s infection. It is a common part of all of our practices to use this medicine in the setting of serious infection.

“At the time, neither the volunteer medical team nor Martin considered that Probenecid would be on the banned substance list. It has no performance enhancing effects, and in fact, Martin’s performance was likely to have been impaired in the weeks following due to the severity of the infection.” - Dr. Tom Jerram MBChB (Hons) FACEM Emergency Physician and Volunteer Medical Director of the New Zealand Enduro.

On June 1, 2019, Martin received a denial for his Therapeutic Use Exemption (TUE) request. While the CADF TUE committee recognized the Probenecid was purely for medical reasons and that it would not have provided additional enhancement to Martin’s performance, the TUE was still not approved.

GT Factory Racing fully supports Martin Maes in this situation due to the understanding that neither he, nor the team, took any actions to intentionally violate anti-doping rules or regulations. On the contrary, Martin inquired with the official race doctors if the prescriptions they had given him were acceptable for use by a UCI athlete and the race doctors were acting within their clinical responsibility to treat a potentially life-threatening infection in Martin’s leg.

GT Factory Racing is committed to creating and fostering an environment where riders can perform to the best of their ability, within all rules and regulations mandated by the governing body of the sport. GT invests in teams and athletes because of the love of the sport, and racing is a way to connect with their passionate fan base.

Each GT team and rider understands that support comes with strict requirements regarding the rules and regulations that govern the sport. It is for this reason that Martin will accept the UCI’s ruling.

The UCI complies with a set of strict rules and regulations, but also fully acknowledged the circumstances and that this was not a deliberate violation of any antidoping rules. As a result, Martin will be prohibited from racing for a period of ninety days. He will be disqualified from rounds 1 and 2 of the EWS and will be required to pay a fine of 2,500CHF. However, his win and results from EWS Madeira will not be affected as he returned a negative test result after going through doping controls at this event.

Martin is and will remain an advocate for clean and fair racing. He will return to the season stronger than before. Meanwhile, he’ll stand next to his teammates and will fully support them during the next Enduro World Series’ events.

Dr. Tom Jerram's Complete Statement (Volunteer Medical Director of the New Zealand Enduro)

Dated 23 May 2019

To Whom It May Concern:

I am a Specialist Emergency Physician, and have been practising Emergency Medicine for over 15 years. On March 8th–10th 2019, I was acting in a voluntary role as a event doctor on the New Zealand Enduro, a backcountry mountain bike race in Marlborough, New Zealand.

On the afternoon of March 8th 2019, I was reviewing and treating a number of riders who had been injured in the day’s racing. Mark Maurissen approached me, and asked me to review Martin Maes, who had sustained a significant laceration to his right pretibial area (lower leg) during the day’s racing. Martin had sustained an approximately five centimeter long vertically orientated burst type laceration to his lower leg. There was significant soft tissue damage, and the wound was grossly contaminated (conditions were particularly muddy that day).

I irrigated and debrided the wound extensively, applied a topical antiseptic solution, and sutured the skin using 4 x interrupted sutures. I was concerned about a significant risk of infection given the wound location, tissue damage, and initial contamination. At that point I dispensed a course of Flucloxacillin (an antibiotic) in a standard dose (500 milligrams 4 times a day for 3 days with a goal of preventing infection). I gave Martin standard wound care advice, and planned to follow him up in two days.

On March 10th 2019 at around 10am, I reviewed Martin’s wound. At that point, he had a clearly established serious infection surrounding the wound, despite the prophylactic

antibiotics. This infection had developed over the last 24 hours. I removed 2 of the sutures, draining a small amount of pus, and irrigated and further debrided the wound. A higher dose of antibiotic was clearly indicated, as the infection was significant enough be life or limb threatening if left unchecked. My standard practice in a case like this is to give a higher dose of Flucloxacillin in combination with a medicine called Probenicid. In this case, Probenicid acts to reduce the excretion of penicillin type antibiotics from the kidneys, thus boosting the blood levels of antibiotic. These higher levels of antibiotic are particularly important for treating serious infection, and I do not believe Martins infection would have resolved without them. The only other option would have been hospitalisation for intravenous antibiotics, which carries its’ own set of risks and costs, and would not necessarily be more effective than adding Probenicid.

I provided Martin with a prescription for 2 grams of Flucloxacillin 3 times a day for the next 2 days (dropping to 1 gram 3 times a day for a further 5 days), and Probenicid 500 milligrams 3 times a day for 7 days. I discussed all of this with Dr Julian Balance, an Orthopaedic Surgeon also volunteering as a race doctor. He agreed with the management plan as above.

Both Martin and Mark asked if the medications I were permissible for racing. I informed them that Probenicid has no performance enhancing effects, and as far as I was aware was not a prohibited substance for racing. I checked this with Dr. Balance, as well as Dr. Sam Grummitt (another of the race doctors), neither of whom were aware that Probenicid was a prohibited substance. There was no cellular data coverage at the event to enable us to check this.

Martin began vomiting that afternoon, likely as a result of the higher doses of Flucloxacillin, which often cause significant gastrointestinal upset. At that point we discussed referring him to hospital, and elected to give him a trial of an anti-vomiting drug prior to this. I dispensed 4 milligrans of ondansetron, which settled his vomiting, and enabled him to take the prescribed antibiotics.

I understand Martin made a good recovery, and was able to race two weeks later I also understand that Martin returned a positive urine drug test for Probenicid at that

event. I have subsequently learned that Probenicid is on the UCI prohibited substances list, and has previously been used as a masking agent, although it has no performance

enhancing effects.

The Probenicid I prescribed Martin was clearly medically indicated and I would do so again given the same clinical scenario. I believe he would have experienced a significant impairment to health had I not prescribed it, with the potential for life threatening spread of infection. Had I known it was a prohibited substance, I would have been happy to fill in a therapeutic exemption form. I am confident that there was no performance enhancing benefit from the prescription, and in fact the severity of the infection was likely to have been detrimental to his performance in the next few weeks.

Please let me know if I can be of further assistance

Yours Sincerely,

Dr. Tom Jerram

Bachelor of Medicine, Bachelor of Surgery(hons) Otago

Fellow of the Australasian College for Emergency Medicine

Nelson Hospital Emergency Deopartment

New Zealand

UCI Statement on Martin Maes

Jun 26, 2019

The Union Cycliste Internationale (UCI) announces that the Belgian rider Martin Maes has been suspended for a period of 90 days for a non-intentional Anti-Doping Rule Violation (ADRV).

The affair concerns an ADRV for the presence of the prohibited substance Probenecid* in samples collected in-competition on 24 and 31 March 2019.

As per the World Anti-Doping Code (WADC) and the UCI Anti-Doping Rules (ADR), the sanction began on 13 May 2019.

Moreover, the results obtained by the rider in rounds 1 and 2 of the Enduro World Series have been annulled. This is not the case however for round 3, where he tested negative.

The case has been resolved via an acceptance of consequences as provided for by the WADC and the UCI ADR.

The UCI will not comment any further.

* Probenecid is classified in the category “Diuretics and Masking Agents” and considered a specified substance as per the World Anti-Doping Prohibited List.