With the inaugural Enhanced Games set to begin Sunday night in Las Vegas, the company behind the controversial competition has released the first batch of data from its clinical trial of athletes using performance-enhancing drugs. The numbers are striking: 91 percent of the 36 athletes in the study used testosterone or testosterone esters in the 12 weeks leading up to the Games.
The figures, published Tuesday by Enhanced Group, Inc. (NYSE: ENHA), offer the clearest picture yet of what athletes have been taking in preparation for a competition that openly permits drugs banned by the World Anti-Doping Agency. The study, titled “Impact of Medically Supervised Performance-Enhancing Substances (PES) on Elite Athletes,” has been posted to ClinicalTrials.gov under the acronym ASCEND001 and is sponsored by Enhanced Emirates Limited.
For an audience accustomed to the strict anti-doping framework that governs marathon running and most Olympic sports, the data marks a sharp departure from how elite competition has been organized for decades.
What the Athletes Took
Forty-two athletes are expected to compete at the Games. Thirty-six of them participated in the clinical trial, with two of those 36 competing naturally. Six athletes did not participate in the study, two of whom are also competing naturally. That leaves four clean athletes in total.
Enhanced reported the following aggregate usage across the 36 trial participants:
- 91% used testosterone or testosterone esters
- 79% used human growth hormone (hGH)
- 62% used stimulants such as Adderall
- 50% used metabolic modulators, primarily ancillary compounds such as Anastrozole, used alongside anabolic agents
- 41% used erythropoietin (EPO), the blood-boosting agent at the center of many of running’s most notorious doping scandals
- 29% used an anabolic steroid agent such as Deca-Durabolin
- 5% used hormonal support therapies such as hCG
The trial registration on ClinicalTrials.gov lists a longer roster of specific drugs that were available within the protocol, including testosterone enanthate, cypionate and propionate, Sustanon, methenolone enanthate (Primobolan), nandrolone decanoate, modafinil, meldonium, darbepoetin, clomiphene, levothyroxine, beta-blockers such as propranolol and metoprolol, and diuretics such as furosemide. The presence of meldonium is notable. It is the substance that led to tennis star Maria Sharapova’s two-year ban in 2016.
Enhanced said only substances legal under U.S. Food and Drug Administration guidelines were studied, and that no peptides on the FDA’s Category 2 banned list were included.
A First-of-Its-Kind Study
The trial’s interventional phase has now concluded, and a five-year observational monitoring period has begun. Primary endpoints, as registered with ClinicalTrials.gov, are the incidence of treatment-related adverse events and the proportion of participants who discontinue use because of those events.
According to the study description, assessments included cardiology evaluation and imaging, respiratory testing, organ health imaging, body composition analysis, musculoskeletal assessment, neurocognitive screening, and biomarker analysis using blood, urine and saliva samples. Participants will be followed for up to five years.
“We are encouraged to share that our clinical trial is now open for review with some of the preliminary aggregate totals from the study ahead of the Games,” said Dr. Guido Pieles, Chair of Enhanced’s Independent Medical Commission and Independent Scientific Commission. “We have been regularly assessing the athletes throughout the study period and we’re very pleased with the results and the overall health picture each participating athlete has demonstrated during the study.”
Enhanced has said it will not comment further on the aggregate totals until a scheduled press conference Saturday at 1:15 p.m. PST, expected to draw roughly 200 credentialed journalists from 20 countries.
Maximilian Martin, the company’s chief executive, said in a statement that the company was pleased with what it has seen so far. “We are very encouraged by the early findings, which indicate excellent progress toward achieving the study’s objectives,” he said. “We are particularly encouraged by the initial impacts the protocols appear to have had on athlete recovery and injury prevention.”
The Games and the Stakes
The World Anti-Doping Agency, the International Olympic Committee, and the U.S. Anti-Doping Agency have repeatedly condemned the concept of the Enhanced Games. Critics argue that even under medical supervision, the long-term health risks of supraphysiologic testosterone, growth hormone, EPO and stimulant use are not fully understood, and that the Games risk normalizing drug use among younger athletes who lack access to the medical oversight Enhanced is touting. Enhanced has also filed an $800 million lawsuit against WADA, and the company recently went through a leadership shake-up ahead of the Games.
Enhanced has framed its approach as the opposite: a transparent, supervised alternative to what it characterizes as the hidden doping that exists in conventional sport. The study, the company says, is the foundation of a broader commercial play. Data from the elite athletes will feed into Enhanced’s consumer-facing “Live Enhanced” platform, which sells protocols and products to the general public. The company recently went public on the NYSE, and the athlete roster now includes former 100m world champion Fred Kerley.
“The clinical data generated through this study is proprietary to Enhanced and forms the foundation of the company’s competitive moat,” the company said in its release. “What works for a world record holder informs what works for consumers.”
The first Enhanced Games are scheduled for Sunday, May 24, at 8:30 p.m. EDT (5:30 p.m. PDT) at a purpose-built complex inside Resorts World Las Vegas. Enhanced has promoted the event as offering “unprecedented financial incentives” to athletes, including bonuses for breaking world records, though the company has not specified figures in this release.
Individual athlete protocols will not be released. Enhanced says clinical oversight rests with the Principal Investigators, with independent monitoring through a Data and Safety Monitoring Board. Participants consented to the trial and may discontinue at any time. While research suggests drug use among ultramarathon runners remains relatively low compared to other sports, the Enhanced Games represents a starkly different model.
For the wider running community, the Games represent a test of a proposition that has hovered around the sport for years: whether openly permitted, medically supervised performance enhancement can coexist with the idea of fair competition. Sunday night in Las Vegas, the first answers will arrive.
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