Baffert and betamethasone

[Electrocutionist]

As a horseracing fan and scientist who has spent a career studying steroid metabolism in farm animals, I’d like to share my thoughts on the current discussion. Full disclosure, I do have a dog in this fight since in addition to a win bet on Mandaloun I had boxed the exacta of Mandaloun, Hot Rod Charlie and Essential Quality in the third futures pool back in February. The Mandaloun-Hot Rod Charlie exacta was paying $2162. I thought I was sitting pretty as the horses entered the stretch. I had tossed Medina Spirit and chalked up this loss to Baffert’s training acumen. Now that there is a possible drug issue, I question whether it was a legitimate beat and have looked into it more deeply.
 
First, betamethasone is indeed a component of a topical anti-fungal gel (Otomax) that could have been used to treat Medina Spirit. After a quick search through medical literature for studies of betamethasone pharmacokinetics, I did not find any which examined betamethasone metabolism after topical administration in horses. One study in humans showed that topical administration can in fact produce measurable levels in the blood of comparable magnitude as that found in Medina Spirit 72 hours after administration (Kubota K, Lo ES, Huttinot G, Andersen PH, Maibach HI. Plasma concentrations of betamethasone after topical application of betamethasone 17-valerate: comparison with oral administration. Br J Clin Pharmacol. 1994 Jan;37(1):86-8).

However, the fact that Baffert suggested several laughable scenarios (transdermally from a stable worker wearing a skin patch, ingestion of hay contaminated by urine from a stable worker) before disclosing that it could have been from a legitimate anti-fungal gel leads one to seriously question his veracity, since he certainly would have been aware of any medications being administered to one of the top horses in his stable. Even moreso given his history of drug positives.

Another common use of betamethasone is to treat joint inflammation. This is commonly done in racehorses, and betamethasone metabolism has been well-studied. (Knych HK, Stanley SD, Harrison LM, Mckemie DS. Pharmacokinetics of betamethasone in plasma, urine, and synovial fluid following intra-articular administration to exercised thoroughbred horses. Drug Test Anal. 2017 Sep;9(9):1385-1391). Based on the known half-life of betamethasone in plasma of racehorses, 21 picograms per ml would be in the range expected at 72-96 hours post injection. It is thought to be non-detectable in plasma after 96 hours, but sensitivities of these tests are always increasing. Interestingly this study also demonstrated measurable levels of betamethasone within the fetlock joint at 14-21 days post-injection despite inability to find measurable concentrations in plasma.  In addition, there is always variability between animals as far as drug metabolism, and there are many legitimate medications and feedstuffs that can affect drug metabolism, which could inhibit breakdown and prolong the presence of detectable levels of the drugs being investigated.

In my opinion the anti-fungal gel excuse is unlikely, given Baffert’s fumbling over the explanation. I believe it is more likely to be a result of normal variation of metabolism following legal administration of an injection to treat joint inflammation. I am not aware, however, of information that this horse may or may not have received such treatment, and so I can only speculate here.

Given the above, I cannot conclude that Baffert behaved in a manner to illegally boost a horse’s performance. But clearly administration of anti-inflammatory medications directly into a joint would allow a horse to race closer to his best ability without feeling the pain of any existing inflammation.

So my question is this- if indeed he had been administered such medication, was the horse treated in the same manner prior to his losing effort in the Santa Anita Derby? Did he only receive this treatment after that loss, and just prior to the Kentucky Derby? Shouldn’t the betting public have all the information concerning medications that horses are receiving in order to make informed wagering decisions? Isn’t that the reason why Lasix information is made public?

The questions raised are important and go directly to the perceived honesty and legitimacy of the sport. Unless and until information concerning medications given to racehorses are shared publicly, as with Lasix, I for one have decided to take a long break to reconsider my continued interest and support of horse racing.

[billk5300s]

Thank you for sharing this.

[hellersorr]

Ditto!

[T Severini]

Electrocutionist Wrote:
-------------------------------------------------------
> As a horseracing fan and scientist who has spent a
> career studying steroid metabolism in farm
> animals
>
> Given the above, I cannot conclude that Baffert
> behaved in a manner to illegally boost a horse’s
> performance.

I\'m not a scientist and have many questions about this Steroid, one of which pertains to whether near race day injection can hide another drug or an alchemy of drugs that in union may boost performance.

Sticking to the drug in question, if the drug is present upon race day it involves behavior that is illegal.  Whether that steroid, so clearly injected near race day, can do more than reduce inflammation or mask the sensations of joint deterioration is not something I wish to make acquitting conclusions about.

[Electrocutionist]

Looking into this further, I see that Otomax also contains the antifungal agent clotrimazole. Clotrimazole is a well-known inhibitor of a liver enzyme called CYP3A4, which is the primary liver enzyme involved in detoxification (breakdown and subsequent elimination of drugs). CYP3A4 is the primary enzyme involved in betamethasone degradation. Thus, the presence of  clotrimazole in the Otomax could well have caused an increase in the half-life of the betamethasone. I sincerely doubt that the regulations concerning betamethasone would have been determined  in the presence of other compounds that may have affected its metabolism.

I\'m no fan of Bob Baffert, from a horse-racing fan\'s perspective. Over the years he\'s cost me many times. While I did stand to gain substantially had Medina Spirit not spoiled my Mandaloun-Hot Rod Charlie exacta, as a scientist I think the presence of betamethasone in the plasma is easily explainable when one considers how these compounds are metabolized and how other medications can affect it. This is the same reason that doctors warn against eating grapefruit while taking certain medications- it interferes with CYP3A4 resulting in slower than normal degradation of legally administered drugs.

While Baffert may be guilty if the determining fact is whether there is any trace of betamethasone in the horse, I think there is a scientifically sound reason for the fact pattern that seems to have occurred.

[HP]

You have no idea what he gave the horse.

You have no idea how it was administered.

That’s usually enough to stop most people, but now based on what you don’t know you are piling assumptions on top of your ignorance of any real facts (see first two sentences). Pure speculation based on whatever Baffert threw out there, which could just be his way of covering up whatever it is that he did.

You sound (read?) educated enough to know that as knowledgeable as you may be, you have no clue as to how applicable anything you are saying is in the present case. All you know is what everyone else does, that the horse tested positive. Why are you wasting time on a bulletin board, maybe Baffert needs an expert witness?

[Silver Charm]

Hey Clown neither do you. So perhaps you needs to shut up on something YOU have no factual based insight on. Just innuendo. Just I dont know what he did I just know he did something. Really?

[hellersorr]

I think Electrocutionist\'s posts on this matter are of great interest.  More knowledge is preferable to less knowledge, as far as I\'m concerned.

[Silver Charm]

He is someone who knows what he is talking about. But to the crowd of \"we dont know what Baffert did but we know he did something\"...that doesnt work. Common sense doesnt work.

Vet Mary Scolly led the telecast with what TGJB said. We DONT consider this medication a PED.....

If this next test comes back over the limit. There will be a DQ. Those were the rules in the jurisdiction he was working in. As someone who holds a License in a Few States its a professional responsibility.

[HP]

Silver I’ll say whatever I please. I didn’t say Baffert did anything. I just said this guy has no idea what Baffert did or didn’t give the horse. And neither do you. Assuming delays in the liver breaking something down is a LONG way from anything anybody knows about what really happened. You can read his posts all day. I hope you enjoy them.

[HP]

I’m not in that crowd Silver. You sound like a self righteous jackass. We’ll see what the authorities do. Whatever they do you’ll still be you.

[Silver Charm]

Try reading again what you wrote and how it was implied.


You have no idea what he gave the horse.

You have no idea how it was administered.

And then you come back and try and clarify \"what he did or didnt give the horse\". And I might know more than I will tell you or this Board. So we will leave it at that.

Facts don\'t matter? Just wild accusations and speculations. Wow a Kangaroo Court indeed

[HP]

Good. Leave it at that. Your inside knowledge is the envy of us all.

[Silver Charm]

Nawwww. Just a highly respected Licensed Professional here in South Florida. Its been a good day so far. I mean I hope I didnt get under your skin too much. Good Luck in the Preakness

[HP]

Not at all. Like to toot your horn eh? Mr. Highly Respected! I’m flattered by your attention Florida Man.