Erythropoietin or EPO is a hormone involved in generating red blood cells. In medicine, EPO is used to treat some forms of anemia.
The U.S. anti-doping agency claims record seven-time Tour de France winner Lance Armstrong used EPO and in 1998, two entire cycling teams at the gruelling Tour de France competition were taken out of the race on suspicion of its use.
The World Anti-Doping Agency defines doping as the misuse of certain techniques or substances to increase red blood cell mass, which allows the body to transport more oxygen to muscles and increase stamina and performance.
"The results of this literature search show there is no scientific basis to conclude recombinant human erythropoietin has performance enhancing properties in elite cyclists," Adam Cohen, a professor of clinical pharmacology at the Centre for Human Drug Research in Leiden, The Netherlands, and his co-authors wrote in a review published in the British Journal of Clinical Pharmacology.
"The reported studies have many shortcomings regarding translation of the results to professional cycling endurance performance."
The review looked at studies on EPO's role in endurance performance and anti-inflammatory effects.
Educating athletes instead of enforcing
Beliefs in performance enhancement were based on assumptions extrapolated from other populations that don’t necessarily apply to elite cyclists.
The evidence on factors measured in the research, such as maximal oxygen uptake, was "soft" at best, Cohen's team said.
Research on EPO doesn't consider all of the other factors that contribute to an elite cyclist’s success, such as muscle power.
"When elite athletes and their coaches discover that there is no evidence of benefit and clear risk of harm, I hope many may … reconsider trying to cheat," Cohen said in a release.
He acknowledged that although doping is forbidden, the pressure to win in sport is so great that some athletes seem to be willing to try anything.
"Education may work where attempts at enforcement have failed," he said.