Simona Halep, a two-time Grand Slam champion, has been provisionally suspended from tennis after testing positive for a prohibited substance. At the US Open in August, the former world number one provided a sample that tested positive for roxadustat.

The International Tennis Integrity Agency confirmed that the 31-year-old Romanian tennis player had been provisionally suspended under Article 7.12.1 of the 2022 Tennis Anti-Doping Programme (TADP).

Halep provided a sample (split into A and B samples) during the US Open in August of this year, and the analysis discovered that the A sample contained FG-4592 (Roxadustat), a prohibited substance listed on the World Anti-Doping Agency (WADA) Prohibited List for 2022. According to ITIA, adverse analytical findings for non-specified substances result in a mandatory provisional suspension.

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What is Roxadustat?

Roxadustat is an anti-anaemia medication that stimulates the body’s production of red blood cells.

It was studied in clinical trials to treat anaemia caused by chronic kidney disease. Roxadustat received its first global approval in China on December 17, 2018, for the treatment of CKD-related anaemia in dialysis patients.

It has been put into tests for performance-enhancing substances because of its potential usage in athletic doping and because athletes have already been found using it illegally despite it not yet having received medical approval.

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It was approved in Japan in 2019 for the treatment of anaemia caused by CKD in dialysis patients, and in 2020 for non-dialysis patients. In August 2021, Roxadustat was approved for medical use in the European Union.

The most common side effects are high blood pressure, blood clots in dialysis-related blood vessels, diarrhoea, swelling, especially in the ankles and feet, high blood potassium levels, and nausea.

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According to reports, roxadustat raises VEGF, a signal protein that can promote the growth of tumours and is also thought to be a contributor to pulmonary hypertension. Patients receiving roxadustat were found to develop metabolic acidosis and hyperkalemia, or a rise in serum potassium, in the phase 3 trial carried out at 29 sites around China.