Author(s): SITKOWSKI, D., POKRYWKA, A., KÜHN, U., RYNKOWSKI, M., KRZYWANSKI, J., Institution: INSTITUTE OF SPORT - NATIONAL RESEARCH INSTITUTE, Country: POLAND, Abstract-ID: 1435

INTRODUCTION:
Therapeutic Use Exemptions (TUEs) are a fundamental component of the anti-doping system, enabling athletes to receive necessary medical treatment while remaining compliant with anti-doping regulations. However, longitudinal analyses of national-level TUE application patterns remain limited. The aim of this study was to analyse temporal trends in TUE applications submitted to the Polish Anti-Doping Agency (POLADA) between 2018 and 2025, with particular emphasis on decision outcomes and the contribution of substances classified under the WADA S6 category.
METHODS:
A retrospective analysis of administrative data from POLADA was conducted. Annual numbers of submitted and approved TUE applications were analysed, including decision outcomes (approved, refused, unfounded) and the number and proportion of approved TUEs granted for S6 substances. Descriptive statistics were used to assess temporal trends.
RESULTS:
Between 2018 and 2025, the annual number of approved TUEs increased from 36 to 78. Approved applications constituted the majority of decisions in all analysed years. The proportion of approved TUEs granted for substances classified under the S6 category increased markedly over time, from 3-7% in 2018-2019 to 40% in 2025. Methylphenidate was the most frequently approved S6 substance across all years, particularly in 2024-2025, while other S6 substances were granted TUEs sporadically. While approved TUEs constituted the majority of decisions, refused and unfounded applications represented a non-negligible proportion, reaching approximately one quarter of decisions in selected years.
CONCLUSION:
The observed increase in both the number of approved TUEs and the proportion related to S6 substances suggests a changing structure of TUE applications submitted to POLADA. This trend may reflect evolving health needs in the athlete population, particularly in relation to mental health, rather than changes in anti-doping enforcement. Further research is needed to determine whether the observed increase in TUE applications reflects genuine therapeutic needs or, in part, differences in application quality and eligibility, as suggested by the analysis of refused and unfounded applications.