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Within the class S4 of hormone and metabolic modulators of the WADA Prohibited List, 39% of the adverse analytical findings (AAF) reported in 2020 resulted from SERMs (tamoxifen and clomiphene) and another 29% from AIs (letrozole, anastrozole, exemestane, and adrostatrienedione) (World Anti-Doping Agency, 2022)
(Notably, tirzepatide in diabetics also lowers HbA1c, and even though the OSA trial excluded diabetics, the drugs metabolic effects would likely benefit prediabetic OSA patients by improving glycemic control.) This multifaceted impact can be viewed as a holistic approach to a cardiometabolic syndrome, where OSA is one piece of the puzzle
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