Dear Editor:
This letter is to briefly address the “House of Cards” article by Natalie Voss relating to Medina Spirit's pre-race screening.
Ms. Voss focused on the pre-race screening testing for Medina Spirit performed by Industrial Labs on April 18, 2021, preceding the May 1, 2021 Kentucky Derby. As now confirmed by the Kentucky Horse Racing Commission (KHRC), the pre-race “out of competition” screening reported no medications or foreign substances in Medina Spirit in excess of lab screening limits excepting the commonly used antiacid ulcer medication Omeprazole, which was used in accordance with published regulations.
Ms. Voss seems to insinuate that the clearance reported by the lab screening report suggests that the now infamous Otomax (containing Gentamicin, Clotrimazole with a 9% Betamethasone Valerate component) could not be the source for the post-race Betamethasone positive because it was not reported in the pre-race screening testing. Not referenced in her article are: lab screening limits for pre-race screening, situational bioavailability of a topical ointment on a horse in a race training environment, progression of the skin lesion, variance of usage and dosage based upon clinical indications, and other factors that a cautious reporter might query before displaying a “house of cards” banner headlining such a superficial effort.
The Voss article also makes a glancing reference to “a separate sample from another horse… did indicate a level of .319 ng/ml of dexamethasone/Betamethasone.” Ms. Voss omits that the “sample from another horse” on the same screening sheet was NOT from Mr. Baffert's barn. That sample “from another horse” reported a result of .319 ng/ml of Betamethasone which is 15 times in excess of the 21 picograms reported in Medina Spirit from the Otomax ointment. The sample “from another horse” also contained phenylbutazone at a level 6.5 times the permitted race threshold. Who was that horse and did he run in the Derby? Ms. Voss did not report on those facts.
The KHRC, the Association of Racing Commissioners International (ARCI), the Racing Medication and Testing Consortium (RMTC), and every racing regulatory agency in the United States expressly classifies and regulates Betamethasone as an intra-articular injectable. Racing regulatory agencies, including the KHRC, rely on peer-reviewed scientific studies and the esteemed advisory associations that publish the monographs, bulletins, and proposed rules relating to the use of medications and substances administered to a race horse in competition. All studies and rule proposals regarding Betamethasone relate specifically to the injectable form and the stated risks associated with joint injections. There are no peer-reviewed studies, industry advisories, or agency rulemaking regarding topical use of an ointment containing any corticosteroid.
Ointments containing corticosteroids for skin lesions, rashes, skin infections and fungal outbreaks have been prevalently used for decades for humans and animals. The FDA has formally approved more than 40 such ointments and salves. The World Anti-Doping Agency (WADA) clearly spoke to the use of such ointments, and specifically those containing betamethasone. Under WADA's rules, betamethasone present in an athlete is expressly permitted–including on the day of competition–if due to the use of a topical medication. The medication, as a topical route of administration, has no effect on performance, and its use is legitimate. The use of Otomax for Medina Spirit was clinically indicated, prescribed and dispensed by a treating veterinarian and was transparently and promptly reported to the California Horse Racing Board and to the Jockey Club medication reporting data site on the same day it was prescribed and dispensed. “House of Cards” to “House Restored.”
–Clark Brewster
Attorney for Zedan Racing
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