{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T13:47:24Z","timestamp":1792849644449,"version":"4.5.0"},"reference-count":32,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2021,10,7]],"date-time":"2021-10-07T00:00:00Z","timestamp":1633564800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxics"],"abstract":"<jats:p>A 43-year-old male, sport coach, presented him-self at the Emergency unit of a local hospital for epigastric pain, myalgia pain and severe headache. He claimed having used for some days a combination of GW1516 (cardarine), a peroxisome proliferator-activated receptor delta agonist (PPAR- \u03b4) and MK2866 (ostarine), a selective androgen receptor modulator (SARM) to gain skeletal muscles. Cytolysis with marked increase of alanine aminotransferase or ALT (up to 922 UI\/L) and aspartate aminotransferase or AST (up to 2558 UI\/L) and massive rhabdomyolysis with elevated creatine phosphokinase or CPK (up to 86435 UI\/L) were the main unusual biochemistry parameters. Using a specific liquid chromatography coupled to tandem mass spectrometry method, cardarine and ostarine tested positive in blood at 403 and 1 ng\/mL, respectively. In urine, due to extensive metabolism, the parent GW1516 was not identified, while ostarine was at 88 ng\/mL. Finally, both drugs were identified in hair (2 cm in length, brown in colour), at 146 and 1105 pg\/mg for cardarine and ostarine, respectively. This clearly demonstrates repetitive abuse over the last 2 months. Asthenia was persistent for 2 weeks and 6 weeks after the admission, the subject fully recovered.<\/jats:p>","DOI":"10.3390\/toxics9100251","type":"journal-article","created":{"date-parts":[[2021,10,11]],"date-time":"2021-10-11T01:59:47Z","timestamp":1633917587000},"page":"251","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Peroxisome Proliferator-Activated Receptor Delta Agonist (PPAR- \u03b4) and Selective Androgen Receptor Modulator (SARM) Abuse: Clinical, Analytical and Biological Data in a Case Involving a Poisonous Combination of GW1516 (Cardarine) and MK2866 (Ostarine)"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4174-5362","authenticated-orcid":false,"given":"Pascal","family":"Kintz","sequence":"first","affiliation":[{"name":"Institut de M\u00e9decine L\u00e9gale, 11 rue Humann, 67000 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurie","family":"Gheddar","sequence":"additional","affiliation":[{"name":"Institut de M\u00e9decine L\u00e9gale, 11 rue Humann, 67000 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4892-1496","authenticated-orcid":false,"given":"Camille","family":"Paradis","sequence":"additional","affiliation":[{"name":"Centre Antipoison et de Toxicovigilance, Groupe Hospitalier Pellerin, Place Am\u00e9lie Raba L\u00e9on, CEDEX, 33076 Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mickael","family":"Chinellato","sequence":"additional","affiliation":[{"name":"Service des Urgences, Centre Hospitalier de Marmande, 76 rue du Dr Courret, 47200 Marmande, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Ameline","sequence":"additional","affiliation":[{"name":"Institut de M\u00e9decine L\u00e9gale, 11 rue Humann, 67000 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-S\u00e9bastien","family":"Raul","sequence":"additional","affiliation":[{"name":"Institut de M\u00e9decine L\u00e9gale, 11 rue Humann, 67000 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magali","family":"Oliva-Labadie","sequence":"additional","affiliation":[{"name":"Centre Antipoison et de Toxicovigilance, Groupe Hospitalier Pellerin, Place Am\u00e9lie Raba L\u00e9on, CEDEX, 33076 Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1517\/17460441.2013.741582","article-title":"Deciphering the selective androgen receptor modulators paradigm","volume":"8","author":"Zhang","year":"2013","journal-title":"Expert Opin. 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