In Baffert Appeal, an Expert Weighs in on Betamethasone

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Photo: ©UC Regents 2010. Photo by Don Preisler. All Rights Reserved
Heather Knych provided expert testimony Aug. 24 on behalf of the Kentucky Horse Racing Commission in a hearing appealing the 2021Kentucky Derby disqualification of Medina Spirit

On the third day of a hearing appealing the disqualification of Medina Spirit  from victory in the 2021 Kentucky Derby Presented by Woodford Reserve (G1), an expert witness for the Kentucky Horse Racing Commission testified on the effects, potential effects, and unknown effects of low levels of corticosteroids on horses, but didn't wade into specifics of the case.

That expert witness, Heather Knych of the Ken L. Maddy Equine Analytical Chemistry Laboratory at the University of California-Davis, testified Aug. 24 by Zoom video on betamethasone, corticosteroids, and a few other related studies. Medina Spirit was disqualified from his Derby win after post-race testing found betamethasone, a corticosteroid, in his system.

Knych was the only witness to testify publicly at Wednesday before hearing officer Clay Patrick in Frankfort, because after her testimony concluded at 1 p.m. ET, and a break for lunch, the rest of the day saw hearing participants meet behind closed doors under a protective order related to proprietary information. 

Testifying on behalf of the KHRC, Knych said betamethasone can be administered in several different ways. In response to KHRC general counsel Jennifer Wolsing, Knych said the effects of betamethasone are not dependent on the route of administration.

"No I don't think it matters. The drug is the drug once it gets into the system, once it gets into the body," Knych said. "I don't think the route of administration matters, at least relative to the (Racing Medication & Testing Consortium) recommendations."

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Related to that topic, Knych said the RMTC, the industry group that shapes such rules, doesn't vary its classification of betamethasone based on the method of administration. Knych, who serves on the RMTC's Scientific Advisory Committee, said it's a Class C substance that can't be in the horse's system on race day.

Later Knych outlined one of her studies that showed betamethasone administered to one joint spreads by blood throughout the system—including to other joints.

Medina Spirit
Photo: Anne M. Eberhardt
Medina Spirit

The appellants have argued that the source of the post-Derby betamethasone finding in Medina Spirit was a cream used to treat a rash, Otomax, that initially was prescribed on or around April 9 and was administered daily through the day before the Derby, April 30.

While Knych, an expert on pharmacokinetics, pharmacodynamics, drug metabolism, and biomarkers, offered her insights on the effects of betamethasone regardless of the type of administration, she stopped short of weighing in on the specifics of the case.

At one point Wolsing asked, "We are told that Medina Spirit was administered approximately 45 milligrams of Otomax from a period of about April 9 through April 30, the day before the Derby, which I guess is about three weeks. From a pharmacological standpoint, what, if any, impact can you say that would have had on a horse?"

Knych responded: "I don't think we can say one way or the other. We don't have the science to say one way or the other."

Wolsing followed up by asking if betamethasone at 21-25 picograms per milliliter of blood would have a pharmacological effect on a horse. The two numbers framing that range are the levels of betamethasone found in Medina Spirit's system in the initial post-race test and in the split sample test, respectively.

Again, Knych avoided commenting on specifics of the case: "I can't say if it does or doesn't have a pharmacological effect at those levels. We know that corticosteroids have prolonged effects, so it's possible."

In general terms, Knych said it's important that betamethasone be regulated.

"Certainly in sufficient concentrations, it's a potent anti-inflammatory," Knych said. "It has the potential to mask lameness or injury. And the primary reason that corticosteroids are so tightly regulated in horse racing, and other performance horse events for that matter, is to eliminate the potential to affect performance, the potential to mask injury.

"At the end of the day, the goal, first and foremost, is to protect the horse and protect the jockey."

As a main thrust of the appellants' argument is that Kentucky rules on betamethasone, specifically when it's not administered in an injection, are vague, there was an interesting exchange Wednesday involving Craig Robertson, attorney for Medina Spirit's trainer Bob Baffert, and Wolsing on Kentucky rules following a prominent, precedent-setting case in Kentucky.

The case referenced was the 2015 methocarbamol finding in a post-race test of Kitten's Point  that initially was fully overturned by Franklin (Ky.) Circuit Court Judge Thomas Wingate in 2017. But following that initial court decision, major parts of Wingate's ruling were reversed by the Kentucky Court of Appeals in December 2018.



Kitten's Point
Photo: Keeneland/Coady Photography
Kitten's Point

As Robertson represented Kitten's Point's trainer, Graham Motion, he is well familiar with the case. Oddly enough, Wednesday's session started with an acknowledgment that Knych had testified as an expert witness at a commission hearing on behalf of Motion in that case.

At one point Knych testified about studies that pointed to potential effects of corticosteroids and Patrick asked her if they were getting a bit off-topic. In arguing that the testimony was important to hear, Wolsing referenced that Court of Appeals decision, saying it gives the KHRC wide latitude in shaping rules.

"Your honor, it's my understanding pursuant to the Graham Motion case that it was held by the Court of Appeals that in order for regulation to withstand scrutiny, as it relates to the rational basis for that regulation, particularly as it relates to medication regulations; if the scientific community does not have a definitive answer, the regulator, in this case the KHRC, is allowed to be conservative, especially as it relates to issues of health, safety, and integrity," Wolsing said. "As a result, Your Honor, that's why we are introducing this type of testimony—to show there's some very reasonable reasons to believe that these topical corticosteroids can have these systemic effects that the KHRC is concerned about and was concerned about. 

"Moreover, if you have uncertainty, it's appropriate to regulate; according to the Graham Motion case."

In an objection of testimony being introduced along those same lines Wednesday, Robertson contended that Wolsing was misinterpreting that Motion ruling.

"I just want to object to the mischaracterization of the Motion case where she seems to say, "Well, we can do whatever we want when there's no science and that is not at all what that case says. That case says you have to have a rational, scientific basis for what you do in all of this stuff. 

"In this (Medina Spirit) case, all the stuff that you're talking about now was not presented as a reason for the rule change at all. They're ex post facto trying to make up a reason to justify trying to punish a man for a topical ointment when the rule change was solely based on intra-articular."

When Judge Wingate ruled in favor of Motion, he said in his decision, "The evidence presented by the KHRC merely indicates that a possibility for an effect at a certain dosing level exists. The court cannot allow mere speculation to stand for scientific evidence."

But in its decision overturning Judge Wingate, the Appeals Court found that the KHRC has wide latitude in its rulemaking.

"Limiting the amount of a drug in a horse's system that is not fully understood is a rational reason for the low threshold," the court said of the KHRC's rule on methocarbamol. "This is especially true in light of the broad powers given to the commission. Horse racing as we know it 'exists only because it is financed by the receipts from controlled legalized gambling which must be kept as far above suspicion as possible.' 

"Indeed, in its unusually expansive statement of legislative purpose (in Kentucky law), the Kentucky General Assembly acknowledges as much and more."

As for Wednesday's hearing, the closed-door session lasted 3 1/2 hours, beginning after lunch at 1:45 and concluding at 5:15 p.m.

Addressing apparent social media rumors of a potential deal, Clark Brewster, attorney for Medina Spirit's owner Zedan Racing Stables, said they would continue to appeal the ruling, "until we prevail, which we will."

The hearing is scheduled to continue Aug. 25 at 9 a.m.