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Exogenous AAS inhibit endogenous testosterone production, and discontinuation of their use is often associated with a prolonged decrease in testosterone secretion ( The substances used in PCT are administered in the treatment of male hypogonadism unrelated to androgen abuse ( To restore endogenous testosterone, mainly aromatase inhibitors (AIs), selective estrogen receptor modulators (SERMs), and human chorionic gonadotropin (hCG) are used ( In the 2024 WADA Prohibited List ( Aromatase is an enzyme that converts testosterone to estradiol (the most potent estrogen form) and androstenedione to estrone ( The anti-estrogenic compounds mentioned in the WADA list can be divided into two groups: SERMs (bazedoxifene, clomiphene, cyclofenil, ospemifene, raloxifene, tamoxifen, and toremifene) and selective estrogen receptor degraders (SERDs), of which fulvestrant is a representative

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In addition, the mRNA and protein levels of SIRT1 in RA LFS are lower than normal FLS, and increased SIRT1 expression strikingly suppresses the invasiveness of RA FLS by inhibiting MMP1 and MMP13 expression (303)