In my opinion yes.
There are some drugs (and some of them doesn't yet exist) which can make competitive sport healthier (reduce the risk of sudden death, for example) but they will be definitely performance increasers. Just a few example:
1. Anti aging drugs (real rejuvenative drugs, not healthspanish b**lshit such as resveratrol or metformin).
- Advanced glycation end products cross-link breaker. They will reverse the major root cause of aging. Skin, and especially blood vessels will become as elastic as in young age. Arterial stiffness decrease oxygen kinetics which decrease exercise performance.
- Senolytics. They give a 10-20% lifespan gain in rodents. Senescent cells secrete inflammatory compounds (inflammation decrease vo2max) and are a main driver of lung function decline. Reversing this kind of damage will increase exercise performance
2. Aging decelerators
- Direct AMPK agonists in combination with PPAR delta agonists (elefibranor, telmisartan, the later one isn't yet banned) are very cardio, nephroprotective. Mice didn't gain weight after a high cal.diet on these drugs. In endurance sport this combo will reprogram your muscles to a type 1. type 1 muscles are better for diabecity prevention and are more resistant to sarcopenia
- Anti sarcopenia drugs. For example follistatin gene therapy. Sarcopenia is a direct cause of age related performance decline
- Osteocalcin. You bones secrete this hormone. As you age, your bones get less dense and secrete less osteocalcin. Osteocalcin is a root driver of exercise induced adaptations. Less osteocalcin, and you will not improve from exercise. Old mice injected with osteocalcin restored their ability to gain functions from training and exercise became hormetic again.
- everything that restores your endocrine system to a young level
3. Fecal microbiota transplantation (FMT). Kenyan microbiome has a very great biodiversity. Some bacterial strains (prevotella) are more likely absent in weak athletes. Bad diet, stress, aging, antibiotics will irreversible decrease your microbiome biodiversity, and FMT is the only way to change it
4. Gene therapy
- There are a lot of pathways which will decrease the chance you will get atherosclerosis. For example, ApoA1 milano - a very rare mutation which completely protects you from plaques. No atherosclerosis = very very less deaths during marathons.
- there are genes which decrease your ability to increase exercise related biomarkers from training. For example, a higher antioxidant status means less vo2max increase from exercise. a gene therapy can resolve this unfairness