
L. AAGAARD    ET  AL. 
 
Copyright © 2011 SciRes.                                                                                OJSST 
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people working with drug regulation. Available product 
information and/or patient leaflets were of very limited 
quality or non-existing and difficult to get access to, as 
these documents were only produced in a limited number 
of copies [4].   
Internal documents from the GDR health authorities 
revealed that from 1981 to 1983 spontaneous reports 
covering information about more than 120 deaths from 
use of anti-rheumatic medications containing indome- 
tacin (Metindol/Amuno), diclofenac (Rewodina), phenyl- 
butazone (Butaz olidin ), aminophenazone + phenylbuta- 
zone (Wofapyrin) and the antidiarrheal Mexaform plus 
(phanquinon + dichlorhydroxychinolin) and dichlorhy- 
droxychinolin (Endiaron) existed, but no restrictions for 
the use of these products were made [4]. For the X-ray 
contrast agent iomeglamic acid (Falignost) several seri- 
ous cases of allergies and anaphylactic shocks were re- 
ported which led to changes in the production, as radio- 
graphic examination were frequently used as a diagnostic 
method in the GDR [4].   
Of political reasons the GDR were not able to join the 
international WHO collaboration on medicines safety 
until 1983, despite that other Comecon countries such as 
Bulgaria, the Czech Republic, Poland and Romania had 
already joined this collaboration in the 1970s. From 1985 
until the German reunification in 1990, ADR reports 
were forwarded to the WHO ADR database, VigiBase by 
the GDR health authorities [4,6-7].   
We aim to characterize these ADRs reports, as these 
data has never been published before, and therefore 
would be of interest to the public.   
 
2. Methods 
 
2.1. Design 
 
We retrospectively analysed all ADR reports occurring 
in the GDR which were reported to VigiBase from July 
1985 to May 1990. ADR data were placed at the disposal 
of this study in anonymous form with encrypted identi- 
fication of the medicine user. ADR reports were pro- 
vided by the Uppsala Monitoring Centre (UMC) as 
CIOMS reports, and data from these reports were manu- 
ally entered into Microsoft Excel. The unit of analysis 
was one ADR.   
We analysed the reports with regard to type of reporter, 
age and gender of the patient, type (system organ class 
[SOC]) and seriousness of reported ADRs with respect to 
medications involved.   
 
2.2. Seriousness and Causality Criteria 
 
The severity of ADRs was rated as certain, probable or 
possible according to the CIOMS scale [1]. Causality 
was rated as established, probable, possible, improbable 
and not to be ascertained. Reports were later classified as 
being serious or non-serious according to international 
criteria.  
 
2.3. Classification of reported ADRs 
 
Any ADRs reported were classified according to the in- 
ternational classification system Medicinal Dictionary 
for Regulatory Activities (MedDRA) by preferred term 
(PT) and (SOC) [8].   
 
2.4. Setting  
 
A national ADR reporting system was established in 
1964 by law by the GDR’s Ministry of Health [5]. The 
system was managed by the “Institut für Arzneimittel- 
wesen der DDR” (IfAr), and physicians and pharmacists 
were required to report ADRs [4-5].   
An official reporting form (“Meldung von Schädlichen 
Arzneimittelwirkungen”) had to be completed, and the 
following information was required: age and gender of 
the patient; severity and characteristics of the ADR(s), 
suspected and concomitant medicines, indication for use, 
dosage, treatment period, date of onset of ADR, causality 
assessment and other relevant information such as labo- 
ratory data if available (internal documents).   
 
2.5. Medicine Use in the GDR 
 
Medicines licensed for use in the GDR were listed in the 
“Arzneimittel Verzeichnis”, published periodically by 
the IfAr and containing information about the active 
ingredients of available medicines, dosage, warnings, 
ADRs and contra-indications [6]. From 1945 to 1990 
approximately 1770 different types of medicines (pres- 
cription medicine, over-the-counter medicine, comple- 
mentary medicine, herbals, homeopathic medicine, aller- 
gen extracts, blood products and radioactive medications) 
were licensed for use in the GDR [7]. The number and 
assortment varied over time. In the same period, up to 
57,000 different pharmaceutical products were licensed 
for use in West Germany [7]. In the beginning of the 
1960s, the number of medicines imported into the GDR 
constituted 5% of all licensed medicines in the GDR, but 
this share increased up to approximately 30% of all 
licensed medicine in 1989/1990 [6]. The imported me- 
dicines were produced by pharmaceutical companies 
located in COMECON member states (estimated 20%) 
or in Western European countries (estimated 10%), and 
imported in the GDR by the special office/pharmacy: 
“Beratungsbüro für Arzneimittel”, which worked for the