Fingolimod real world experience

Fingolimod is a Multiple Sclerosis treatment licensed in Europe since 2011. Its efficacy has been demonstrated in three large phase III trials, used in the regulatory submissions throughout the world. As usual, in these trials the inclusion and exclusion criteria were designed to obtain a homogeneous population, with interchangeable characteristics in the different treatment arms. Although this is the best strategy to achieve a robust answer to the investigation question, it does not guaranty the treatment efficacy in the clinical practice, since in the real world there are concomitant treatments, comorbidities, adherence and persistence challenges. But, to make informed treatment decision for a real life patient, we need to have evidence of the treatment efficacy, what has been called treatment effectiveness. This work aims to review fingolimod effectiveness, using as source of information abstracts, posters and manuscripts. This unorthodox strategy was developed because more than half of the published experience with fingolimod is still on abstracts and posters. Only a small part of the studies reviewed are already published in peer reviewed journals. Fingolimod seems to be, at least, as effective and safe as it was on clinical trials, and with its long term experience no new safety signals were observed. In the Portuguese hospital perspective, early treatment with fingolimod is expected to result in better clinical outcomes associated with a more efficient healthcare resources allocation.

Context-aware framework for collaborative applications

Future pervasive environments will take into consideration not only individual user’s interest, but also social relationships. In this way, pervasive communities can lead the user to participate beyond traditional pervasive spaces, enabling the cooperation among groups and taking into account not only individual interests, but also the collective and social context. Social applications in CSCW (Computer Supported Cooperative Work) field represent new challenges and possibilities in terms of use of social context information for adaptability in pervasive environments. In particular, the research describes the approach in the design and development of a context.aware framework for collaborative applications (CAFCA), utilizing user’s context social information for proactive adaptations in pervasive environments. In order to validate the proposed framework an evaluation was conducted with a group of users based on enterprise scenario. The analysis enabled to verify the impact of the framework in terms of functionality and efficiency in real-world conditions. The main contribution of this thesis was to provide a context-aware framework to support collaborative applications in pervasive environments. The research focused on providing an innovative socio-technical approach to exploit collaboration in pervasive communities. Finally, the main results reside in social matching capabilities for session formation, communication and coordinations of groupware for collaborative activities.