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Highly active multiple sclerosis (HAMS) is an aggressive form of the disease. This review clarifies HAMS definition and available treatments for better patient management.

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Area of Science:

  • Neurology
  • Immunology

Background:

  • Multiple sclerosis (MS) is a chronic CNS inflammatory disease affecting over 2 million globally.
  • MS presents with relapsing remitting (RRMS), primary progressive (PPMS), and secondary progressive (SPMS) phenotypes.
  • A subset of RRMS patients exhibits rapid progression despite disease-modifying drugs (DMTs), termed highly active MS (HAMS).

Purpose of the Study:

  • To review the definition of highly active MS (HAMS).
  • To discuss current treatment strategies for HAMS.
  • To address the lack of consensus on HAMS definition and treatment algorithms.

Main Methods:

  • Literature review of HAMS definition and treatment.
  • Analysis of existing data on aggressive MS phenotypes.
  • Synthesis of expert opinions on HAMS management.

Main Results:

  • HAMS is characterized by rapid physical and cognitive decline in RRMS patients, even with DMTs.
  • Current definitions and treatment algorithms for HAMS lack universal consensus.
  • The severe nature of HAMS necessitates distinct therapeutic approaches.

Conclusions:

  • Clearer definition and standardized treatment protocols for HAMS are crucial.
  • Further research is needed to optimize HAMS management.
  • Addressing HAMS is vital for improving outcomes in aggressive MS cases.