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Multiple sclerosis
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=== Special courses === Independently of the types published by the MS associations, regulatory agencies such as the FDA often consider special courses, trying to reflect some clinical trial results on their approval documents. Some examples could be "highly active MS" (HAMS),<ref name="sorensen">{{cite journal |vauthors=Sørensen PS, Centonze D, Giovannoni G, et al. |title=Expert opinion on the use of cladribine tablets in clinical practice |journal=Ther Adv Neurol Disord |volume=13 |pages=1756286420935019 |year=2020 |pmid=32636933 |pmc=7318823 |doi=10.1177/1756286420935019 |type= Review}}</ref> "active secondary MS" (similar to the old progressive-relapsing)<ref name="novartis.com">{{Cite web|url=https://www.novartis.com/news/media-releases/novartis-receives-fda-approval-mayzent-siponimod-first-oral-drug-treat-secondary-progressive-ms-active-disease|title=Novartis receives FDA approval for Mayzent® (siponimod), the first oral drug to treat secondary progressive MS with active disease|website=Novartis.com|access-date=12 November 2021|archive-date=20 November 2020|archive-url=https://web.archive.org/web/20201120002815/https://www.novartis.com/news/media-releases/novartis-receives-fda-approval-mayzent-siponimod-first-oral-drug-treat-secondary-progressive-ms-active-disease|url-status=live}}</ref> and "rapidly progressing PPMS".<ref>{{cite journal |vauthors=Saida T |title=多発性硬化症: 再燃時の治療と再発予防 |trans-title=Multiple sclerosis: treatment and prevention of relapses and progression in multiple sclerosis |language=ja |journal=臨床神経学 |trans-journal=Rinsho Shinkeigaku |volume=44 |issue=11 |pages=796–8 |date=November 2004 |pmid=15651294 |type= Review}}</ref> Also, deficits always resolving between attacks is sometimes referred to as "benign" MS,<ref name="pmid18219812">{{cite book | vauthors = Pittock SJ, Rodriguez M | chapter = Benign Multiple Sclerosis: A Distinct Clinical Entity with Therapeutic Implications | veditors = Rodriguez M | title = Advances in multiple Sclerosis and Experimental Demyelinating Diseases | series = Current Topics in Microbiology and Immunology | volume = 318 | pages = 1–17 | year = 2008 | pmid = 18219812 | doi = 10.1007/978-3-540-73677-6_1 | isbn = 978-3-540-73676-9 }}</ref> although people still build up some degree of disability in the long term.<ref name="pmid1897097722"/> On the other hand, the term [[malignant multiple sclerosis]] is used to describe people with MS having reached a significant level of disability in a short period.<ref>{{cite book | vauthors = Feinstein A | chapter = Chapter 1 - Multiple sclerosis: diagnosis and definitions |title=The Clinical Neuropsychiatry of Multiple Sclerosis |date=2007 |isbn=978-0-521-85234-0 | pages = 1–27 |doi=10.1017/CBO9780511543760 }}</ref> An international panel has published a standardized definition for the course HAMS.<ref name="sorensen" />
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