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Objective: We aimed to assess the causes of death, the mortality and survival time of MS patients in Hungary., Patients and Methods: Between 1993 and 2013, 740 patients (10,303person-years) were treated at our Outpatients' Clinic, of which 121 died. The causes of death were established from the pathological records or the medical certificates of the cause of death. The standardized mortality ratios (SMR) were calculated. Survival time was assessed with Gehan-Breslow test., Results: Sixty-four percent of our patients died of MS-related causes. The SMR was 2.52. Primary progressive (PPMS) patients' SMR was higher (4.10) than initially relapsing patients' (RR/SPMS) was. There was no difference between the genders (2.46 for men vs 2.57 for women). The median survival time of woman was 3years longer (p<0.001). RR/SPMS patients' median survival (35years) was more than twice as long as PPMS patients' (14years)., Discussion: The frequency of the MS-related cause of death, SMR and the median survival times were mostly similar to previous results from Scandinavia and North-America, despite the very different socio-economic backgrounds of these areas which shows that the survival risk can solely be attributed to MS itself. These are the first data on the topic from Central-Eastern-Europe., (Copyright © 2016. Published by Elsevier B.V.)

Biomarkers capable of predicting the clinical course and the rate of disease progression in multiple sclerosis are currently unavailable. Our objective was to examine if the levels of proteins associated with axonal and neuronal degeneration (Tau, p-Tau and β-amyloid(1-42)) and T-cell-mediated autoimmunity (osteopontin) are altered in the cerebrospinal fluid (CSF) of MS patients, and to assess their potential in reflecting the clinical severity and predicting the progression and clinical evolution of early MS. The CSF samples collected from patients presenting with different clinical forms of MS were evaluated by enzyme-linked immunosorbent assays. The patients were regularly followed-up and their clinical status was re-evaluated 5 years after sampling. The results demonstrated that while CSF levels of Tau, p-Tau and β-amyloid(1-42) did not differ between MS and Control groups, the levels of osteopontin were significantly elevated in MS patients. This increase was associated with the presence of a relapse and correlated with clinical severity, which findings were independent of age and blood-CSF barrier function. However, none of the examined protein levels differed significantly between groups with different clinical evolutions and no positive correlations with clinical progression could be detected. We conclude that Tau, p-Tau and β-amyloid(1-42) are inappropriate as biomarkers in MS. This is the first report on CSF osteopontin as an independent marker of clinical severity in definite MS., (Copyright © 2013 Elsevier B.V. All rights reserved.)