Rationale for Correct Answer

The correct answer is: Antimuscarinics

Antimuscarinics are considered first-line therapy for patients with MS and overactive bladder (OAB).1 Mirabegron is effective in managing OAB and has been studied in patients with MS.2 Botulinum toxin A injections are approved for OAB, and their efficacy has been confirmed in trials of MS.3 Percutaneous tibial stimulation and sacral neuromodulation are also used in treating medically-refractory OAB; they are not well-studied in the MS population.4 Alpha-1 adrenergic blockers are the only pharmacologic treatment option for voiding dysfunction, and they are first-line therapy for people with enlarged prostates; however, their efficacy has not been well-studied in patients with MS.1

References:
1. Tornic J et al. Curr Neurol Neurosci Rep. 2018;18:54.
2. Krhut J et al. Res Rep Urol. 2022;14:167-175.
3. Kaviani A et al. Urol Clin North Am. 2017;44:463-474.
4. Rahnama’i MS et al. Mult Scler. 2020;26:1274-1280.