Abstract
Asthma bronchiale has been considered as chronic inflammatory airway disease characterized by airway hyperresponsiveness and remodeling for more than 100 years. The proof of a causal link between disease and inflammation is, among others, a clear clinical effect of maintenance antiinflammatory therapy, which dramatically improved the course and prognosis of asthma and minimized its lethality after its introduction in the second half of last century.
However, there still remain almost 5 % of patients suffering from severe form of the disease prone to exacerbations and resistent to conventional therapy. These patients usually need to be treated by systemic corticosteroids with plenty of adverse events, First time in 2015 have the international guidelines proposed the use of biologicals or ultralong-acting muscarinic antagonists as first line ad-on therapy instead of the oral corticosteroids initiation.
This approach improves the effectiveness and safety of treatment, as well as the comfort of patients significantly.