Presently, use of combined medicines including inhalative glucocorticosteroids and prolonged P_2-agonists is recommended by national and international consensuses to achieve control of bronchial asthma (BA) in moderate and severe asthma patients in cases, when monotherapy with inhalative glucocorticosteroids was insufficient. High efficiency of such combination of medicines in obtaining a high level of BA control was proved by GOAL study. However, there is a category of patients, in whom despite of the use of combined drugs persist clinical, functional and laboratory signs of asthma. In patients with severe bronchial asthma significantly deteriorates quality of life, exist high risk of invalidization, their treatment is associated with considerable economic costs. The characteristic symptoms of severe BA: permanent occurrence of daily symptoms, frequent exacerbations, frequent night symptoms, restrictions of physical activity, FEV_1 or PEFR < 60 % predicted, PEFR or FEV_1 diurnal variability > 30 %, increase of frequency of using rescue medication - short-acting beta_2-agonists over 8 inhalations per day, over 2-3 courses of oral GCS per year, as well as frequent emergency ambulance calls.
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