Abstract
The proportion of patients with controlled asthma has increased over the last 15 years, however, still there is a significant proportion of patients who do not achieve control of the disease, and therefore have a high risk of exacerbations, hospitalizations, and poor quality of life. Patients with severe asthma, for which there were limited additional pharmacotherapy are the major problem. For the first time in recent years in the treatment of asthma a new class of drugs appeared: longacting anticholinergics - tiotropium which had been entered in stepwise therapy of asthma by GINA 2015. The definition of severe asthma, the role of the cholinergic nervous system in bronchial asthma, mechanism of action and clinical efficacy of tiotropium in severe bronchial asthma adults are described in the article.
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