Structural and functional changes in small bronchi (< 2 mm in diameter) play an important role in reducing the air flow in bronchial asthma. New techniques using gas analysis and high-resolution computed tomography shows the direction for new applications. The new formulations of inhaled β2-agonists and glucocorticosteroids in aerosols with ultra-fine particles may be more effective in controlling asthma. New combinations are more effective than previously used, because they deposit in small bronchi.
Disclosed ciclesonide rapid therapeutic effect and its formulation indicate that it can be used in asthma exacerbation, and in severe and difficult asthma, where inflammation takes place in the peripheral bronchi.