Inhaled Steroids and Control of Severe Asthma

Inclusion Criteria: * Severe persistent asthma bronchiale with diagnosis according to the criteria of the Global Initiative for Asthma (GINA) executive summary * Treatment with at least inhaled corticosteroids (ICS) and long acting b agonists (LABA) * Evidence of inflammatory triggered form of asthma with at least one of the following: * sensitization to typical aerogenous allergens * increased Serum IgE levels * Eosinophilia in peripheral blood * Proven Eosinophilia in sputum differential (\> 3%) in the previous 2 years * at least 2 exacerbations of asthma within the previous 24 months leading to unscheduled presentation at a health care provider and/or systemic corticosteroid * Signed informed consent * Requirements of the local ethics committee are met Exclusion Criteria: * Acute exacerbation of asthma within the last 6 weeks Rtot \> 350% predicted capillary pO2 \< 60mmHG, pCo2 \> 50mmHG near fatal asthma or anaphylaxis in history * Age ≤ 18 and \> 80 years * Active smoking or \> 15 pack-years former smoking * Oral steroid treatment with a prednisolon-equivalent dose exceeding 10 mg per day * Pregnancy, nursing females * Female without use of effective contraceptive method * Treatment with investigational drugs over the past 30 days or during the course of the trial * Severe and uncontrolled gastroesophageal reflux disease * Ongoing psychiatric disorder * Treatment with systemic corticosteroids for any reason other than asthma * Other active lung diseases * Medical hist…