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Many individuals with asthma and chronic obstructive pulmonary disease overlap (ACO) have recurrent acute exacerbations despite optimal inhaled therapy. There is little evidence regarding the potential benefits of anti-interleukin-5 (anti-IL-5) medications in subjects with ACO and elevated blood eosinophils. We aimed to determine if such patients had a significant reduction in acute exacerbations requiring oral corticosteroids (OCS) and improved 5-item Asthma Control Questionnaire (ACQ-5) scores after one year of anti-IL-5 therapy. ACO patients prescribed an anti-IL-5 medication (from 2018 to 2020) for a minimum of 1 year at Montfort Hospital (Ottawa, Ontario, Canada) were reviewed. Subjects included had at least 20 pack-years smoking history and radiographic emphysema on chest computed tomography. All patients had two or more acute exacerbations with OCS use in the past year (or …