A second and pragmatic aspect is that ACOS provides a rationale to treat COPD patients with elevated eosinophils with ICS to minimize pneumonia risk and allocate expensive future biological medicines currently in development such as dupilumab (IL4Ra), mepolizumab (IL-5), and benralizumab (IL5Ra), seeFigure 3. This evidence concerns the gene IL5 and chronic obstructive pulmonary disease.