Despite the prognostic role of smoking in asthma [1], clinical studies of asthma usually exclude current smokers or ex-smokers with a smoking history of >10 pack-years [2–5]. Specifically, the role of humanised monoclonal antibody therapy in patients with severe asthma and prior smoking exposure has not been studied; however, these drugs are used in patients with severe asthma and a history of smoking [6–9]. The aim of the present study was to evaluate in a real-world setting how a history of smoking and comorbid COPD affect the clinical outcome of patients suffering from severe asthma that are treated with monoclonal antibodies.