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Introduction: Bronchiectasis is a heterogeneous disease. Previous phenotyping of this disease has been based solely on 5 European databases which do not really account for the remaining world population. Aims and Objectives: This study looked at the Indian EMBARC Registry to try and identify discrete patient groups with different clinical and biological characteristics. Methodology: Principal component and cluster analyses were performed using demographics, co-morbidities, clinical, radiological, physiological and microbiological variables collected during the stable disease state. Results: The data from 1368 prospectively enrolled outpatients from 33 centres in India from the EMBARC India Registry were included for the cluster analysis. Among these patients (mean age 54 years, 60% men) six clusters were identified. Our clusters were driven by patient demographics (age and sex), BMI (median BMI 21.48), aetiology of Bronchiectasis (Idiopathic 22.9%, post TB 34.3%, Post infectious 21.3%, ABPA 9.9%) Lung function (mean FEV1 53.36%, FVC 63.71%). Patients in the six clusters showed significant differences in terms of quality of life, exacerbations and hospitalisations. This is in complete contrast to the European cohort where four clusters were identified driven by the presence of chronic infection with Pseudomonas Aeruginosa or other pathogens and daily sputum production. Conclusion: Hence this is the first effort to define discrete phenotypes of Bronchiectasis patients in an Asian population. Identification of six clinical phenotypes in Bronchiectasis could favour focused treatments in future interventional studies designed to alter the natural history of the disease.

Introduction and Methods: The European Multicenter Bronchiectasis Audit and Research Collaboration (EMBARC) network established across 23 European countries was extended to India to explore unique features of Non-cystic fibrosis Bronchiectasis in this sub-continent. 34 investigator sites located across different parts of India contributed to 2062 cases of Non-CF Bronchiectasis, of which post-tuberculosis lung disease was identified as the biggest risk factor contributing to 34.7% (N=717) cases. The aim of this study was to describe the unique features of Post-TB Bronchiectasis observed on HRCT in this Indian cohort. Results: The mean (± SD) age of the 717 cases of Post-TB Bronchiectasis was 54.9 ± 14 yrs with a M:F ratio of 60:40. The location of Bronchiectasis was 71% (67.7,74.3) in the upper lobes, 66% (62.5,69.5) in the middle lobe/lingula and 60% (56.4,63.6) in the lower lobes. The cystic type was the most common 56% (53.1,60.4), followed by cylindrical 46% (42.3,49.6) and varicose 8.9% (6.8,10.9). More than 43.8% had bilateral disease. 13.6% (11.3,16.3) of the cases presented with hemoptysis that required hospitalization. Sputum microbiological samples collected in 39.8% of the cases isolated Pseudomonas in 17.1% during stable disease and 18.9% during exacerbations, while Klebsiella was isolated in 4.5% and 16.0% of cases respectively. Myco TB was isolated in the sputum in 5% of cases. 39.5% of the subjects had FEV1/FVC values Conclusion: Post TB lung disease is the commonest cause for Non CF Bronchiectasis in India and presents with unique features that are distinct from those reported in the western world.