Project update: September 2023

In May 2022, the Australian Government awarded grant funding to the VALUE-Ig study. Led by Professor Dennis Petrie from the Centre for Health Economics, the VALUE-Ig team consists of eight passionate researchers.

The objective of the VALUE-Ig study is to generate evidence to inform the optimal use of immunoglobulin (Ig) in four patient cohorts.

Cohort 1: Acquired hypogammaglobulinaemia secondary to haematological malignancy or stem cell transplantation (HGG + HM/SCT)

For Cohort 1, HGG + HM/SCT, we are adapting our existing EpiMAP Myeloma microsimulation model and starting to build a de novo model for lymphoma. We are currently analysing Victorian hospital data, which we are using to examine the relationship between Ig replacement and serious infections in these patients. We will also collect additional data from some Victorian hospitals, including laboratory data, to complement hospital data. We hypothesise that understanding Ig levels will be helpful in explaining Ig replacement therapy and infections.

Cohort 2: Acquired hypogammaglobulinaemia not secondary to haematological malignancy or stem cell transplantation (HGG – HM/SCT)

Cohort 2, HGG – HM/SCT is a diverse range of patients, including solid organ transplant recipients, patients receiving B-cell depletion therapy such as rituximab, and patients with Goods’ syndrome. We also plan to analyse Victorian hospital data for these patients, and we are making enquiries regarding access to registry data for specific solid organ transplant cohorts. We are looking for clinical expertise on patients in this Cohort to join our team. If you are interested in providing clinical input, please reach out to the team via email at value.ig@monash.edu

Cohort 3: Primary immunodeficiencies (PID)

The highest quality RCT evidence on the use of Ig replacement therapy is available for Cohort 3, PID patients. In Victoria, many PID patients receive subcutaneous Ig (SCIg) at home rather than intravenous Ig (IVIg) in hospitals. We are making enquiries to link Victoria Hospital data with an external data source that includes SCIg usage. We are also looking for clinical expertise for this Cohort. If you are an immunologist or specialist with an interest in PID and interested in this project, please reach out to the team via email at value.ig@monash.edu

Cohort 4: Myasthenia Gravis (MG)

Patients in Cohort 4, MG receive Ig for immunomodulatory purposes to relieve their symptoms, rather than as replacement therapy to prevent infections as in Cohorts 1, 2 & 3. We are collaborating with MGBase, a national MG registry, to prospectively enrol and capture additional data for patients with MG to help understand the value of Ig in this patient population. Recruitment will begin this year.

Given the broad range of patients involved in this study, we have many diverse sets of investigators, collaborators, and partner organisations.

We expect this project to run until June 2026, and we will provide updates every six months. Please reach out to us via email at value.ig@monash.edu if you have questions or suggestions.