Reversing InGuinal Hernia Trial: The Evaluation of Sex Hormones to Reverse Inguinal Hernias in Males (RIGHT)
Reversing InGuinal Hernia Trial (RIGHT Trial): The Evaluation of Sex Hormones to Reverse Inguinal Hernias in Males
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 1
Contacts and Locations
Study Locations
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-
Illinois
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Chicago, Illinois, United States, 60611
- Northwestern Memorial Hospital
-
Contact:
- Nancy Ly, MD
- Phone Number: 3126956868
- Email: nancy.ly@nm.org
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Male sex
- Age ≥ 50 years at time of enrollment
- Symptomatic unilateral inguinal hernia confirmed on physical examination
- Hernia visible / confirmed on groin ultrasound
- Non-recurrent inguinal hernia (primary hernia only)
- Willing and able to provide written informed consent
- Able and willing to comply with all protocol-required visits, laboratory assessments, imaging, and follow-up
- Willing to use contraception and avoid fathering a child during study participation and for 12 months after last dose
- Willing to be counseled regarding vitamin D and calcium supplementation Bone safety mitigation measure per PIND response.
Exclusion Criteria:
Hernia Characteristics
- Scrotal hernia (any)
- Bilateral inguinal hernia
- Recurrent inguinal hernia (prior repair at same site)
Renal & Hepatic
- Clinically significant renal dysfunction judged by investigator to increase study risk
- Clinically significant hepatic dysfunction at baseline
Hematologic
■ Clinically significant baseline hematologic abnormality (including elevated hematocrit or polycythemia)
Urologic / Prostate
- Symptomatic benign prostatic hyperplasia (BPH) requiring active medical or procedural treatment
- Clinically significant untreated prostate disease
Skeletal / Bone
- Baseline osteoporosis (T-score ≤ -2.5 on DEXA at any site)
- Recent fragility fracture (within prior 12 months or as judged by investigator)
- Other clinically significant skeletal vulnerability judged to increase risk from estrogen suppression
Immunosuppression ■ Active immunosuppression (e.g., systemic corticosteroids, biologic agents, post-transplant regimens)
Psychiatric
■ Unstable or uncontrolled psychiatric illness that, in the investigator's judgment, would interfere with safe study participation
Reproductive / Fertility ■ Actively pursuing fertility or planning conception during study participation
Prior / Concomitant Therapy
- Current use of androgen replacement therapy, exogenous estrogen, or other endocrine-active agents that would confound study interpretation
- Prior or current use of aromatase inhibitor or selective estrogen receptor modulator / degrader within 6 months of enrollment
General
■ Any other clinically significant medical condition, laboratory abnormality, or circumstance that, in the investigator's judgment, would place the participant at unacceptable risk or compromise study integrity
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Fulvestrant 250 mg
Participants will receive fulvestrant 250 mg intramuscularly on Days 1, 15, and 29, then monthly for 6 months.
|
Participants will receive fulvestrant 250 mg intramuscularly on Days 1, 15, and 29, then monthly for 6 months.
|
|
Experimental: Anastrozole 5 mg
Participants will receive anastrozole 5 mg orally once daily for 6 months.
|
Participants will receive anastrozole 5 mg orally once daily for 6 months.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Composite Safety Event Rate
Time Frame: 6 months
|
Proportion of participants experiencing a composite safety event, defined as hernia-related complications including incarceration, strangulation, or emergent surgery; drug-related toxicity Grade 2 or higher by CTCAE v5.0; or procedure/treatment-related events Clavien-Dindo Grade III or higher.
|
6 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Serum Estradiol Level
Time Frame: Baseline to 6 months
|
Change in Serum Estradiol Level
|
Baseline to 6 months
|
|
Serum Testosterone Level
Time Frame: Baseline to 6 months
|
Change in Serum Testosterone Level
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Baseline to 6 months
|
|
Serum LH Level
Time Frame: Baseline to 6 months
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Change in Serum LH Level
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Baseline to 6 months
|
|
Serum FSH Level
Time Frame: Baseline to 6 months
|
Change in Serum FSH Level
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Baseline to 6 months
|
|
Hernia Size on Ultrasound
Time Frame: Baseline to 6 months; baseline to 1 year
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Change in Hernia Size on Ultrasound
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Baseline to 6 months; baseline to 1 year
|
|
Bone Mineral Density on DEXA
Time Frame: Baseline to 1 year
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Change in Bone Mineral Density on DEXA
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Baseline to 1 year
|
|
Euro Quality of Life 5 Dimension 5 Level (EQ-5D-5L) Score
Time Frame: Baseline to 6 months; baseline to 1 year
|
The EQ-5D-5L is a standardized quality-of-life instrument assessing mobility, self-care, usual activities, pain/discomfort, and anxiety/depression.
Index scores range from 0-5, with higher scores indicating worse health-related quality of life.
|
Baseline to 6 months; baseline to 1 year
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|
European Registry for Abdominal Wall Hernias Quality of Life (EuraHS-QoL) Score
Time Frame: Baseline to 6 months; baseline to 1 year
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The EuraHS-QoL questionnaire assesses pain, activity restriction, and cosmetic discomfort related to abdominal wall hernias.
Scores range from 0 to 90, with higher scores indicating worse hernia-related quality of life and symptom burden.
|
Baseline to 6 months; baseline to 1 year
|
Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
General Publications
- HerniaSurge Group. International guidelines for groin hernia management. Hernia. 2018 Feb;22(1):1-165. doi: 10.1007/s10029-017-1668-x. Epub 2018 Jan 12.
- Potluri T, You T, Yin P, Coon J 5th, Stulberg JJ, Dai Y, Escobar DJ, Lieber RL, Zhao H, Bulun SE. Estrogen receptor-alpha ablation reverses muscle fibrosis and inguinal hernias. J Clin Invest. 2025 Feb 4;135(6):e179137. doi: 10.1172/JCI179137.
- Zhao H, Zhou L, Li L, Coon V J, Chatterton RT, Brooks DC, Jiang E, Liu L, Xu X, Dong Z, DeMayo FJ, Stulberg JJ, Tourtellotte WG, Bulun SE. Shift from androgen to estrogen action causes abdominal muscle fibrosis, atrophy, and inguinal hernia in a transgenic male mouse model. Proc Natl Acad Sci U S A. 2018 Oct 30;115(44):E10427-E10436. doi: 10.1073/pnas.1807765115. Epub 2018 Oct 16.
- Matthews RD, Neumayer L. Inguinal hernia in the 21st century: an evidence-based review. Curr Probl Surg. 2008 Apr;45(4):261-312. doi: 10.1067/j.cpsurg.2008.01.002. No abstract available.
- Potluri T, Taylor MJ, Stulberg JJ, Lieber RL, Zhao H, Bulun SE. An estrogen-sensitive fibroblast population drives abdominal muscle fibrosis in an inguinal hernia mouse model. JCI Insight. 2022 Apr 19;7(9):e152011. doi: 10.1172/jci.insight.152011.
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Pathologic Processes
- Pathological Conditions, Anatomical
- Necrosis
- Hernia, Abdominal
- Pathological Conditions, Signs and Symptoms
- Fibrosis
- Hernia
- Hernia, Inguinal
- Gangrene
- Hormones
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Organic Chemicals
- Heterocyclic Compounds, 1-Ring
- Heterocyclic Compounds
- Azoles
- Polycyclic Compounds
- Steroids
- Fused-Ring Compounds
- Nitriles
- Estradiol
- Estrenes
- Estranes
- Estradiol Congeners
- Gonadal Steroid Hormones
- Gonadal Hormones
- Triazoles
- Fulvestrant
- Anastrozole
Other Study ID Numbers
Other Study ID Numbers
- 00225501
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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