Elamipretide (SS-31 / Forzinity)
FROM THE REEL TO THE RESEARCH
What can targeting mitochondrial machinery change?
These are not four versions of the same mitochondrial treatment. NAD+ participates in redox chemistry and enzyme reactions; MOTS-c is investigated as a metabolic stress signal; SS-31 binds cardiolipin; Humanin has experimental cell-survival actions. Their human evidence is also unequal and disease-specific. None of the comparisons reviewed here establishes a four-way winner for healthy-person energy, fat loss, hypertrophy or longevity, and different mechanisms do not prove a beneficial stack.
From MOTS-c vs NAD+ vs SS-31 vs Humanin · Editorial update 2026-10-16
A visual comparison of elamipretide (SS-31) and MOTS-c: cardiolipin, stress signaling, human trials, FDA approval, exercise claims and the evidence missing from peptide stacks.
Related comparisons (1)
- MOTS-c vs NAD+ vs SS-31 vs Humanin — Four mitochondrial stories. Four different evidence trails.
What it is & what research shows
Study example availableElamipretide is a mitochondria-targeted tetrapeptide that interacts with cardiolipin in the inner mitochondrial membrane. It has been developed as an investigational drug for mitochondrial and related diseases. Human trials have examined safety, exercise capacity and fatigue in people with primary mitochondrial myopathy and other conditions. Results are indication-specific and do not establish a general performance or longevity benefit. [1.1][1.2][1.3]
One selected study: A randomized, double-blind trial compared intravenous elamipretide with placebo. The primary outcome was change in six-minute walking distance after five days. The study included 36 adults with genetically confirmed primary mitochondrial myopathy. A verified dose and schedule have not yet been added to this study summary. Walking distance increased by 64.5 metres at the highest dose versus 20.4 metres with placebo; this unadjusted comparison did not reach statistical significance. Dose-response and adjusted analyses favored elamipretide. Other efficacy and safety outcomes showed no significant differences. The authors called for larger trials with longer treatment periods. These five-day results do not establish sustained benefit or long-term safety. [2.1]
Sources & reading scope
- [1.1] Phase 1 elamipretide studyHuman study · safety and pharmacokinetics
- [1.2] MMPOWER-3 randomized trialHuman randomized trial · primary mitochondrial myopathy
- [1.3] Elamipretide crossover trialHuman crossover trial · exercise-related outcomes
- [2.1] Randomized dose-escalation trial of elamipretide in adults with primary mitochondrial myopathy.Human · Abstract summarized · not a full-paper review
Evidence summarized on PED Evidence
7 completed summaries
4 human-study reports
3 randomized-trial candidates
1 safety-topic reports
More about Elamipretide: identity, safety & reference details
Also known as SS-31 · SS31 · MTP-131 · Bendavia · Forzinity
Start with the research
An outcome-specific synthesis has not been prepared for this compound. This is a coverage gap, not evidence that it has no effect.
Open studies and trial records- Uses & research
Human trials have examined safety, exercise capacity and fatigue in people with primary mitochondrial myopathy and other conditions. Results are indication-specific and do not establish a general performance or longevity benefit. [1][2][3]
- Known half-life
No source-verified value in this profile yet. A treatment schedule or duration of an effect is not a drug half-life.
Half-life describes how quickly the measured drug concentration falls by half. It does not set a dosing interval.
Safety & evidence boundaries
In the MMPOWER-3 trial, elamipretide did not improve the primary six-minute-walk or fatigue outcomes versus placebo at 24 weeks. Earlier studies contained exploratory or secondary signals, so they should not be presented as a confirmed treatment effect.
Explore safety questions by system
These are literature filters, not claims that this compound causes each effect. A keyword match is not a confirmed adverse reaction.
Identity, names & formulations
Canonical compound: Elamipretide · elamipretide
Searchable names: SS-31, SS31, MTP-131, Bendavia, Forzinity
Names share a parent research page. Different esters, salts, routes and brands are not assumed to have the same half-life, indication or exposure.
Combination evidence stays attached to the studied combination. It is not automatically assigned to each ingredient.
Understand the evidence types
Read the model and design first, then the population, outcome and limitations. These categories describe evidence, not a best-compound ranking.
- Randomized human trials
- Compare assigned interventions. Randomization does not by itself establish low bias or relevance to every population.
- Controlled human studies
- Use a comparison group; allocation and confounding still matter.
- Prospective human research
- Follows participants forward. It may be observational or interventional, so this is not a separate quality grade.
- Observational human research
- Describes associations. Confounding can explain differences.
- Case reports and series
- Useful for unusual events and safety signals, not reliable rates or effect sizes.
- Animal research
- Can test biology and function in a living model. Human exposure, benefit and safety remain separate questions.
- Cell and tissue research
- Tests responses in a preparation, including human-derived cells. It is not a human participant trial.
- Mechanistic and computational evidence
- Helps explain or predict a pathway; predictions need experimental and clinical testing.
- Anecdotal reports
- Self-reported experiences can generate questions. Product identity, selection bias and other interventions may be uncontrolled.
Systematic reviews synthesize studies and depend on their quality. Preprint status and abstract versus full-paper reading are separate labels. Citation popularity measures attention, not reliability. A study summary is not a formal quality appraisal.
Sources for this profile
- 1. Phase 1 elamipretide study Human study · safety and pharmacokinetics
- 2. MMPOWER-3 randomized trial Human randomized trial · primary mitochondrial myopathy
- 3. Elamipretide crossover trial Human crossover trial · exercise-related outcomes
Reference facts checked 2026-09-16. Source scope is listed above; this is not a formal quality appraisal. See each label for full prescribing information.
Study model describes the source. Confidence depends on methods, replication, population and outcome.
Loading compound research…
Elamipretide study summaries
Human-first reading order. Intervention candidates are distinguished from background mentions in the library.
- In vivo mitochondrial ATP production is improved in older adult skeletal muscle after a single dose of elamipretide in a randomized trial. · Human · 2021-07-15
- Randomized dose-escalation trial of elamipretide in adults with primary mitochondrial myopathy. · Human · 2018-03-02
- A phase 2/3 randomized clinical trial followed by an open-label extension to evaluate the effectiveness of elamipretide in Barth syndrome, a genetic disorder of mitochondrial cardiolipin metabolism. · Human · 2020-10-20
- Effects of Elamipretide on Left Ventricular Function in Patients With Heart Failure With Reduced Ejection Fraction: The PROGRESS-HF Phase 2 Trial. · Human · 2020-02-14
- Elamipretide Rejuvenates Oocyte Quality and Restores Female Fertility During Reproductive Aging. · Animal · Cell / tissue · 2026-10-02
- Targeting Mitochondria in MASLD: Comparative Evaluation of MitoQ and SS-31 (Elamipretide) in Aged Female Mice under Nutritional Stress. · Animal · 2026-08-01
- Targeting Mitochondrial Dysfunction With Elamipretide (SS-31) Improves Skeletal Muscle Performance in a HFpEF Rat Model. · Animal · 2026-06-15