SS-31 / Elamipretide
Also known as: Elamipretide, Forzinity, Bendavia, MTP-131
A mitochondria-targeted peptide that was granted FDA accelerated approval in September 2025 as the first-ever approved treatment for Barth syndrome, a rare genetic mitochondrial disorder. It is also being studied for broader mitochondrial diseases and age-related decline.
How it works
SS-31 is a small peptide that concentrates inside mitochondria by binding to cardiolipin, a lipid found on the inner mitochondrial membrane. By stabilizing cardiolipin, it improves the efficiency of the electron transport chain (your cells' energy production system), reduces the production of harmful free radicals, and prevents mitochondrial damage. Clinical studies showed it can improve muscle strength by 45% and heart function by 40% in Barth syndrome patients.
Common uses
- Barth syndrome muscle weakness (FDA-approved)
- Primary mitochondrial myopathy (clinical trials)
- Age-related mitochondrial decline (research)
- Heart failure with mitochondrial dysfunction (research)
Side effects
- Injection site reactions
- Headache
- Fatigue
- Nausea
- Muscle pain
- Upper respiratory infection symptoms
Key research
- TAZPOWER clinical trial demonstrated improved knee extensor muscle strength in Barth syndrome patients, leading to FDA accelerated approval in September 2025
- NuPower Phase 3 trial exploring efficacy for nuclear DNA-related primary mitochondrial disease
- Hundreds of mitochondrial disease patients studied across multiple clinical trials
- Forzinity became commercially available in December 2025
Safety notes
- FDA-approved only for Barth syndrome in patients weighing at least 30 kg
- Approved via accelerated approval pathway, so confirmatory trials are still needed
- Not approved for general anti-aging or longevity use
- Off-label use for other mitochondrial conditions is at physician discretion
- Brand pricing expected to be high as an orphan drug for a rare disease
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