Elamipretide (SS-31)

Overview

Elamipretide (SS-31) is a small mitochondria-targeting peptide that binds cardiolipin in the inner mitochondrial membrane, helping stabilize cristae structure and improve mitochondrial energy production while reducing oxidative stress. It is the most clinically advanced compound on this list: it reached Phase 2/3 testing for several mitochondrial conditions, and in September 2025 the FDA approved it (brand name Forzinity) for Barth syndrome, a rare genetic mitochondrial disorder. However, its trial record is mixed — the Phase 3 MMPOWER-3 study in primary mitochondrial myopathy did not meet its primary endpoints (6-minute walk distance and fatigue). So while there is now an FDA-approved use in one rare disease, broader 'mitochondrial health' or anti-aging claims are not supported by successful trials.

Commonly Reported Uses

These are uses commonly discussed or marketed by users and vendors — not a list of proven or approved benefits, and not a recommendation.

• Barth syndrome (FDA-approved indication as Forzinity, 2025)
• Primary mitochondrial myopathy / fatigue (investigated in Phase 3 MMPOWER-3, which missed its primary endpoints)
• General mitochondrial / anti-aging and athletic 'energy' support (marketed claim; not supported by successful human trials)

What to Track

Data points you and your clinician might monitor. For observation only — not a diagnostic protocol.

• WHOOP — recovery score, resting heart rate, HRV, and sleep stages as energy/recovery context
• Subjective — daily fatigue, energy, and exercise-tolerance check-ins
• InBody / DEXA — lean mass trend if used in a performance context
• Labs — clinician-ordered monitoring appropriate to the indication

Sources & References

1. [1]Efficacy and Safety of Elamipretide in Individuals With Primary Mitochondrial Myopathy: The MMPOWER-3 Randomized Clinical Trial — PMC
2. [2]FDA Approves First Mitochondrial Disease Therapy: Elamipretide for Barth Syndrome — UMDF