What is SS-31 (Elamipretide)?

A mitochondria-targeted peptide, described as a "bodyguard" for the inner mitochondrial membrane.

SS-31 (Elamipretide) in the library · · Human Trials · What are peptides?

30 registered trials · 15 indexed papers · 96 human / 231 animal studies

From the PeptideWhiz library entry. "As described" sections summarize claims made in the sources; they are not PeptideWhiz endorsements.

What it is

A mitochondria-targeted peptide, described as a "bodyguard" for the inner mitochondrial membrane.

Mechanism (as described)

Membrane: lipophilic; binds cardiolipin on the inner membrane and patches its "rips and tears." Restores membrane charge and keeps the permeability pore closed, so cytochrome c stays in.
Energy: preserves the proton gradient and ATP synthase. Lowers ROS and restores ATP.
Protected cell types:
heart muscle (failing hearts; a single infusion cited as improving cardiac energy efficiency within hours)
kidney tubules and podocytes
neurons, including dopamine neurons in Parkinson's models
oligodendrocytes in MS
blood-forming stem cells and skeletal muscle
Safety: described as having a very wide margin.

Additional points (as described)

Its positive charge draws it to the negatively charged damaged inner membrane; healthy mitochondria repel it, so it targets the worst. It binds cardiolipin, keeps cytochrome c in place and keeps the permeability pore shut.
Damaged mitochondria release danger signals (NLRP3 inflammation), and overloaded mitochondria drive insulin resistance.
In the heart it's preferred over broad antioxidants because it keeps useful signaling. Described alongside TB-500 for heart scarring.

Registered human trials (30)

Trial	Phase	Status	Year	Enrolled
Clinical Trial in Patients With Barth Syndrome- 4TAZPower	Phase 4	recruiting	2026	48
Study of Healthy Aging and Physical Function With Elamipretide	Phase 2	recruiting	2025	30
ReNEW:Phase 3 Study of Efficacy, Safety & Pharmacokinetics of Subcutaneous Injections of Elamipretide in Subjects With Dry Age-Related Macular Degeneration (Dry AMD)	Phase 3	active not recruiting	2024	313
FRDA Investigator Initiated Study (IIS) With Elamipretide	Phase 1/Phase 2	completed	2022	20
Study to Evaluate Efficacy and Safety of Elamipretide in Subjects With Primary Mitochondrial Disease From Nuclear DNA Mutations (nPMD)	Phase 3	completed	2022	102
An Intermediate Size Expanded Access Protocol of Elamipretide		available	2020
ReCLAIM-2 Study to Evaluate Safety,Efficacy & Pharmacokinetics of Elamipretide in Subjects With AMD With Non-central GA	Phase 2	completed	2019	176
A Trial to Evaluate Safety, Tolerability and Efficacy of Elamipretide in Subjects With Barth Syndrome	Phase 2/Phase 3	completed	2017	12
A Trial to Evaluate Safety and Efficacy of Elamipretide Primary Mitochondrial Myopathy Followed by Open-Label Extension	Phase 3	terminated	2017	218
Open-Label Extension Trial to Characterize the Long-term Safety and Tolerability of Elamipretide in Subjects With Genetically Confirmed Primary Mitochondrial Myopathy (PMM)	Phase 2	terminated	2016	28
A Study Investigating the Safety, Tolerability, and Efficacy of Elamipretide Topical Ophthalmic Solution for Treatment of Leber's Hereditary Optic Neuropathy	Phase 2	completed	2016	12
A Study Investigating the Safety, Tolerability, and Efficacy of Elamipretide Topical Ophthalmic Solution for the Treatment of Fuchs' Corneal Endothelial Dystrophy (FCED)	Phase 1/Phase 2	completed	2016	22
An Open-Label, Phase 1 Clinical Study to Evaluate the Safety and Tolerability of Subcutaneous Elamipretide in Subjects With Intermediate Age-Related Macular Degeneration	Phase 1	completed	2016	40
A Phase 2 Study to Evaluate the Cardiac and Renal Effects of Short Term Treatment With Elamipretide in Patients Hospitalized With Congestion Due to Heart Failure	Phase 2	completed	2016	308
Safety, Tolerability, Efficacy of MTP-131 for Treatment of Mitochondrial Disease in Subjects From the MMPOWER Study	Phase 2	completed	2016	30
Effect of Elamipretide on Left Ventricular Function in Subjects With Stable Heart Failure With Reduced Ejection Fraction	Phase 2	completed	2016	71
A Study to Evaluate the Effects of 4 Weeks Treatment With Subcutaneous Elamipretide on Left Ventricular Function in Subjects With Stable Heart Failure With Preserved Ejection Fraction	Phase 2	completed	2016	46
A Phase 2 Study to Evaluate the Impact of MTP-131 (Bendavia™) on Skeletal Muscle Function in Elderly	Phase 2	completed	2015	41
Safety, Tolerability, and Efficacy of MTP-131 for the Treatment of Mitochondrial Myopathy	Phase 1/Phase 2	completed	2015	36
A Phase 1 Study Investigating the Safety and Pharmacokinetics of Repeat-dose Intravenous Infusion of MTP-131 in Subjects With Impaired Renal Function	Phase 1	completed	2015	23
A Multiple Ascending Dose Study to Evaluate the Safety, Tolerability, Pharmacokinetics and Efficacy of Bendavia™ (MTP-131) in Patients With Heart Failure	Phase 1	withdrawn	2015
A Study of MTP-131 Topical Ophthalmic Solution in Subjects With Diabetic Macular Edema and Non-Exudative Intermediate Age-related Macular Degeneration	Phase 1/Phase 2	completed	2014	20
A Study Investigating the Safety, Tolerability, and Pharmacokinetics of MTP-131 in Subjects With Congestive Heart Failure	Phase 1	completed	2014	36
Safety and Pharmacokinetic (PK) Study of Oral Bendavia Administered for 7 Days	Phase 1	completed	2013	30
Effects of Intravenous Bendavia™ on Reperfusion Injury in Patients Undergoing Angioplasty of the Renal Artery	Phase 1/Phase 2	terminated	2012	16
Evaluation of Myocardial Effects of MTP-131 for Reducing Reperfusion Injury in Patients With Acute Coronary Events	Phase 2	completed	2012	300
A Phase 1 Study Examining the Pharmacokinetics and Tolerability of a Single Oral Dose of Bendavia (MTP-131)	Phase 1	completed	2012	30
Study to Assess the Pharmacodynamic Effects of Unfractionated Heparin (UFH) in Healthy Volunteers With and Without Bendavia	Phase 1	completed	2012	12
The Impact of Intravenous Bendavia™ on Endothelial Reactivity Dysfunction in Cigarette Smoking	Phase 1	completed	2012	6
Study to Evaluate Safety, Tolerability, and Pharmacokinetics (PK) of Intravenous (IV) Infusion of MTP-131 (Bendavia™) in Healthy Adults	Phase 1	completed	2010	40

Peer-reviewed studies (15)

Paper	Authors	Journal	Year	Type
Genotype-specific effects of elamipretide in patients with primary mitochondrial myopathy: a post hoc analysis of the MMPOWER-3 trial	Karaa A et al.	Orphanet journal of rare diseases	2024	Randomized Controlled Trial
Long-term efficacy and safety of elamipretide in patients with Barth syndrome: 168-week open-label extension results of TAZPOWER	Thompson WR et al.	Genetics in medicine : official journal of the American College of Medical Genetics	2024	Randomized Controlled Trial
Elamipretide Topical Ophthalmic Solution for the Treatment of Subjects with Leber Hereditary Optic Neuropathy: A Randomized Trial	Karanjia R et al.	Ophthalmology	2024	Randomized Controlled Trial
Efficacy and Safety of Elamipretide in Individuals With Primary Mitochondrial Myopathy: The MMPOWER-3 Randomized Clinical Trial	Karaa A et al.	Neurology	2023	Randomized Controlled Trial
Identifying responders to elamipretide in Barth syndrome: Hierarchical clustering for time series data	Van den Eynde J et al.	Orphanet journal of rare diseases	2023	Randomized Controlled Trial
Natural history comparison study to assess the efficacy of elamipretide in patients with Barth syndrome	Hornby B et al.	Orphanet journal of rare diseases	2022	Clinical Trial, Phase III
In vivo mitochondrial ATP production is improved in older adult skeletal muscle after a single dose of elamipretide in a randomized trial	Roshanravan B et al.	PloS one	2021	Randomized Controlled Trial
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	Reid Thompson W et al.	Genetics in medicine : official journal of the American College of Medical Genetics	2021	Randomized Controlled Trial
A randomized crossover trial of elamipretide in adults with primary mitochondrial myopathy	Karaa A et al.	Journal of cachexia, sarcopenia and muscle	2020	Randomized Controlled Trial
Effects of Elamipretide on Left Ventricular Function in Patients With Heart Failure With Reduced Ejection Fraction: The PROGRESS-HF Phase 2 Trial	Butler J et al.	Journal of cardiac failure	2020	Randomized Controlled Trial
The mitochondria-targeting peptide elamipretide diminishes circulating HtrA2 in ST-segment elevation myocardial infarction	Hortmann M et al.	European heart journal. Acute cardiovascular care	2019	Randomized Controlled Trial
Randomized dose-escalation trial of elamipretide in adults with primary mitochondrial myopathy	Karaa A et al.	Neurology	2018	Randomized Controlled Trial
Novel Mitochondria-Targeting Peptide in Heart Failure Treatment: A Randomized, Placebo-Controlled Trial of Elamipretide	Daubert MA et al.	Circulation. Heart failure	2017	Randomized Controlled Trial
Phase 2a Clinical Trial of Mitochondrial Protection (Elamipretide) During Stent Revascularization in Patients With Atherosclerotic Renal Artery Stenosis	Saad A et al.	Circulation. Cardiovascular interventions	2017	Randomized Controlled Trial
EMBRACE STEMI study: a Phase 2a trial to evaluate the safety, tolerability, and efficacy of intravenous MTP-131 on reperfusion injury in patients undergoing primary percutaneous coronary intervention	Gibson CM et al.	European heart journal	2016	Randomized Controlled Trial

More cited research

Elamipretide in pediatric Barth syndrome: from heart failure to school return (2026, human case report)
Elamipretide: The first cardiolipin-directed mitochondrial therapeutic for Barth syndrome approved under accelerated approval (2026, human RCT)
Expanded-access use of elamipretide in a newborn with Barth syndrome: a case report (2025, human observational)
Milk-derived exosome-loaded SS31 as a novel strategy to mitigate UV-induced photodamage in skin (2025, human observational)
Elamipretide (SS-31) and Nicotinamide Mononucleotide (NMN) Combination Therapy Targets TREM2 to Mitigate Post-ischemic Brain Injury in Mice (2026, animal)
Elamipretide (SS-31) promotes recovery by preserving mitochondrial bioenergetics and neural remodeling after spinal cord injury (2026, animal)
Elamipretide Improves Mitochondrial Function in Mitochondrial Trifunctional Protein-Deficient Mice and Human Fibroblasts (2026, animal)
Elamipretide Rejuvenates Oocyte Quality and Restores Female Fertility During Reproductive Aging (2026, animal)

Conditions researched

Related compounds

FAQ

What is SS-31 (Elamipretide)?

A mitochondria-targeted peptide, described as a "bodyguard" for the inner mitochondrial membrane.

How many registered human trials study SS-31 (Elamipretide)?

The PeptideWhiz trial index lists 30 registered trials for SS-31 (Elamipretide), the most recent from 2026.

How much published research exists on SS-31 (Elamipretide)?

The PeptideWhiz paper index links 15 PubMed papers to SS-31 (Elamipretide); by study type, 96 human and 231 animal studies.

Which conditions is SS-31 (Elamipretide) researched for?

Fatigue & low energy (incl. midlife), Heart repair: after heart attack, heart failure & enlarged heart, Atherosclerosis, cardiovascular disease & high blood pressure, Fatty liver & elevated liver enzymes, Parkinson's disease, Dementia, Alzheimer's & cognitive decline, Multiple sclerosis, Lupus (SLE), Ankylosing spondylitis, Mold illness (mycotoxin exposure), Lyme disease & chronic infections, Kidney protection (CKD, diabetic kidney, lupus kidney), High-demand jobs: military, fire, police, EMT (and combat-sport athletes), Anti-aging & longevity, Autism support, Gout, Gut: IBD (Crohn's, colitis), leaky gut, IBS & ulcers, Sleep apnea (obstructive), EBV and reactivated viruses, Fat loss, obesity & body recomposition, High cholesterol and statins, Diabetic retinopathy and glaucoma, Eyes: macular degeneration & retinal health, Lymphedema and swelling, Mitochondrial dysfunction, Muscle disease (myopathy), Neuropathy and CRPS.

Research and education only. Not medical advice. No dosing guidance. Data: ClinicalTrials.gov registry and PubMed via the PeptideWhiz index (204,289 studies).

Reported dosing ranges from research