SS-31 (Elamipretide)

clinical trials

Also known as: Elamipretide, MTP-131, Bendavia

**Mechanism of Action** SS-31 (Elamipretide) is a mitochondria-targeting tetrapeptide (D-Arg-dimethylTyr-Lys-Phe-NH₂) that selectively binds to cardiolipin, a phospholipid enriched in the inner mitochondrial membrane. This interaction stabilizes the cristae structure, optimizes electron transport chain supercomplex assembly, and restores ATP synthesis under oxidative stress. By reducing mitochondrial reactive oxygen species (ROS) production and preventing cytochrome c release, SS-31 mitigates apoptosis and preserves cellular bioenergetics. **Key Research Findings** Preclinical studies demonstrate SS-31 improves mitochondrial function in models of ischemia-reperfusion injury, heart failure, and neurodegenerative diseases. Phase II clinical trials (e.g., in primary mitochondrial myopathy and acute kidney injury) showed trends toward improved exercise tolerance and reduced cardiac remodeling, though primary endpoints were not uniformly met. A Phase III trial (MM-01) in Barth syndrome reported significant improvements in cardiac function and quality of life. Safety profiles are favorable, with mild injection-site reactions as the most common adverse event. **Clinical Relevance** SS-31 is under investigation for conditions with mitochondrial dysfunction, including Barth syndrome, heart failure, and age-related sarcopenia. Its ability to target cardiolipin offers a novel therapeutic approach distinct from general antioxidants. Ongoing trials aim to confirm efficacy in broader patient populations and optimize dosing regimens. For research purposes only — not medical advice.

Key data

Category
Anti-Aging & Longevity
Molecular weight
639.8 g/mol
Molecular formula
C32H49N9O5
CAS number
736992-21-5
Administration
subcutaneous, intravenous
Research status
clinical trials
References
214
Tags
mitochondrial, cardiolipin, antioxidant

Research & studies

Elamipretide: First Approval
Drugs · 2026 · PubMed

Elamipretide is a mitochondrial cardiolipin binder developed by Stealth BioTherapeutics.; Approved in the USA in September 2025 for improving muscle strength in Barth syndrome patients weighing ≥30 kg.; First disease-specific treatment for Barth syndrome, an ultra-rare X-linked recessive disorder.; Also in phase III development for dry age-related macular degeneration and mitochondrial myopathies.

Elamipretide Hydrochloride
American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists · 2026 · PubMed
Barth Syndrome
2026 · PubMed
Therapeutic Approaches Involving Mitochondria in the Treatment of Acute Kidney Injury
Seminars in nephrology · 2026 · PubMed
Elamipretide in the Management of Barth Syndrome: Current Evidence and a Case Report
Molecular genetics and metabolism · 2025 · PubMed
Advances in Management of Mitochondrial Myopathies
International journal of molecular sciences · 2025 · PubMed
Beyond the injection: delivery systems reshaping retinal disease management
Expert opinion on pharmacotherapy · 2025 · PubMed

Frequent intravitreal injections create a significant treatment burden due to limited drug half-life and chronic disease nature.; Emerging approaches include intravitreal sustained-release platforms and alternative delivery routes like suprachoroidal, subretinal, topical, and subcutaneous.; Specific innovations include the ranibizumab port delivery system, EYP-1901, KSI-301, OTX-TKI, and encapsulated cell therapy.; Challenges include overcoming the blood-retinal barrier, surgical complications, and ensuring patient adherence.

Contemporary insights into elamipretide's mitochondrial mechanism of action and therapeutic effects
Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie · 2025 · PubMed

Elamipretide's mechanism of action involves binding to cardiolipin, modulating mitochondrial membrane electrostatic potentials, and assembling cardiolipin-dependent proteins.; Elamipretide improves mitochondrial function, structure, and bioenergetics in animal models of cardiac and skeletal muscle myopathies and ocular pathologies.; Recent clinical trials have been completed for Barth syndrome, primary mitochondrial myopathy, and age-related macular degeneration, with elamipretide showing continued promise as a potential therapy.

Frequently asked questions

What is SS-31 (Elamipretide)?

**Mechanism of Action** SS-31 (Elamipretide) is a mitochondria-targeting tetrapeptide (D-Arg-dimethylTyr-Lys-Phe-NH₂) that selectively binds to cardiolipin, a phospholipid enriched in the inner mitochondrial membrane. This interaction stabilizes the cristae structure, optimizes electron transport chain supercomplex ass

How does SS-31 (Elamipretide) work?

Mitochondria-targeting tetrapeptide that binds cardiolipin on the inner membrane to stabilize cristae and restore ATP production.

What is the research status of SS-31 (Elamipretide)?

SS-31 (Elamipretide) is currently classified as clinical trials, with 214 research references on record. This is for research purposes only and is not medical advice.

What is the molecular weight of SS-31 (Elamipretide)?

SS-31 (Elamipretide) has a molecular weight of approximately 639.8 g/mol (formula C32H49N9O5).

Related peptides

Build on SS-31 (Elamipretide) data programmatically

Structured peptide data, semantic search, and AI summaries via one API.

Get a free API key