Elamipretide

The mitochondrial peptide that actually went through modern trial machinery. Results are mixed by indication: some rare-disease signals, several failed larger programs. That mixed record is more informative than hype.

A mitochondria-targeted tetrapeptide that associates with cardiolipin on the inner membrane, aiming to stabilize electron-transport efficiency and reduce ROS in stressed mitochondria.

Trials in primary mitochondrial myopathy, Barth syndrome, heart failure, and geographic atrophy have reported a mix of missed primary endpoints and subgroup or secondary signals. Barth syndrome has been the most closely watched rare-disease path. This is a live clinical-development story, not a supplement.

Not FDA-approved as of this record. Stealth BioTherapeutics development programs. Research-chemical 'SS-31' is not the trial product.

Investigational (Stealth BioTherapeutics programs). Access is a trial or, in limited cases, an expanded-access/rare-disease pathway — not a retail peptide shop. Research-chemical 'SS-31' is not the trial product.

Same four pathways as the Sourcing guide.

Trial product is study-funded. No approved US benefit. Rare-disease expanded access is case-by-case.

SS-31 powders sold to longevity buyers. Those are not GMP trial supply.

Strand does not list vendors. See the grey market.

Injection-site reactions are common. Systemic safety in trials has been generally acceptable, which is not a green light for unregulated SS-31 sold as a research powder.

• Injection-site reactions are common in trials.
• Mixed efficacy by indication — failed primaries are data, not a conspiracy.
• Unregulated SS-31 adds identity and sterility risk the trial never assigned.

• MMPOWER-3 · 2023 · Neurology

  Karaa et al. Randomized trial of elamipretide in primary mitochondrial myopathy. PMID 37268436.

• Szeto SS-peptide reviews

  Cardiolipin-targeting mechanism of the Szeto-Schiller peptides. PMID 24389208.