Important: The pivotal Phase 3 MMPOWER-3 trial (primary mitochondrial myopathy; Neurology 2023, n≈218) did not meet its primary endpoint. A separate heart failure program (MMPOWER-HF) also did not demonstrate efficacy. Anti-aging and longevity effects are preclinical only. SS-31 is not FDA-approved.
Overview
SS-31 (also known as Elamipretide or MTP-131) is a tetrapeptide that selectively concentrates in the inner mitochondrial membrane, where it binds cardiolipin — a phospholipid essential for electron transport chain function. The proposed mechanism involves stabilizing cardiolipin and restoring cristae architecture. Phase II trials in heart failure showed encouraging signals. The pivotal Phase 3 MMPOWER-3 trial (primary mitochondrial myopathy; Neurology 2023, n≈218) did not meet its primary endpoint. A separate heart failure program (MMPOWER-HF) also did not demonstrate efficacy. Efficacy is not demonstrated in humans. Anti-aging and longevity effects are preclinical only.
Mechanism of Action
SS-31 concentrates in the inner mitochondrial membrane via electrostatic interactions, where it binds cardiolipin — a phospholipid that anchors electron transport chain complexes. By stabilizing cardiolipin, SS-31 maintains optimal cristae architecture and ETC complex conformation, improving ATP synthesis efficiency and reducing electron leak (and consequent ROS generation).
Research Evidence
- Phase 2 trials showed encouraging signals; pivotal Phase 3 MMPOWER-3 trial (primary mitochondrial myopathy; Neurology 2023, n≈218) did not meet its primary endpoint
- Separate heart failure program (MMPOWER-HF) also did not meet its primary endpoint
- Reversed age-related decline in skeletal muscle function in old mice (Science, 2020)
- 1,000-fold concentration in inner mitochondrial membrane vs. cytoplasm
- Reduces mitochondrial ROS by stabilizing cardiolipin and preventing electron leak
Bottom line: SS-31 is a mitochondria-targeted tetrapeptide with a well-characterized mechanism and the most advanced clinical program of any mitochondria-targeted peptide. However, the Phase 3 MMPOWER-3 trial (primary mitochondrial myopathy) failed its primary endpoint, as did the separate MMPOWER-HF heart failure program. Human efficacy is not demonstrated. Anti-aging effects are preclinical only.
Research Protocols & Dosage
Evidence-based research protocols, administration routes, and dosage considerations for SS-31 are detailed in the full compound profile. See also: Dosage guide for SS-31.
Sourcing & Quality
SS-31 is available from Purgo Labs with third-party COA verification and research-grade purity standards. View SS-31 at Purgo Labs.