SS-31

evidence score

peptide

Research Only

208 studies

elamipretideBendaviaMTP-131+1 more

SS-31 (elamipretide) is a water-soluble aromatic-cationic tetrapeptide that selectively targets the inner mitochondrial membrane via cardiolipin interaction. It stabilizes mitochondrial cristae structure, reduces ROS production, and restores ATP synthesis efficiency in damaged mitochondria. Phase II and III trials are ongoing for heart failure with preserved ejection fraction (HFpEF), Barth syndrome, and age-associated frailty. Has demonstrated significant improvements in exercise capacity and cardiac function in multiple RCTs.

Evidence

Moderate evidence

Safety

Unknown safety profile

Clinical Status

Phase II

Research Sync

Feb 19, 2026

Dosing

Typical

40 mg

4 mgRange40 mg

FrequencyOnce daily subcutaneous (clinical trial dose)

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Pharmacology

Half-life~2.6 hours (plasma)

OnsetAcute: 30–60 minutes; Clinical: weeks to months

DurationRequires ongoing treatment for sustained benefits

Routes

subcutaneous

intravenous

Evidence Score

Level B — Moderate

208 studies indexed · 1 meta-analysis

Scoring Factors

Volume(40%)~46/100

Quality(30%)~44/100

Sample Size(10%)~100/100

Consistency(10%)~100/100

Replication(5%)~100/100

Recency(5%)~100/100

Scores estimated from study counts. Exact breakdown computed after research sync.

Evidence Levels

AScore ≥75 with at least 1 meta-analysis and 3+ RCTs

BScore ≥50 with at least 1 RCT or meta-analysis

CScore ≥25 — observational or animal evidence only

DScore <25 — very limited or preclinical data

Plain-English Snapshot

SS-31 is currently categorized as a peptide compound.

Evidence is moderate (67/100): promising signal from 208 indexed studies, but context and population still matter.

Safety scoring is incomplete. Start conservatively and monitor carefully.

Core mechanism

Selectively partitions to inner mitochondrial membrane via cardiolipin binding; stabilizes cristae, reduces ROS, and restores ATP production efficiency

Practical Context

Strongest current signals

Level C: The Potential of Mitochondrial Therapeutics in the Treatment of Oxidative Stress and Inflammation in Aging.
Level C: Elamipretide: A Review of Its Structure, Mechanism of Action, and Therapeutic Potential.
Level C: Contemporary insights into elamipretide's mitochondrial mechanism of action and therapeutic effects.