○ Evidence tier 3 — Human RCT — functional endpoint

Record verify: primary source pending

DesignRandomized, double-blind, placebo-controlled Phase 3 trial (functional endpoints; negative)
DOI10.1212/WNL.0000000000207402
Citation statusdoi verified via Crossref 2026-07-12 (Neurology 2023;101(3), Karaa et al., 'Efficacy and Safety of Elamipretide in Individuals With Primary Mitochondrial Myopathy' = MMPOWER-3 primary results). Barth-syndrome FDA accelerated approval (FORZINITY, Sept 2025) verified via FDA press release + Stealth BioTherapeutics announcement (websearch 2026-07-12). PMID + NCT: needs_primary_fulltext.

Five-qualifier claim

Species / populationAdults with genetically confirmed primary mitochondrial myopathy — a DISEASE population.
Exposure, route, scheduleSubcutaneous elamipretide daily for 24 weeks.
Comparator / durationPlacebo-controlled, randomized, double-blind; 24-week primary readout.
Endpoint / numeric resultDid NOT meet its co-primary endpoints (6-minute walk distance and a mitochondrial-myopathy symptom assessment).
What it did NOT establishA failed Phase 3 in a disease population; NOT an aging trial and NOT evidence of any healthy-aging benefit. Separately, elamipretide later received FDA accelerated approval for Barth syndrome (a different, rare disease) in 2025 — also not an aging indication.

Primary reference

https://doi.org/10.1212/WNL.0000000000207402

Exact identifier confirmed against the primary record via Crossref/ClinicalTrials.gov where stated in the citation status; anything marked needs_primary_fulltext is not yet confirmed.