Why interest is growing
Longevity became a market and peptides its flagship product. In July 2026 the FDA's Pharmacy Compounding Advisory Committee put MOTS-c and epitalon on its agenda alongside BPC-157, TB-500 and others9. But the core question is unchanged: is there human evidence that any of them slows aging?
Epitalon and telomeres
Epitalon (AEDG) is a tetrapeptide. Its reputation comes from a 2003 study in cultured human fetal fibroblasts, where it was associated with telomerase activation and telomere lengthening1. Much of the later literature comes from the same St. Petersburg group.
In 2025 an independent study confirmed telomere lengthening in normal cells, via telomerase. But it also found something uncomfortable: in breast-cancer cell lines, telomeres lengthened too, through a different mechanism (ALT)2. We found no independent controlled trials measuring clinical outcomes.
MOTS-c: mouse data
MOTS-c is a peptide encoded in mitochondrial DNA. In mice it was associated with preventing diet- and age-related insulin resistance3 and with better physical capacity4. In humans, exercise has been shown to raise the body's own MOTS-c4, which is not evidence that injecting it has an effect. We found no published human efficacy trials; the first registered randomized trial, a phase 2a study in adults with prediabetes and overweight or obesity, was recruiting as of October 202612.
NAD+: it rises in the blood, and then?
A 2026 systematic review examined 33 human intervention studies. Oral precursors (NR, NMN) do raise NAD metabolites, but effects on function and health were "heterogeneous and often null or endpoint-specific". And it found no outcome trials of intravenous or intramuscular NAD+ for anti-aging or wellness5. In adults over 60, NMN and NR did not preserve muscle mass or function6.
SS-31: the only approval, and it is something else
SS-31, or elamipretide, is the only one in this group with a regulatory approval. On September 19, 2025 the FDA granted accelerated approval to Forzinity for Barth syndrome, an ultra-rare mitochondrial disease, in patients weighing at least 30 kg. It was based on improved knee-extensor strength as a surrogate endpoint and requires a confirmatory trial7. In the open-label extension of the TAZPOWER study, 8 of 10 patients reached week 168, with +96.1 m on the 6-minute walk8.
Sources
- Khavinson VKh, Bondarev IE, Butyugov AA. Epithalon peptide induces telomerase activity and telomere elongation in human somatic cells. Bull Exp Biol Med. 2003;135(6):590-2. PubMed 12937682 ↗
- Al-Dulaimi S, et al. Epitalon increases telomere length in human cell lines through telomerase upregulation or ALT activity. Biogerontology. 2025;26(5):178. PubMed 40908429 ↗
- Lee C, et al. The mitochondrial-derived peptide MOTS-c promotes metabolic homeostasis and reduces obesity and insulin resistance. Cell Metab. 2015;21(3):443-54. PubMed 25738459 ↗
- Reynolds JC, et al. MOTS-c is an exercise-induced mitochondrial-encoded regulator of age-dependent physical decline and muscle homeostasis. Nat Commun. 2021;12(1):470. PubMed 33473109 ↗
- Gallagher C, et al. NAD+ supplementation for anti-aging and wellness: a PRISMA-guided systematic review of preclinical and clinical evidence. Ageing Res Rev. 2026;116:103057. PubMed 41655607 ↗
- Prokopidis K, et al. The effect of nicotinamide mononucleotide and riboside on skeletal muscle mass and function: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle. 2025;16(3):e13799. PubMed 40275690 ↗
- U.S. Food and Drug Administration. FDA grants accelerated approval to first treatment for Barth syndrome. 19 September 2025. fda.gov ↗
- Thompson WR, et al. Long-term efficacy and safety of elamipretide in patients with Barth syndrome: 168-week open-label extension results of TAZPOWER. Genet Med. 2024;26(7):101138. PubMed 38602181 ↗
- American Med Spa Association. FDA Advisory Committee Recommends Adding BPC-157 to Compounding List. 23 July 2026. americanmedspa.org ↗
- Jacobus N. FDA Panel Votes to Loosen Restrictions for Four Peptides. Pharmaceutical Executive. 24 July 2026. pharmexec.com ↗
- Regulatory Focus (RAPS). FDA advisory committee backs two more peptides, rejects one for compounding list. Julio de 2026. raps.org ↗
- ClinicalTrials.gov. NCT07505745: A Phase 2a, Randomized, Double-blind, Placebo-controlled Study to Evaluate the Efficacy, Safety, and Pharmacodynamics of MOTS-c in Adults With Prediabetes and Overweight/Obesity (en reclutamiento). Consultado el 9 de octubre de 2026. clinicaltrials.gov ↗
Informational article. It summarizes news, official statements and published studies; it is not medical or legal advice. Sources were checked on the publication date.
