DEL MAR HEIGHTS -- Dr. Laurent Fischer, 42, wanted to make a difference in the world, but he said that he never imagined he would do it as a chief executive officer. Now he heads up Ocera Therapeutics, which he co-founded in San Diego last year.

"The company was started with one person -- myself -- in January of 2005," he recounted in a telephone interview this week. "We added a second person in June of 2005. We now have 10 employees … and have been growing very rapidly from the standpoint of the industry standard."

Ocera Therapeutics specializes in the development and commercialization of new drugs for gastrointestinal and liver diseases.

The company's current product, AST-120, is a new treatment for use in fighting the formation of fistulas in Crohn's disease, a form of inflammatory bowel syndrome that afflicts more than 500,000 people in this country. Fistulas are abnormal passages that can open up between the stomach, for example, and the body's surface.

Ocera licensed AST-120 from a Japanese company, Kureha Corp., almost a year ago, and recently completed a successful round of fundraising to finance new clinical trials that he said will hopefully pave the way for the drug's use in the United States and Europe.

"It's a very interesting product," Fischer said. "It's composed of orally delivered absorbent carbon microspheres that travel through the GI tract, absorb a number of toxins that are involved in Crohn's disease, and as a result decrease the number of fistulas."

Fischer says AST-120 has fewer side effects than existing drug treatments for Crohn's disease, which expose patients to the risk of TB infections and, for a small number of patients, a rare type of lymphoma.

"AST-120 is a relatively benign drug," Fischer said. "Constipation was seen, but no more so than in the sugar pill which was the placebo that was used in (earlier) clinical trials."

Fischer was born and raised in Switzerland and trained at Geneva Medical School, where he earned a medical degree in 1989. He left his ear-nose-throat practice soon afterward and joined pharmaceutical giant Hoffman LaRoche in 1992.

"I wanted to have an impact in a large patient population and see medical progress realized and improve the quality of life of patients who suffer from very debilitating diseases," Fischer said. "And I've been very fortunate to be involved in the development of a number of significant drugs, and I hope to continue that for many years."

Despite leading groundbreaking work with the protease inhibitor Invirase -- the first AIDS cocktail drug -- Fischer said he felt stifled by corporate regulations and layers of bureaucracy.

"I was always frustrated because I was not able to effect change in larger organizations or institutions the way I wanted," he said.

It comes as no surprise, then, that Fischer revels in the freedom and responsiveness of a young company such as Ocera Therapeutics.

"I really love the fact that we're a very lean organization that's very efficient, and that can make things happen, and that's what I enjoy," he said.

He comes from a family of medical practitioners -- his father is a retired dentist, his brother an orthopedic surgeon. He confesses to missing the human contact that came with being a medical doctor.

"It's something that nothing can replace, and it was particularly hard when I left my practice," Fischer said. "But the fact that I have been able to contribute to (fights against) really important diseases like HIV, and the fact that I'm still involved in not-for-profit organizations like the AIDS Healthcare Foundation, compensates I think for that lack of face-to-face interactions with patients."

In the executive suite, Fischer says he likes to lead by example.

"One of the ways I do that is the way I deal with my board of directors," he said. "I always reward people for telling me what the news is, good or bad. And I don't punish people that tell me the news I don't want to hear, and I think that part of being successful in this environment in this day and age is to be honest and transparent, and when there's bad news, I want to be the first to know."

The news with AST-120 has been good so far.

"I think we all live in the post-Vioxx days where companies and the Food and Drug Administration look at the safety profile of drugs very carefully," Fischer said. "And indeed for us, one of the critical aspects of licensing this compound was its very clean safety profile."

Contact freelance writer Andrew Peterson at andrew.a.peterson@cox.net.