When Dr. José Trevejo thinks back to that day his mother became sick, he mostly remembers running.
He was just four or five years old and living in Ghana. His mother was feverish with malaria — an illness as terrible as it is common in many tropical parts of the world — and so weak she could barely get out of bed.
“She asked me to go fetch the doctor, so I literally went out into the street — there were no phones — and I ran to get the doctor and bring him back,” he said. “In West Africa in the 70s, you didn’t really have communication besides going to places.”
And so he took off onto the unpaved road in the humid Ghanaian heat, and ran until he reached the doctor’s office. He doesn’t remember much else — like how he got home or even being afraid — but the doctor came, and eventually his mother recovered.
“I just remember moving. And maybe that’s how I am now,” he said. “If something needs to be done to help people to stop suffering? I’m just like, OK, let’s do it. Let’s move it.”
Trevejo has been staying in motion as a physician-scientist ever since, and is now the chief medical officer at Tarsus Pharmaceuticals, a California-based biopharma. Its lead candidate, TP-03, could become the first FDA-approved treatment for Demodex blepharitis, an inflammatory eyelid condition that affects about 25 million U.S. patients and that’s cause by an infestation of the microscopic Demodex mite, a common ectoparasite found on humans. TP-03 kills the mites themselves.
“It’s definitely a high unmet need. It would be a first-in-class treatment for it,” Trevejo said.
With its phase 3 studies wrapped, the FDA has accepted an NDA for the drug and set a PDUFA target date of Aug. 25.
“It was a really exciting time to join the company as we move from a clinical stage company to potentially a commercial stage company,” said Trevejo, who came to Tarsus in February 2022.
In addition to there being a high unmet need for a treatment, Demodex blepharitis is also very easily overlooked. But there’s a tell-tale sign — cone-shaped waxy buildup along the eyelid. Part of Tarsus’s current work in prepping for a potential FDA approval is a disease education campaign for eye care professionals called “Look at the Lids.”
“Once eye care providers start looking for those, they realize how prevalent it is,” Trevejo said. “And it makes sense because the mite that causes it is present on 100% of people. Everybody is infested with these mites in their face area, and most of the time they can co-exist on the face with us, but when they get up into the eyelash, then there can be issues like Demodex blepharitis.”
The science-medicine intersection
At its root, Demodex blepharitis is an infectious disease – a focus area that’s been part of Trevejo’s clinical interest for years.
“In the practice of infectious disease, you basically have a lot of medical mysteries come at you, and you have to figure them out,” he said.
After completing his undergrad at UCLA in applied mathematics, Trevejo earned a Ph.D. in molecular and cellular biology from Cornell and a medical degree from the Cornell-Rockefeller-Sloan Kettering Tri-Institutional Program. From there, he moved to Boston where he did fellowships in internal medicine at Brigham and Women’s Hospital and infectious disease at Beth Israel Deaconess Medical Center, both of which are teaching affiliates of Harvard Medical School, where he was also an instructor.
“In the practice of infectious disease, you basically have a lot of medical mysteries come at you, and you have to figure them out.”
Dr. José Trevejo
Chief medical officer, Tarsus Pharmaceuticals
His later transition into industry was a logical one, given his scientific interests and his medical degree, which specifically trains physician–scientists.
“I wanted to do something translational and bridge a gap between technology and medicine,” he said. “Industry is actually an ideal trajectory for an M.D.-Ph.D. graduate because that’s exactly what you’re doing. You have to understand the science. You have to understand the clinical application.”
He found that bridge at Draper Laboratory, a nonprofit, MIT-borne research lab where he was working on a project to use novel technologies to rapidly diagnose tuberculosis. From there, he did stints in clinical research and development at Genentech, Ironwood Pharmaceuticals, Vertex Pharmaceuticals and others.
“My passion has been going after high-unmet-need diseases,” he said.
Diseases that affect the world
Trevejo was born in California, but his mother moved with him to Ghana when he was a baby. She was following her own father as he tried his hand at starting businesses there. Those businesses eventually failed, and, after a brief stop in neighboring Togo, Trevejo and his mother moved back to the U.S.
“We started from scratch,” he said. “It was just the two of us.”
His mother’s dedication and work ethic stuck with him — he recalls her taking three buses to her job as she worked her way up from a secretary to an office manager — and so did growing up internationally.
“I’m an American, but I do see myself as a citizen of the world. I care about what happens everywhere,” he said. “I also learned to be adaptable and flexible and appreciate different approaches and views on life.”
He’s applied that worldview to his work as a leader and drug developer.
“When you’re developing a drug … you have to really be able to connect and empower your team. My appreciation for different perspectives has brought a philosophy where we really try to bring a diverse group of folks together, and we try to get to the best answer to solve some of these difficult problems,” he said. “Other people think of things differently, and sometimes the right answer can come from other places, and you have to be open-minded to that.”
His experience living abroad and watching family members become sick with malaria was formative, too.
“From a young age I was always fascinated by diseases that affected the world,” he said. “I think that stuck with me from when I was a child, and I always wanted to work on ways to help people that have these devastating diseases.”
Now, he’s coming full circle in that respect: Tarsus is investigating whether their pipeline product TP-05, which they’re developing for Lyme disease, could also be used as a prophylactic for malaria. In some ways, he’s still that little boy, running to fix a problem.
“Maybe that’s an allegory,” he said, “I’m always looking for the solution.”