Ardelyx (ARDX) 10-K 20 Feb 25 2024 FY Annual report Financial data

Cover

Cover - USD ($)	12 Months Ended
	Dec. 31, 2024	Feb. 14, 2025	Jun. 28, 2024
Cover [Abstract]
Document Type	10-K
Document Annual Report	true
Document Period End Date	Dec. 31, 2024
Current Fiscal Year End Date	--12-31
Document Transition Report	false
Entity File Number	001-36485
Entity Registrant Name	ARDELYX, INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	26-1303944
Entity Address, Address Line One	400 FIFTH AVE.
Entity Address, Address Line Two	SUITE 210
Entity Address, City or Town	WALTHAM
Entity Address, State or Province	MA
Entity Address, Postal Zip Code	02451
City Area Code	510
Local Phone Number	745-1700
Title of 12(b) Security	Common Stock, par value $0.0001 per share
Trading Symbol	ARDX
Security Exchange Name	NASDAQ
Entity Well-known Seasoned Issuer	Yes
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
ICFR Auditor Attestation Flag	true
Document Financial Statement Error Correction [Flag]	false
Entity Shell Company	false
Entity Public Float			$ 1,744,324,359
Entity Common Stock, Shares Outstanding		238,356,222
Entity Central Index Key	0001437402
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	FY
Amendment Flag	false
Documents Incorporated by Reference	Portions of the Registrant’s Definitive Proxy Statement for its 2025 Annual Meeting of Stockholders, which will be filed with the Commission within 120 days of December 31, 2024, the close of the Registrant’s 2024 fiscal year, are incorporated by reference into Part III of this Report .

Audit Information

Audit Information	12 Months Ended
	Dec. 31, 2024
Audit Information [Abstract]
Auditor Name	Ernst & Young LLP
Auditor Location	Boston, MA
Auditor Firm ID	42

BALANCE SHEETS

BALANCE SHEETS - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Current assets
Cash and cash equivalents	$ 64,932	$ 21,470
Short-term investments	185,168	162,829
Accounts receivable	57,705	22,031
Inventory	21,173	12,448
Prepaid commercial manufacturing	16,378	18,925
Prepaid expenses and other current assets	11,096	8,408
Total current assets	356,452	246,111
Property and equipment, net	1,495	1,009
Inventory, non-current	70,011	37,039
Prepaid commercial manufacturing, non-current	0	4,235
Right-of-use assets	2,380	5,589
Other assets	5,416	3,596
Total assets	435,754	297,579
Current liabilities
Accounts payable	16,000	11,138
Accrued compensation and benefits	14,940	12,597
Current portion of operating lease liability	1,562	4,435
Deferred revenue	10,686	7,182
Accrued expenses and other current liabilities	34,642	15,041
Total current liabilities	77,830	50,393
Operating lease liability, net of current portion	1,023	1,725
Long-term debt, net of current portion	150,853	49,822
Deferred revenue, non-current	7,232	8,644
Deferred royalty obligation related to the sale of future royalties	25,527	20,179
Total liabilities	262,465	130,763
Commitments and contingencies
Stockholders’ equity
Common stock, $0.0001 par value; 500,000,000 shares authorized; 238,015,825 and 232,453,190 shares issued and outstanding as of December 31, 2024 and December 31, 2023, respectively.	24	23
Additional paid-in capital	1,058,548	1,012,773
Accumulated deficit	(885,340)	(846,204)
Accumulated other comprehensive income	57	224
Total stockholders’ equity	173,289	166,816
Total liabilities and stockholders’ equity	$ 435,754	$ 297,579

BALANCE SHEETS (Parenthetical)

BALANCE SHEETS (Parenthetical) - $ / shares	Dec. 31, 2024	Dec. 31, 2023
Statement of Financial Position [Abstract]
Common stock, par value (in dollars per share)	$ 0.0001	$ 0.0001
Common stock, shares authorized (in shares)	500,000,000	500,000,000
Common stock, shares issued (in shares)	238,015,825	232,453,190
Common stock, shares outstanding (in shares)	238,015,825	232,453,190

STATEMENTS OF OPERATIONS AND CO

STATEMENTS OF OPERATIONS AND COMPREHENSIVE LOSS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Revenues
Total revenues	$ 333,615	$ 124,456	$ 52,158
Cost of goods sold
Total cost of goods sold	50,556	17,795	4,117
Operating expenses
Research and development	52,317	35,536	35,201
Selling, general and administrative	258,692	134,401	76,599
Total operating expenses	311,009	169,937	111,800
Loss from operations	(27,950)	(63,276)	(63,759)
Interest expense	(13,006)	(4,950)	(3,400)
Non-cash interest expense related to the sale of future royalties	(7,088)	(3,924)	(1,673)
Other income, net	9,174	6,630	1,633
Loss before provision for income taxes	(38,870)	(65,520)	(67,199)
Provision for income taxes	266	547	8
Net loss	$ (39,136)	$ (66,067)	$ (67,207)
Net loss per share of common stock - basic (in dollars per share)	$ (0.17)	$ (0.30)	$ (0.42)
Net loss per share of common stock - diluted (in dollars per share)	$ (0.17)	$ (0.30)	$ (0.42)
Shares used in computing net loss per share - basic (in shares)	235,232,927	219,331,253	158,690,083
Shares used in computing net loss per share - diluted (in shares)	235,232,927	219,331,253	158,690,083
Comprehensive loss
Net loss	$ (39,136)	$ (66,067)	$ (67,207)
Unrealized (losses) gains on available-for-sale securities	(167)	278	(48)
Comprehensive loss	(39,303)	(65,789)	(67,255)
Product sales, net
Revenues
Total revenues	319,196	82,526	15,600
Cost of goods sold
Total cost of goods sold	6,851	2,323	566
Product supply revenue
Revenues
Total revenues	11,649	6,121	1,527
Licensing revenue
Revenues
Total revenues	78	35,809	35,031
Non-cash royalty revenue related to the sale of future royalties
Revenues
Total revenues	2,692	0	0
Other cost of revenue
Cost of goods sold
Total cost of goods sold	$ 43,705	$ 15,472	$ 3,551

STATEMENTS OF STOCKHOLDERS' EQU

STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-In Capital	Accumulated Deficit	Accumulated Other Comprehensive (Loss) Income
Beginning balance (in shares) at Dec. 31, 2021		130,182,535
Beginning balance at Dec. 31, 2021	$ 82,617	$ 13	$ 795,540	$ (712,930)	$ (6)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock under employee stock purchase plan (in shares)		308,356
Issuance of common stock under employee stock purchase plan	195		195
Issuance of common stock for services (in shares)		711,675
Issuance of common stock for services	390		390
Issuance of common stock upon exercise of options (in shares)		14,080
Issuance of common stock upon exercise of options	7		7
Issuance of common stock upon vesting of restricted stock units (in shares)		3,243,828
Issuance of common stock in at-the-market offering (in shares)		64,114,542
Issuance of common stock in at-the-market offering	71,625	$ 7	71,618
Stock-based compensation	10,750		10,750
Unrealized gains (losses) on available-for-sale securities	(48)				(48)
Net loss	(67,207)			(67,207)
Ending balance (in shares) at Dec. 31, 2022		198,575,016
Ending balance at Dec. 31, 2022	98,329	$ 20	878,500	(780,137)	(54)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock under employee stock purchase plan (in shares)		435,708
Issuance of common stock under employee stock purchase plan	808		808
Issuance of common stock for services (in shares)		86,095
Issuance of common stock for services	337		337
Issuance of common stock upon exercise of options (in shares)		225,988
Issuance of common stock upon exercise of options	365		365
Issuance of common stock upon vesting of restricted stock units (in shares)		855,642
Issuance of common stock in at-the-market offering (in shares)		32,274,741
Issuance of common stock in at-the-market offering	119,236	$ 3	119,233
Stock-based compensation	13,530		13,530
Unrealized gains (losses) on available-for-sale securities	278				278
Net loss	(66,067)			(66,067)
Ending balance (in shares) at Dec. 31, 2023		232,453,190
Ending balance at Dec. 31, 2023	166,816	$ 23	1,012,773	(846,204)	224
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock under employee stock purchase plan (in shares)		479,609
Issuance of common stock under employee stock purchase plan	2,227		2,227
Issuance of common stock for services (in shares)		40,549
Issuance of common stock for services	$ 257		257
Issuance of common stock upon exercise of options (in shares)	2,654,000	2,654,370
Issuance of common stock upon exercise of options	$ 5,911	$ 1	5,910
Issuance of common stock upon vesting of restricted stock units (in shares)		2,388,107
Stock-based compensation	37,381		37,381
Unrealized gains (losses) on available-for-sale securities	(167)				(167)
Net loss	(39,136)			(39,136)
Ending balance (in shares) at Dec. 31, 2024		238,015,825
Ending balance at Dec. 31, 2024	$ 173,289	$ 24	$ 1,058,548	$ (885,340)	$ 57

STATEMENTS OF CASH FLOWS

STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Operating activities
Net loss	$ (39,136)	$ (66,067)	$ (67,207)
Adjustments to reconcile net loss to net cash used in operating activities
Depreciation and amortization expense	2,063	1,292	1,144
Non-cash lease expense	4,008	3,624	3,457
Stock-based compensation	37,381	13,530	10,750
Non-cash interest expense	7,400	4,220	1,962
Non-cash royalty revenue related to the sale of future royalties	(2,692)	0	0
Gain on sale of equipment	0	0	(1,260)
Other, net	(4,664)	(2,930)	685
Changes in operating assets and liabilities
Accounts receivable	(35,674)	(14,298)	(7,231)
Inventory	(41,697)	(21,141)	(28,346)
Prepaid commercial manufacturing	6,782	(9,593)	(4,161)
Prepaid expenses and other assets	(4,543)	(6,035)	2,299
Accounts payable	4,862	279	6,582
Accrued compensation and benefits	2,343	5,049	2,126
Operating lease liabilities	(4,588)	(3,928)	(3,491)
Accrued and other liabilities	21,254	3,691	4,138
Deferred revenue	2,092	2,590	8,509
Net cash used in operating activities	(44,809)	(89,717)	(70,044)
Investing activities
Proceeds from maturities and redemptions of investments	177,854	84,321	67,000
Purchases of investments	(195,161)	(215,225)	(50,328)
Proceeds from sale of property and equipment	0	0	1,798
Purchases of property and equipment	(1,011)	(344)	(55)
Net cash (used in) provided by investing activities	(18,318)	(131,248)	18,415
Financing activities
Proceeds from issuance of common stock in at the market offering, net of issuance costs	0	119,236	71,625
Proceeds from 2022 Loan Agreement, net of issuance costs	99,451	22,386	26,971
Proceeds from the sale of future royalties, net of issuance costs	0	5,000	9,581
Proceeds from issuance of common stock under equity incentive and stock purchase plans	8,138	1,173	202
Payment of the exit fees	(1,000)	(1,500)	0
Payments for the 2018 Loan, net of costs	0	0	(33,038)
Net cash provided by financing activities	106,589	146,295	75,341
Net increase (decrease) in cash and cash equivalents	43,462	(74,670)	23,712
Cash and cash equivalents at beginning of period	21,470	96,140	72,428
Cash and cash equivalents at end of period	64,932	21,470	96,140
Supplementary disclosure of cash flow information
Cash paid for interest	11,408	4,240	2,901
Cash paid for income taxes	266	51	6
Supplementary disclosure of non-cash activities
Right-of-use assets obtained in exchange for lease obligations	1,010	339	0
Issuance of common stock for services	257	337	390
Issuance of derivative in connection with issuance of loan payable	$ 0	$ 0	$ 375

Nature of Operations

Nature of Operations	12 Months Ended
	Dec. 31, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Nature of Operations	NATURE OF OPERATIONS We are a biopharmaceutical company founded with a mission to discover, develop and commercialize innovative, first-in-class medicines that meet significant unmet medical needs. We developed a unique and innovative platform that enabled the discovery of new biological mechanisms and pathways to develop potent and efficacious therapies that minimize the side effects and drug-drug interactions frequently encountered with traditional, systemically absorbed medicines. The first molecule we discovered and developed was tenapanor, a minimally absorbed, first-in-class, oral, small molecule therapy. Tenapanor, branded as IBSRELA ® , is approved in the U.S. for the treatment of adults with IBS-C. Tenapanor, branded as XPHOZAH ® , is approved in the U.S. to reduce serum phosphorus in adults with CKD on dialysis as add-on therapy in patients who have an inadequate response to phosphate binders or who are intolerant of any dose of phosphate binder therapy. We operate in one business segment, which is the development and commercialization of biopharmaceutical products. Refer to Note 17. Segment Reporting for further segment reporting information.

Summary of Significant Accounti

Summary of Significant Accounting Policies	12 Months Ended
	Dec. 31, 2024
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES Basis of Presentation The accompanying financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America (U.S. GAAP). Certain prior year amounts have been reclassified to conform to the current year presentation. Refer to the Summary of Abbreviated Terms at the end of this Annual Report on Form 10-K for definitions of terms used throughout the document. Use of Estimates The preparation of financial statements requires management to make estimates, judgments and assumptions. The most significant assumptions are estimates used in our revenue gross-to-net accruals and other assumptions. Management bases its estimates on historical experience and on various other market-specific and relevant assumptions that management believes to be reasonable under the circumstances. Actual results could materially differ from those estimates. Cash and Cash Equivalents Cash and cash equivalents consist of highly liquid investments purchased with an original maturity date of 90 days or less and are recognized at cost, which approximates fair value. Short-Term Investments Short-term investments consist of debt securities classified as available-for-sale and have maturities greater than 90 days, but less than one year, from the date of acquisition. Short-term investments are carried at fair value based upon quoted market prices or other observable market data. Unrealized (losses) gains on available-for-sale securities are included in accumulated other comprehensive income on our balance sheets. The cost of available-for-sale securities sold is based on the specific-identification method. Marketable debt securities are reviewed for impairment by determining whether the decline in their market value below carrying value is other-than-temporary. This assessment considers the intent and ability to retain the investment for a period of time sufficient for an anticipated recovery in market value, the duration and extent that the market value has been below cost, and the investee’s financial condition. Other-than-temporary impairments and credit losses are recorded in the statements of operations and comprehensive loss. Concentration of Credit Risk Financial instruments that potentially subject us to significant concentrations of credit risk consist primarily of cash, cash equivalents, short-term investments and accounts receivable. We are exposed to credit risks in the event of default by the counterparties to the extent of the amount recorded in our balance sheets. Cash, cash equivalents and short-term investments are invested through banks and other financial institutions in the U.S. Foreign Currency Our business is conducted in U.S. dollars; however, a portion of our expense and capital activities are transacted in foreign currencies which are subject to exchange rate fluctuations that can affect cash or earnings. Foreign currency transactions are translated into the functional currency using exchange rates prevailing at the dates of the transactions. At the end of each reporting period, monetary assets and liabilities that are denominated in foreign currencies are translated at the rates prevailing at that date. All gains and losses on these foreign currency transactions are recorded in other income, net in our statements of operations and comprehensive loss. Property and Equipment Expenditures for property and equipment are capitalized at cost. Depreciation is computed using the straight-line method over the estimated useful lives of the respective assets, ranging from three Impairment of Long-Lived Assets The carrying values of long-lived assets, including property and equipment, are reviewed for impairment whenever events or changes in circumstances indicate that the asset may not be recoverable. An impairment loss is recognized when the total of estimated future undiscounted cash flows, expected to result from the use of the asset and its eventual disposition, are less than the asset’s carrying amount. Impairment, if any, would be assessed using discounted cash flows or other appropriate measures of fair value. Income Taxes The asset and liability method of accounting is used for income taxes. Deferred tax assets and liabilities are determined based on the differences between the financial reporting and the tax basis of assets and liabilities and are measured using the enacted tax rates and laws that will be in effect when the differences are expected to reverse. A valuation allowance is provided when it is more likely than not that a portion or all of a deferred tax asset will not be realized. Accounts Receivable Accounts receivable are stated at amortized cost less allowance for credit losses. The allowance for credit losses reflects our best estimate of future losses over the contractual life of outstanding accounts receivable and is determined on the basis of historical experience, specific allowances for known troubled accounts, other currently available information including customer financial condition and both current and forecasted economic conditions. To date, we have determined that an allowance for doubtful accounts is not required. As of December 31, 2024, our accounts receivable balance was comprised of $56.7 million from commercial customers and $1.0 million from our collaboration partners. As of December 31, 2023, our accounts receivable balance was comprised of $17.1 million from commercial customers and $4.9 million from our collaboration partners. Inventory Inventory costs incurred are capitalized after regulatory approval, or if based on management’s judgment, future commercialization is considered probable and future economic benefit is expected to be realized. We began to capitalize inventory costs associated with IBSRELA during the fourth quarter of 2021, when our intent to commercialize IBSRELA was established and we commenced preparation for the launch of IBSRELA. We began to capitalize inventory costs associated with XPHOZAH during the fourth quarter of 2023, following approval by the U.S. FDA to market XPHOZAH in the U.S. Inventory costs incurred prior to regulatory approval were expensed as research and development. Inventories are stated at the lower of cost or estimated net realizable value with cost determined under the specific identification method. A portion of inventory that represents product that is not expected to be sold or used within the next 12 months is classified as non-current assets on our balance sheets. Revenue Recognition The application of ASC 606 Revenue from Contracts with Customers substantially impacts our reported results, particularly product sales, net, which requires certain estimates in determining the transaction price. Total revenues are recognized following a five-step model: (i) identify the customer contract; (ii) identify the contract’s performance obligations; (iii) determine the transaction price; (iv) allocate the transaction price to the performance obligations; and (v) recognize revenue when or as a performance obligation is satisfied. Product Sales, Net Recognition The transaction price for product sales, net is reduced for estimates of variable consideration related to GTN adjustments for discounts and chargebacks, rebates, wholesaler and GPO fees, copay assistance and returns. Except for certain wholesaler and GPO fees and discounts, which are based on contracts, these adjustments involve estimation and judgment. The GTN adjustments for rebates, copay assistance and chargebacks are impacted by our estimate of payor mix, which requires significant judgment. We consider legal interpretations of applicable laws and regulations, historical experience, current contract prices under applicable programs, unbilled claims, processing time lags and inventory levels in the distribution channel in determining our estimates. Estimates are assessed each period and adjusted as required to revise information or actual experience. Changes in estimates recorded through December 31, 2024 have not been material. Licensing Revenue Recognition Licensing revenue and product supply revenue result from our collaboration and licensing agreements as discussed in Note 7. Collaboration And Licensing Agreements. Goods and services in these agreements may include the grant of licenses for use of our intellectual property and manufacturing services. Significant judgment is required to determine whether promised goods and services represent distinct performance obligations, which are identified and separated when the other party can benefit from the rights, goods or services either on their own or together with other readily available resources and when the rights, goods or services are not highly interdependent or interrelated. Transaction prices for these arrangements may include non-refundable, up-front license fees; research, development, regulatory and commercial milestone payments; payments for manufacturing supply services; and future royalties on net sales of licensed products. Variable consideration is included in the transaction price only to the extent significant reversal of cumulative revenue recognized is not probable of occurring when the uncertainty associated with the variable consideration is subsequently resolved. Significant judgment is required in estimating variable consideration for each performance obligation identified in the contract. This judgment involves assessing factors outside of our influence, including market conditions, development timelines, likelihood of regulatory success, reimbursement rates for personnel costs, forecasted revenues, potential limitations on the selling price of the product, discount rates, lack of relevant past experience and a large number and broad range of possible amounts. The most likely amount method is used to estimate contingent development, regulatory and sales-based milestones because the ultimate outcomes are binary in nature. The expected value method is used to estimate royalties because a broad range of potential outcomes exists, except in instances where the royalties relate to a license. For arrangements with multiple separable performance obligations, the transaction price assigned to each distinct performance obligation is reflective on the relative stand-along selling price and recognized at a point in time upon the transfer of control. Collaboration agreements typically include: (i) licensing intellectual property to a third party with no further performance obligations and (ii) arrangements that include both a license and an additional performance obligation to supply product upon the request of the third party. Out-licensing arrangements that contain a single performance obligation are satisfied upon execution of the agreement, when development and commercialization rights are transferred to a third party. Upfront fees are immediately recognized as licensing revenue. Contingent development and regulatory milestones are assessed each period for likelihood of achievement, however, they are typically constrained and recognized when uncertainty is subsequently resolved for the full amount of the milestone and included in licensing revenue. Licensing revenue also includes sales-based milestones and royalties, which are recognized when the milestone is achieved or when the subsequent sales occur. Certain collaboration agreements also include contingent performance obligations to supply commercial product to the third party upon its request. The license and supply obligations are accounted for as separate distinct performance obligations as the third party can benefit from the license either on its own or together with the other supply resources readily available to it and the other obligations in the contract. Consideration for the supply obligation is based upon stipulated cost-plus margin contractual terms which represent a standalone selling price. The supply consideration is recognized as product supply revenue at a point in time upon transfer of control of the product to the third party. After considering the stand-alone selling price of these supply arrangements, the upfront fees, contingent development, regulatory and sales-based milestones and royalties are allocated to the license. When two or more contracts are entered into with the same customer at or near the same time, we evaluate the contracts to determine whether the contracts should be accounted for as a single arrangement. Contract modifications due to the addition of distinct promised goods or services with price increases consistent with stand-alone selling prices are accounted for as a separate contract. Contract modifications that are not considered a separate contract and containing remaining goods or services distinct from the goods or services transferred on or before the date of the contract modification are accounted for as a termination of the existing contract and the subsequent creation of a new contract. Contract modifications not considered a separate contract and containing remaining goods or services not distinct are accounted for as an add-on to the existing contract and as an adjustment to revenue on a cumulative catch-up basis. Accrued Expenses As part of the process of preparing our financial statements, we are required to estimate our accrued expenses, which involves reviewing open contracts and purchase orders, communicating with our personnel to identify services that have been performed on our behalf and estimating the level of service performed and the associated cost incurred for the service when we have not yet been invoiced or otherwise notified of the actual cost. The majority of our service providers invoice us monthly in arrears for services performed or when contractual milestones are met. We make estimates of our accrued expenses as of each balance sheet date based on facts and circumstances known to us at that time. We periodically confirm the accuracy of our estimates with our service providers and make adjustments if necessary. Service fee accruals are estimated based on the period over which each component of service will be performed, with vendor input if appropriate. If the actual timing of the performance of services or the level of effort varies from our estimate, we adjust the accrued or prepaid expense balance, accordingly. Although we do not expect our estimates to be materially different from amounts actually incurred, if our estimates of the status and timing differ from the actual status and timing of services performed, we may report amounts that are too high or too low in any particular period. Retirement Savings Plan We offer retirement saving plans through our 401(k) plan, which is available to all full-time employees. In June 2023, we expanded the benefit with the inclusion of a company matching contribution.We contribute to tax-qualified retirement plans for the benefit of employees who meet certain eligibility requirements and choose to participate in the plans. Participating employees specify the percentage of salary they wish to contribute from their compensation, and we make matching contributions. We recognized compensation costs from our contributions of $1.1 million and $0.2 million in 2024 and 2023, respectively. Stock-Based Compensation Stock-based compensation expense is recognized for all stock-based payment awards made to employees, non-employees and directors based on estimated fair values. The grant date fair value of the awards is determined using the Black-Scholes option-pricing model. Stock-based compensation expense is recognized on a straight-line basis over the requisite service period and is reduced for estimated forfeitures at the date of grant and revised, if necessary, in subsequent periods if actual forfeitures differ from those estimates. Non-cash Interest Expense on Deferred Royalty Obligation Non-cash interest expense related to the sale of future royalties represents imputed interest expense on our deferred royalty obligation related to the sale of future royalties using the effective interest method. Leases Operating leases are included in right-of-use assets, current portion of operating lease liability, and operating lease liability, net of current portion on our balance sheets. Right-of-use assets represent our right to use an underlying asset for the lease term and lease liabilities represent our obligation to make lease payments arising from the lease. Operating lease right-of-use assets and liabilities are recognized at the lease commencement date based on the present value of lease payments over the lease term. In determining the present value of lease payments, we use our incremental borrowing rate based on information available at the lease commencement date. Operating lease right-of-use assets also include any lease payments made and exclude lease incentives. Our lease terms may include options to extend or terminate a lease when it is reasonably certain that we will exercise any such option. Lease expense is recognized on a straight-line basis over the expected lease term. We have elected not to separate lease and non-lease components, such as common area maintenance charges, and instead account for these as a single lease component. Net Loss per Share Basic net loss per common share is calculated by dividing the net loss by the weighted-average number of shares of common stock outstanding during the period, without consideration of potential shares of common stock. Diluted net loss per common share in the periods presented is the same as basic net loss per common share because the effects of potentially dilutive securities are antidilutive due to net loses recognized for each period presented. Recent Accounting Pronouncements New Accounting Pronouncements - Recently Adopted In November 2023, the FASB issued ASU No. 2023-07, Segment Reporting (Topic 280) - Improvements to Reportable Segment Disclosures . This Update requires publicly traded entities to provide enhanced disclosures about significant segment expenses regularly reviewed by the chief operating decision maker, including publicly traded entities with a single reportable segment. The amendments in this update were effective for fiscal years beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024. We adopted the ASU in the fourth quarter of 2024 and determined that its adoption did not have a material impact on our financial statements. Refer to Note 17. Segment Reporting for additional information. Recent Accounting Pronouncements Not Yet Adopted In December 2023, the FASB issued ASU No. 2023-09, Income Taxes (Topic 740) - Improvements to Income Tax Disclosures , an amendment which modifies the measurement and recognition of credit losses for most financial assets and certain other instruments. The amendments in this Update provide more transparency about income tax information through improvements to income tax disclosures primarily related to the rate reconciliation and income taxes paid information. For public business entities, the amendments in this Update are effective for annual periods beginning after December 15, 2024. Early adoption is permitted on a prospective basis for annual financial statements that have not yet been issued or made available for issuance. Management is currently assessing the impact of this standard on our financial statements. In November 2024, the FASB issued ASU No. 2024-03, Income Statement (Topic 220) - Reporting Comprehensive Income - Expense Disaggregation Disclosures, Disaggregation of Income Statement Expenses , which requires public companies to disclose, in interim and reporting periods, additional information about certain expenses in the financial statements. ASU No. 2024-03 is effective for annual periods beginning after December 15, 2026, and interim reporting periods beginning after December 15, 2027. Early adoption is permitted and is effective on either a prospective basis or retrospective basis. Management is currently assessing the impact of this standard on our financial statements.

Cash, Cash Equivalents and Shor

Cash, Cash Equivalents and Short-Term Investments	12 Months Ended
	Dec. 31, 2024
Cash and Cash Equivalents [Abstract]
Cash, Cash Equivalents and Short-Term Investments	CASH, CASH EQUIVALENTS AND SHORT-TERM INVESTMENTS Securities classified as cash, cash equivalents and short-term investments as of December 31, 2024 and 2023 were as follows: December 31, 2024 Gross Unrealized (in thousands) Amortized Cost Gains Losses Fair Value Cash and cash equivalents Cash $ 16,282 $ — $ — $ 16,282 Money market funds 48,650 — — 48,650 Total cash and cash equivalents 64,932 — — 64,932 Short-term investments U.S. treasury securities $ 79,720 $ 58 $ (5) $ 79,773 U.S. government-sponsored agency bonds 45,960 29 (27) 45,962 Commercial paper 37,061 19 (15) 37,065 Corporate bonds 17,415 4 (6) 17,413 Asset-backed securities 2,983 2 — 2,985 Yankee bonds 1,972 — (2) 1,970 Total short-term investments 185,111 112 (55) 185,168 Total cash, cash equivalents and investments $ 250,043 $ 112 $ (55) $ 250,100 December 31, 2023 Gross Unrealized (in thousands) Amortized Cost Gains Losses Fair Value Cash and cash equivalents Cash $ 2,829 $ — $ — $ 2,829 Money market funds 18,641 — — 18,641 Total cash and cash equivalents 21,470 — — 21,470 Short-term investments U.S. government-sponsored agency bonds $ 101,892 $ 235 $ (34) $ 102,093 Commercial paper 49,630 41 (17) 49,654 Asset-backed securities 8,628 2 (5) 8,625 U.S. treasury securities 2,455 2 — 2,457 Total short-term investments 162,605 280 (56) 162,829 Total cash, cash equivalents and investments $ 184,075 $ 280 $ (56) $ 184,299 Realized gains or losses have not been significant and are included in other income, net, in our statements of operations and comprehensive loss. Unrealized losses in 2024 and 2023 were not material. We determined that none of our available-for-sale securities were other-than-temporarily impaired as of December 31, 2024 and 2023, and no investment was in a continuous unrealized loss position for more than one year. Therefore, we believe that it is more likely than not that the investments will be held until maturity or a forecasted recovery of fair value. Based on our procedures under the expected credit loss model, including an assessment of unrealized losses in our portfolio, we concluded that any unrealized losses on our marketable securities were not attributable to credit and, therefore, we have not recorded an allowance for credit losses as of December 31, 2024 and 2023.

Fair Value Measurements

Fair Value Measurements	12 Months Ended
	Dec. 31, 2024
Fair Value Disclosures [Abstract]
Fair Value Measurements	FAIR VALUE MEASUREMENTS Valuation techniques used to measure fair value must maximize the use of observable inputs and minimize the use of unobservable inputs. The three-level hierarchy for the inputs to valuation techniques is briefly summarized as follows: Level 1 – Valuations are based on quoted prices in active markets for identical assets or liabilities and readily accessible by us at the reporting date. Level 2 – Valuations based on inputs other than Level 1 that are observable, either directly or indirectly, such as quoted prices for similar assets or liabilities; quoted prices in markets that are not active; or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities. Level 3 – Valuations based on unobservable inputs for which there is little or no market data, which require us to develop our own assumptions. The following table sets forth the fair value of our financial assets and liabilities that are measured or disclosed on a recurring basis by level within the fair value hierarchy: December 31, 2024 December 31, 2023 (in thousands) Total Fair Value Level 1 Level 2 Level 3 Total Fair Value Level 1 Level 2 Level 3 Assets Money market funds $ 48,650 $ 48,650 $ — $ — $ 18,641 $ 18,641 $ — $ — U.S. government-sponsored agency bonds 45,962 — 45,962 — 102,093 — 102,093 — U.S. treasury securities 79,773 — 79,773 — 2,457 — 2,457 — Commercial paper 37,065 — 37,065 — 49,654 — 49,654 — Corporate bonds 17,413 — 17,413 — — — — — Asset-backed securities 2,985 — 2,985 — 8,625 — 8,625 — Yankee bonds 1,970 — 1,970 — — — — — Total $ 233,818 $ 48,650 $ 185,168 $ — $ 181,470 $ 18,641 $ 162,829 $ — Liabilities Derivative liabilities for exit fee $ — $ — $ — $ — $ 675 $ — $ — $ 675 Total $ — $ — $ — $ — $ 675 $ — $ — $ 675 The 2022 Exit Fee valuation as of December 31, 2023 as defined and discussed in Note 10. Derivative Liabilities , was classified as Level 3. During 2024, the conditions for payment of the 2022 Exit Fee were met and the $1.0 million contract amount was fully valued and settled accordingly. Fair Value of Debt The principal outstanding under our term loan is subject to a variable interest rate and therefore, we believe the carrying amount of the term loan approximates fair value. See Note 9. Borrowing for a description of the Level 2 inputs used to estimate the fair value of the liability. The carrying value of the deferred royalty obligation related to the sale of future royalties approximates its fair value as of December 31, 2024 and is based on our current estimate of future royalties and commercialization milestones expected to be paid to us by Kyowa Kirin over the life of the agreement. See Note 8. Deferred Royalty Obligation Related To The Sale Of Future Royalties for a description of the Level 3 inputs used to estimate the fair value of the liability.

Inventory

Inventory	12 Months Ended
	Dec. 31, 2024
Inventory Disclosure [Abstract]
Inventory	INVENTORY Inventory consisted of the following: December 31, (in thousands) 2024 2023 Raw materials $ 30,792 $ 22,920 Work in process 58,685 24,582 Finished goods 1,707 1,985 Total $ 91,184 $ 49,487 Reported as Inventory $ 21,173 $ 12,448 Inventory, non-current 70,011 37,039 Total $ 91,184 $ 49,487 Prepaid commercial manufacturing with third-party CMOs not included in inventory was $16.4 million and $23.2 million at December 31, 2024 and 2023, respectively. There were no prepayments expected to be converted into inventory after 12 months at December 31, 2024, compared to $4.2 million at December 31, 2023.

Revenue

Revenue	12 Months Ended
	Dec. 31, 2024
Revenue from Contract with Customer [Abstract]
Revenue	REVENUE Disaggregation of total revenues by nature is as follows: Year Ended December 31, (in thousands) 2024 2023 2022 Product sales, net $ 319,196 $ 82,526 $ 15,600 Product supply revenue 11,649 6,121 1,527 Licensing revenue 78 35,809 35,031 Non-cash royalty revenue related to the sale of future royalties 2,692 — — Total revenues $ 333,615 $ 124,456 $ 52,158 Product Sales, Net Total product sales, net was as follows: Year Ended December 31, (in thousands) 2024 2023 2022 Product sales, net IBSRELA $ 158,286 $ 80,062 $ 15,600 XPHOZAH 160,910 2,464 — Total product sales, net $ 319,196 $ 82,526 $ 15,600 Product sales, net approximated 95.7%, 66.3% and 29.9% of total revenues in 2024, 2023 and 2022, respectively. Products are primarily sold to wholesalers, GPOs and specialty pharmacies, and to a lesser extent, directly to retailers, hospitals, clinics and government agencies. Customer orders are generally fulfilled within a few days from receipt. Contractual performance obligations are fulfilled once control of product is transferred to our customer, which occurs when our customer receives the product and obtains legal title. At this point, our customers are able to direct the use of and obtain substantially all of the remaining benefits of the product. GTN Adjustments Wholesalers, GPOs and specialty pharmacies are initially invoiced at contract list prices. Wholesalers and GPOs may also receive prompt pay discounts for payment within a specified period, generally approximating two percent of the invoiced sales price. Our payment terms are generally 30 to 60 days. At the time of recognition, revenue is reduced from contract list price for estimates of variable consideration related to GTN adjustments for chargebacks and cash discounts, rebates, wholesaler and GPO fees, and copay assistance and returns. These GTN adjustments are attributed to governmental programs such as Medicare, Medicaid and the 340B program, which involve various pricing implications, including mandatory discounts and discounts when Medicare Part D beneficiaries are in the coverage gap. Chargebacks and specialty pharmacies fees are reflected as reductions to receivables and are typically settled within contractual terms through credits to our customers. All other GTN adjustments are reflected as a liability and settled through cash payments to our customer or government payor program, typically over various time periods that may span for multiple quarters. Significant judgment is required to estimate certain of our GTN adjustments, considering factors such as legal interpretations of applicable laws and regulations, historical experience, payor mix (e.g., Medicare or Medicaid), current contract prices under applicable programs, unbilled claims, processing time lags and inventory levels in the distribution channel. The activities and ending reserve balances for each significant category of GTN adjustments on product sales, net, which constitute variable consideration, were as follows: (in thousands) Discounts and chargebacks Rebates, wholesaler and GPO fees Copay assistance and returns Total Balance as of December 31, 2022 $ 142 $ 1,444 $ 1,258 $ 2,844 Provisions 5,341 15,365 10,629 31,335 Credits/payments (5,005) (12,575) (7,971) (25,551) Balance as of December 31, 2023 478 4,234 3,916 8,628 Provisions 15,099 65,833 28,925 109,857 Credits/payments (13,934) (55,592) (21,671) (91,197) Balance as of December 31, 2024 $ 1,643 $ 14,475 $ 11,170 $ 27,288 Adjustments to prior period provisions recorded in the current period were not material. Geographic Information and Concentrations Revenues are attributed to geographical areas based on the location at which we earned revenue for product sales of IBSRELA and XPHOZAH or the domicile of our collaboration partners. A summary of our revenues by geographic area is as follows: Year Ended December 31, (in thousands) 2024 2023 2022 United States (1) $ 319,196 $ 83,276 $ 15,600 International Asia Pacific (2) 14,341 41,121 36,527 North America (3) 78 59 31 Total revenues $ 333,615 $ 124,456 $ 52,158 (1) Revenues from the United States are primarily comprised of amounts earned from sales of IBSRELA and XPHOZAH, as well as the upfront license fee from the METiS Agreement. (2) Revenues from Asia Pacific are primarily comprised of amounts earned in accordance with the Kyowa Kirin Agreement and the Fosun Agreement. (3) Revenues from North America are comprised of amounts earned from Canada in accordance with the Knight Agreement. Gross product sales from Customers and revenues from collaboration partners, each accounting for more than 10% of total revenues, were as follows: Year Ended December 31, 2024 2023 2022 Customers BioRidge Pharma, LLC 75.4 % 24.0 % 3.2 % Cencora 16.4 % 19.1 % 11.1 % Cardinal Health 14.5 % 19.8 % 9.6 % McKesson Corporation 14.1 % 15.7 % 8.9 % Collaboration partners Kyowa Kirin 4.3 % 29.0 % 70.0 %

Collaboration and Licensing Agr

Collaboration and Licensing Agreements	12 Months Ended
	Dec. 31, 2024
Collaboration and Licensing Agreements [Abstract]
Collaboration and Licensing Agreements	COLLABORATION AND LICENSING AGREEMENTS We out-licensed to external partners the development of tenapanor and commercialization of tenapanor through agreements with Kyowa Kirin in Japan, Fosun Pharma in China and Knight in Canada for the development and commercialization of tenapanor for certain indications in their respective territories. We recognize revenue from such arrangements as licensing revenue, product supply revenue or non-cash royalty revenue related to the sale of future royalties. Our significant accounting policies for such revenue streams are as follows: Licensing revenue includes: • upfront license fees, as well as developmental, regulatory and commercialization milestone payments. We assess upfront and milestone payments using the most likely amount method, including variable payments only when it is probable that no significant revenue reversal will occur. Upfront license fees are recognized upon receipt. Milestones tied to external factors, such as regulatory approvals, are considered probable when those accomplishments are achieved. • sales-based royalties, other than non-cash royalty revenue related to the sale of future royalties as discussed below, are recognized when sales occur or when related performance obligations are met. Product supply revenue includes drug substance or drug supply revenue received from our out-licensing agreements. Product supply revenue is recognized when control of goods is transferred upon delivery. Advanced payments from partners for drug substance are recognized as deferred revenue until delivery. Non-cash royalty revenue related to the sale of future royalties includes royalties earned and received under the Kyowa Kirin Agreement, which are remitted to HCR upon receipt, pursuant to the HCR Agreement as discussed in Note 8. Deferred Royalty Obligation Related To The Sale Of Future Royalties . The following table summarizes total revenue by collaboration partner: Year Ended December 31, (in thousands) 2024 2023 2022 Licensing revenue Kyowa Kirin $ — $ 30,000 $ 35,000 Fosun Pharma — 5,000 — METiS — 750 — Knight 78 59 31 Total licensing revenue $ 78 $ 35,809 $ 35,031 Product supply revenue Kyowa Kirin 11,649 6,092 1,518 Fosun Pharma — 29 9 Total supply revenue $ 11,649 $ 6,121 $ 1,527 Non-cash royalty revenue related to the sale of future royalties Kyowa Kirin $ 2,692 $ — $ — Kyowa Kirin We granted Kyowa Kirin an exclusive license (Kyowa Kirin Agreement) to develop and commercialize certain NHE3 inhibitors including tenapanor in Japan for the treatment of cardiorenal diseases and conditions, excluding cancer, in exchange for future royalties defined below, an upfront license fee of $30.0 million, and potential future development and regulatory milestones up to $55.0 million, of which $35.0 million has been received and recognized as revenue to date, as well as approximately ¥8.5 billion for commercialization milestones, or approximately $54.0 million at the currency exchange rate on December 31, 2024. In addition, we are eligible to receive royalties on net sales of tenapanor in Japan throughout the term of the agreement. Under a Commercial Supply Agreement, we supply tenapanor drug substance that will be used to satisfy Kyowa Kirin’s commercial needs which includes advanced payments for reimbursement of costs plus a reasonable overhead for the supply of product. In February 2024, Kyowa Kirin announced the launch of tenapanor, marketed as PHOZEVEL ® , for patients with CKD with hyperphosphatemia in Japan. The Kyowa Kirin Agreement was amended to reduce the royalty rate Kyowa Kirin would pay on tenapanor sales in Japan from high teens to low double digits for a two-year period of time following the first commercial sale in Japan, and then to mid-single digits for the remainder of the royalty term (2022 Amendment). As consideration for reduction in the royalty rate, Kyowa Kirin agreed to pay us up to an additional $40.0 million payable in two tranches, with the first payment due following Kyowa Kirin’s filing with the Japanese MHLW of its application for marketing approval for tenapanor and the second payment due following Kyowa Kirin’s receipt of regulatory approval to market tenapanor for hyperphosphatemia in Japan, both of which occurred as of September 30, 2023. As discussed in Note 8. Deferred Royalty Obligation Related To The Sale Of Future Royalties , future royalties and commercial milestone payments we may receive under the license, as amended, will be remitted to HCR pursuant to the HCR Agreement. The following table presents changes in our current and non-current deferred revenue balances, which are all attributable to Kyowa Kirin: 2024 2023 (in thousands) Current Non-Current Current Non-Current Balance at January 1, $ 7,182 $ 8,644 $ 4,211 $ 9,025 Prepaid product supply 3,716 8,212 1,547 5,629 Product supply delivered (9,836) — (4,586) — Reclassify amounts to be recognized in the next twelve months 9,624 (9,624) 6,010 (6,010) Balance at December 31, $ 10,686 $ 7,232 $ 7,182 $ 8,644 Fosun Pharma We have an exclusive license agreement with Fosun Pharma (Fosun Agreement) for the development, commercialization and distribution of tenapanor in China for both hyperphosphatemia and IBS-C. The Fosun Agreement granted exclusive license rights to Fosun Pharma in exchange for an upfront license fee of $12.0 million, recognized upon execution of the agreement, and potential regulatory milestone payments up to $113.0 million, of which $8.0 million has been received and recognized to date. In addition, we are eligible to receive reimbursement of cost plus a reasonable overhead for the supply of product and tiered royalties on net sales ranging from the mid-teens to 20%. Knight We have an exclusive license agreement with Knight (Knight Agreement) for the development, commercialization and distribution of tenapanor in Canada for hyperphosphatemia and IBS-C. The Knight Agreement granted exclusive license rights to Knight in exchange for an upfront license fee of $2.3 million, recognized upon execution, and potential regulatory and commercialization milestones up to CAD 22.2 million, or approximately $15.4 million at the currency exchange rate on December 31, 2024, of which $0.7 million has been received and recognized to date. In addition, we are eligible to receive royalties ranging from the mid-single digits to the low twenties throughout the term of the agreement and a transfer price for manufacturing supply services. METiS We have an exclusive license agreement with METiS Therapeutics Inc., (METiS Agreement) for the development and commercialization of a portfolio of TGR5 agonist compounds that we discovered and developed for all therapeutic areas in exchange for an upfront license fee of $0.8 million, recognized upon execution in 2023. In addition, we may be eligible to receive development and commercialization milestone payments worth up to $243.0 million. We are also eligible to receive royalties ranging within the mid-single digits throughout the term of the agreement. AstraZeneca In June 2015, we entered into a termination agreement with AstraZeneca (AstraZeneca Termination Agreement) pursuant to which we have agreed to pay AstraZeneca (i) future royalties at a royalty rate of 10% of net sales of tenapanor or other NHE3 products by us or our licensees, and (ii) 20% of non-royalty revenue received from a new collaboration partner should we elect to license, or otherwise provide rights to develop and commercialize tenapanor or other NHE3 products, up to a maximum of $75.0 million in aggregate for (i) and (ii). Royalty expense recognized under this agreement as other cost of revenue on our statements of operations and comprehensive loss was $34.7 million, $12.4 million and $3.6 million in 2024, 2023 and 2022, respectively. As of December 31, 2024, we have recognized $62.3 million of the total $75.0 million outstanding royalty obligation.

Deferred Royalty Obligation Rel

Deferred Royalty Obligation Related To The Sale Of Future Royalties	12 Months Ended
	Dec. 31, 2024
Advance Royalties [Abstract]
Deferred Royalty Obligation Related To The Sale Of Future Royalties	DEFERRED ROYALTY OBLIGATION RELATED TO THE SALE OF FUTURE ROYALTIES In June 2022, we and HCR entered into the HCR Agreement in which HCR agreed to pay up to $20.0 million in exchange for royalty payments and commercial milestone payments that we may receive under our Kyowa Kirin License Agreement. See Note 7. Collaboration And Licensing Agreements for further detail. The $20.0 million is payable as follows: • $10.0 million upfront upon agreement execution, received in June 2022; • $5.0 million upon Kyowa Kirin’s receipt of regulatory approval to market tenapanor for hyperphosphatemia in Japan, received in October 2023; and • $5.0 million in the event net sales by Kyowa Kirin in Japan exceed a certain annual target level by the end of 2025. The HCR Agreement is effective until terminated by the mutual agreement of the parties and contains customary representations and warranties and customary affirmative and negative covenants. Payments received from HCR are recorded as a deferred royalty obligation on our balance sheets. Due to our ongoing manufacturing obligations under the Kyowa Kirin Agreement, we account for the proceeds as imputed debt and therefore recognize royalties earned under the Kyowa Kirin Agreement as non-cash royalty revenue. In conjunction with the HCR Agreement, we incurred approximately $0.4 million in transaction costs, which, along with the deferred royalty obligation, are being amortized as non-cash interest expense over the estimated life of the HCR Agreement using the effective interest method, which is based on the imputed interest rate derived from estimated amounts and timing of future royalty payments to be received from Kyowa Kirin. The deferred royalty obligation will be effectively repaid over the life of the HCR Agreement as we remit royalties paid to us from Kyowa Kirin, recorded as non-cash royalty revenue related to the sale of future royalties, to HCR. We periodically assess the estimated royalty payments from Kyowa Kirin and, to the extent that the amount or timing of such payments is materially different than our original estimates, we prospectively adjust the imputed interest rate and the related amortization of the deferred royalty obligation. A summary of financial information related to the HCR Agreement is as follows: Year Ended December 31, ($ in thousands) 2024 2023 2022 Non-cash interest expense related to the sale of future royalties $ (7,088) $ (3,924) $ (1,673) Effective interest rate 31.0 % 34.7 % 34.4 %

Borrowing

Borrowing	12 Months Ended
	Dec. 31, 2024
Debt Disclosure [Abstract]
Borrowing	BORROWING Long-term borrowing was as follows: December 31, (in thousands) 2024 2023 Interest rate Principal Term A Loan $ 27,500 $ 27,500 7.95% + 0.022% + SOFR (subject to a floor of 1.0%) Term B Loan 22,500 22,500 7.95% + 0.022% + SOFR (subject to a floor of 1.0%) Term C Loan 50,000 — 4.25% + 0.022% + SOFR (subject to a floor of 4.7%) Term D Loan 50,000 — 4.00% + 0.022% + SOFR (subject to a floor of 4.7%) Total principal $ 150,000 $ 50,000 Adjustments to principal value Unamortized discount and debt issuance costs (1,136) (912) Accreted value of final fee 1,989 734 Total long-term debt 150,853 49,822 Less: Current portion of long-term debt — — Long-term debt, net of current portion $ 150,853 $ 49,822 On February 23, 2022 (Closing Date), we entered into a loan and security agreement with SLR (2022 Loan Agreement) as collateral agent (Agent) and the lenders listed in the 2022 Loan Agreement (collectively, the 2022 Lenders), which was subsequently amended in August 2022 (the First Amendment) and February 2023 (the Second Amendment). The 2022 Loan Agreement, as amended, provided for a senior secured loan facility (the Term A Loan) funded on the Closing Date and Term B Loan borrowable on or prior to December 20, 2023; provided that (i) we received approval by the U.S. FDA for our NDA for XPHOZAH by November 30, 2023, and (ii) we achieved certain product revenue milestone targets described in the 2022 Loan Agreement. We met the requirements to borrow Term B Loan and subsequently drew it in October 2023. In October 2023, we entered into a Third Amendment (the Third Amendment) with the 2022 Lenders. The Third Amendment provided us with the option to draw the Term C Loan by March 15, 2024, contingent upon having drawn the Term B Loan; and provided us with the option to draw the Term D Loan of uncommitted capital by December 31, 2026, subject to approval by the Agent’s investment committee. We provided the Agent with notice of our decision to draw the Term C Loan in February 2024 and received the proceeds in March 2024. In October 2024, we entered into a Fourth Amendment (the Fourth Amendment) with the 2022 Lenders. The Fourth Amendment, among other things, provided for the immediate draw of the Term D Loan on the closing date of the Fourth Amendment and provides us with the option to draw an additional $50.0 million of committed capital by June 30, 2025 (the Term E Loan and together with the Term A, B, C and D Loans, the Five Loans). The interest rate for the Term E Loan will be 4.00% plus a SOFR value equal to 0.022% plus the 1-month CME Term SOFR reference rate as published by the CME Term SOFR Administrator on the CME Term SOFR Administrator’s Website, subject to a SOFR floor of 4.7%. We drew the Term D Loan in October 2024. Under the Fourth Amendment, the maturity date for the Five Loans was extended to July 1, 2028 (the Maturity Date) and the period under which we are permitted to make interest-only payments on the Five Loans was extended to the Maturity Date. We paid fees of $0.2 million, $0.1 million, $0.3 million and $0.3 million on each funding date of the Term A, Term B, Term C and Term D Loans, respectively. In addition, we will be obligated to pay 0.5% of the aggregate original principal amount of the Term E Loan commitment, which shall be due on the earliest of (1) the funding of the Term E Loan, (2) June 30, 2025, or (3) the prepayment, refinancing, substitution or replacement of any of the Five Loans on or prior to the date immediately preceding June 30, 2025. We are obligated to pay a final fee equal to 4.95% of the aggregate original principal amount of the Five Loans, to the extent such loans are funded, upon the earliest to occur of the maturity date, the acceleration of the Five Loans, and the prepayment, refinancing, substitution, or replacement of the Five Loans. The total unaccreted final fee was $5.4 million and $1.7 million at December 31, 2024 and December 31, 2023, respectively. We may voluntarily prepay all amounts outstanding under the Five Loans, subject to a prepayment premium of 2% of the outstanding principal amount of the Five Loans if prepaid through and including October 17, 2025 or 1% of the outstanding principal amount of the Five Loans if prepaid after October 17, 2025 and prior to the maturity date. The Five Loans are secured by substantially all of our assets, except for our intellectual property and certain other customary exclusions. Additionally, as discussed in Note 10. Derivative Liabilities , in connection with the Term A and Term B Loans (Original Loans), we paid an exit fee in the amount of $1.0 million in October 2024. The 2022 Loan Agreement, as amended, contains customary representations and warranties that place restrictions on disposition of assets, granting liens, occurring additional debt and other matters, as well as customary events of default. We have agreed to not allow our cash, cash equivalents and available-for-sale investments to be less than the eighty percent (80%) of the outstanding balance of the Five Loans for any period in which our net revenue from the sale of any products, calculated on a trailing six (6) month basis and tested monthly, is less than sixty percent (60%) of the outstanding balance of the Five Loans. We have concluded that the provisions that could cause acceleration of the principal repayment are remote as of December 31, 2024. As of December 31, 2024, our total future payment obligation related to the outstanding balance of the Five Loans, excluding interest payments, was $157.4 million, which is due on July 1, 2028.

Derivative Liabilities

Derivative Liabilities	12 Months Ended
	Dec. 31, 2024
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Derivative Liabilities	DERIVATIVE LIABILITIES 2018 Exit Fee In October 2023, we received approval from the U.S. FDA for XPHOZAH to reduce serum phosphorus in adults with CKD on dialysis as add-on therapy in patients who have an inadequate response to phosphate binders or who are intolerant of any dose of phosphate binder therapy. In connection with a previous loan agreement (2018 Loan), we became obligated to pay an exit fee of $1.5 million, which was paid in 2023. 2022 Exit Fee The 2022 Loan Agreement obligated us to pay an exit fee in the amount of 2% of the Original Loans funded (2022 Exit Fee) upon (i) any change of control transaction or (ii) our achievement of net revenue from the sale of any products equal to or greater than $100.0 million, measured on a six (6) months basis (Revenue Milestone), tested monthly at the end of each month. The 2022 Exit Fee was accounted for as a freestanding derivative and recorded at fair value. The estimated fair value of the 2022 Exit Fee of $0.7 million was recorded as a derivative liability and included in accrued expenses and other current liabilities at December 31, 2023. The Revenue Milestone was achieved in the second quarter of 2024, resulting in a $1.0 million payment in October 2024 to settle the obligation. The Term C and Term D Loans do not contain an exit fee obligation. The fair value of the derivative liability was determined using a discounted cash flow analysis and was classified as a Level 3 measurement within the fair value hierarchy since our valuation utilized significant unobservable inputs prior to June 30, 2024. Specifically, the key assumptions included in the calculation of the estimated fair value of the 2022 Exit Fee derivative liability included: (i) our estimates of both the probability and timing of achieving the Revenue Milestone and (ii) the probability and timing of funding the Term B Loan, which was dependent upon (a) approval by the U.S. FDA for our NDA for the control of serum phosphorus in adult patients with CKD on dialysis by November 30, 2023, and (b) achievement of certain product revenue milestone targets. As of December 31, 2023, uncertainty around all of the noted valuation estimates had been removed, as the Term B Loan had been funded, the U.S. FDA had approved our NDA for the control of serum phosphorus in adult patients with CKD on dialysis prior to November 30, 2023, and we had achieved the Revenue Milestone. Changes in the fair value of recurring measurements are presented as other income, net in our statements of operations and comprehensive loss and were as follows: (in thousands) 2024 2023 January 1, $ 675 $ 1,656 Changes in estimated fair value 2018 Exit Fee — 292 2022 Exit Fee 325 227 2018 Exit Fee payment — (1,500) 2022 Exit Fee payment (1,000) — Fair value of exit fee derivative liabilities at December 31, $ — $ 675

Leases

Leases	12 Months Ended
	Dec. 31, 2024
Leases [Abstract]
Leases	LEASES Our lease obligation is comprised of operating leases for our offices and research facilities with remaining lease terms ranging from two months to four years and each containing customary rent escalation clauses. Our leases contain one renewal, at our option, which is generally for a five-year period. We have not included these renewal periods in the calculation of the right-of-use asset and lease liability since it is uncertain whether we will exercise the renewal option. Our leased offices and research facilities in Fremont, California expired on February 10, 2025 and our sub-lease agreement for office space at that facility, entered into with Chronus Health in 2023 expired on February 1, 2025. The following table provides additional details of our facility leases presented in our balance sheets: ($ in thousands) December 31, Facilities 2024 2023 Right-of-use assets $ 2,380 $ 5,589 Current portion of lease liabilities 1,562 4,435 Operating lease liability, net of current portion 1,023 1,725 Total lease liabilities $ 2,585 $ 6,160 Weighted-average remaining term (in years) 1.8 1.6 Weighted-average discount rate 6.5 % 6.8 % The lease costs, which are included in operating expenses in our statements of operations and comprehensive loss, were as follows: Year Ended December 31, (in thousands) 2024 2023 2022 Operating lease expense $ 4,699 $ 3,857 $ 4,257 Cash paid for operating leases $ 4,931 $ 4,481 $ 4,292 The following table summarizes our undiscounted cash payment obligations for our operating lease liabilities as of December 31, 2024: (in thousands) Operating Leases 2025 $ 1,660 2026 702 2027 238 2028 124 Thereafter 21 Total undiscounted operating lease payments 2,745 Imputed interest expenses (160) Total operating lease liabilities 2,585 Less: Current portion of operating lease liability (1,562) Operating lease liability, net of current portion $ 1,023

Stockholders' Equity

Stockholders' Equity	12 Months Ended
	Dec. 31, 2024
Stockholders' Equity Note [Abstract]
Stockholders' Equity	STOCKHOLDERS’ EQUITY Under a registration statement filed in 2020, we had the ability to sell up to $150.0 million of our common stock through Jefferies, as our sales agent. As of March 2023, we had received the maximum gross proceeds of $150.0 million at a weighted average share price of approximately $1.57. In January 2023, we filed a registration statement on Form S-3, which became effective in January 2023, containing (i) a base prospectus for the offering, issuance and sale by us of up to a maximum aggregate offering price of $250.0 million of our common stock, preferred stock, debt securities, warrants and/or units, from time to time in one or more offerings; and (ii) a prospectus supplement for the offering, issuance and sale by us of up to a maximum aggregate offering price of $150.0 million of our common stock that may be issued and sold, from time to time, under a sales agreement with Jefferies, deemed to be “at-the-market offerings” (2023 Open Market Sales Agreement). Pursuant to the 2023 Open Market Sales Agreement, Jefferies, as sales agent, may receive a commission of up to 3.0% of the gross sales price for shares of common stock sold under the 2023 Open Market Sales Agreement. As of December 31, 2024, we have completed sales pursuant to the 2023 Open Market Sales Agreement resulting in the issuance of 16.8 million shares of our common stock and receipt of gross proceeds of $70.0 million at a weighted average sales price of approximately $4.17.

Equity Incentive Plans

Equity Incentive Plans	12 Months Ended
	Dec. 31, 2024
Share-Based Payment Arrangement [Abstract]
Equity Incentive Plans	EQUITY INCENTIVE PLANS 2008 Plan The 2008 Stock Incentive Plan (2008 Plan), which governed the granting of stock options, stock purchase rights and other equity awards, was terminated in June 2014 for future awards. When the 2014 Equity Incentive Award Plan (2014 Plan) was approved by the board of directors and stockholders on June 18, 2014, all remaining shares available for future award under the 2008 Plan were transferred to the 2014 Plan, as discussed below. 2014 Plan The 2014 Equity Incentive Plan (2014 Plan), effective on June 18, 2014, provided for the stock-based compensation awards, including stock options, stock appreciation rights, restricted stock, service-based RSUs, performance-based RSUs, deferred stock, deferred stock units, dividend equivalents, stock payments and performance awards. The 2014 Plan initially reserved 1.5 million shares, including the 35 thousand shares remaining for future awards under the 2008 Plan, with up to 1.2 million additional shares which could be added from forfeited or lapsed awards from the 2008 Plan. The 2014 Plan allowed for an annual increase in the number of shares available for issuance on the first day of each year through 2024, equal to the lesser of four percent (4.0%) of our outstanding common stock on the last day of the immediately preceding year or a smaller amount determined by the board of directors (2014 Plan evergreen provision). On June 14, 2024, stockholders approved the Amended and Restated 2014 Equity Incentive Award Plan (2014 A&R Plan). The key provisions pursuant to the 2014 A&R Plan include: (1) 19.0 million shares were added to the total existing share reserve; (2) the 2014 Plan evergreen provision was removed such that any increase to the total number of shares that may be issued must be approved by our stockholders; and (3) the limit of shares that may be issued upon exercise of incentive stock options was increased from 10.7 million to 58.5 million shares. In addition to increases resulting from repurchases, forfeitures, expirations and cancellations of awards under the 2008 Plan, shares reserved for issuance under the 2014 A&R Plan will be increased by the number of shares subject to awards granted under the Inducement Plan, as discussed below, that are repurchased, forfeited, expire or are cancelled on or after June 14, 2024. As a result, no new awards will be made under the Inducement Plan after June 14, 2024. As of December 31, 2024, approximately 18.1 million shares of our common stock were available for future issuance under the 2014 A&R Plan. 2016 Plan In November 2016, our board of directors approved the 2016 Employment Commencement Incentive Plan (Inducement Plan) under which 1.0 million shares were reserved. In January 2021, January 2022, December 2022 and January 2024, 0.5 million, 2.0 million, 3.0 million and 5.8 million shares, respectively, were added to the Inducement Plan. As of December 31, 2024, 8.8 million shares of our common stock were subject to inducement grants that were issued pursuant to the Inducement Plan. As of December 31, 2024, approximately 3.9 million shares of our common stock were available for future issuance under the 2016 Plan. Stock Options A summary of our stock option activity and related information during the year ended December 31, 2024 is as follows: Options Issued and Outstanding Weighted Average Remaining Contractual Term (in years) Aggregate Intrinsic Value (in thousands) Number of Shares (in thousands) Weighted-Average Exercise Price per Share Balance at December 31, 2023 22,168 $ 4.20 Options granted 9,674 $ 7.95 Options exercised (2,654) $ 2.24 Options canceled (1,103) $ 5.35 Balance at December 31, 2024 28,085 $ 5.63 7.1 $ 31,830 Vested and expected to vest at December 31, 2024 28,085 $ 5.63 7.1 $ 31,830 Exercisable at December 31, 2024 14,968 $ 5.52 5.7 $ 19,161 The aggregate intrinsic value represents the difference between the total pre-tax value (i.e., the difference between our stock price and the exercise price) of stock options outstanding as of December 31, 2024, based on our common stock closing price of $5.07 per share, which would have been received by the option holders if all their in-the-money options had been exercised as of that date. The intrinsic value of options exercised during the years ended December 31, 2024, 2023 and 2022 was $19.6 million, $1.1 million and $30 thousand, respectively. The total fair value of options vested during the years ended December 31, 2024, 2023 and 2022 was $61.0 million, $24.9 million and $7.0 million, respectively. The weighted-average grant-date estimated fair value of options granted during the years ended December 31, 2024, 2023 and 2022 was $6.22, $2.36 and $0.63 per share, respectively. The estimated grant date fair value of employee stock options was calculated using the Black-Scholes option-pricing model, based on the following weighted-average assumptions: Year Ended December 31, 2024 2023 2022 Expected term (in years) 5.4 5.1 4.9 Expected volatility 100.8 % 97.6 % 92.1 % Risk-free interest rate 4.0 % 3.8 % 2.2 % Dividend yield — % — % — % Expected Term —We estimate the expected term of our options based upon historical exercises and post-vesting termination behavior. Expected Volatility —We use the historic volatility of our own stock over the retrospective period corresponding to the expected remaining term of the options, or the period since our shares were first quoted on The Nasdaq Global Market, if that is shorter, to compute our expected stock price volatility. Risk-Free Interest Rate —The risk-free interest rate assumption is based on the zero-coupon U.S. treasury instruments on the date of grant with a maturity date consistent with the expected term of our stock option grants. Dividend Yield —To date, we have not declared or paid any cash dividends and do not have any plans to do so in the future. Therefore, we use an expected dividend yield of zero. Restricted Stock Units A summary of our RSUs activity and related information for the year ended December 31, 2024 is as follows: Number of RSUs (in thousands) Weighted-Average Grant Date Fair Value Per Share Non-vested restricted stock units at December 31, 2023 3,646 $ 3.09 Granted 7,382 $ 7.94 Vested (2,430) $ 5.65 Forfeited (585) $ 5.68 Non-vested restricted stock units at December 31, 2024 8,013 $ 6.59 The total estimated fair value of RSUs vested during the years ended December 31, 2024, 2023 and 2022 was $16.4 million, $3.5 million and $2.6 million, respectively. Issuance of Common Stock for Services During the years ended December 31, 2024, 2023 and 2022, we issued approximately 41 thousand, 0.1 million and 0.7 million shares, respectively, of common stock to members of the board of directors who elected to receive stock in lieu of their cash fees under our Non-Employee Director Compensation Program. The shares issued during the years ended December 31, 2024, 2023 and 2022 were valued at $0.3 million, $0.3 million and $0.4 million, respectively, based on the fair value of the common stock on the date of grant. Employee Stock Purchase Plan The 2014 ESPP, effective on June 18, 2014, initially reserved approximately 0.2 million shares of common stock for our eligible employees to purchase shares of our common stock at a discount. If approved by the administrator of the ESPP, on the first day of each calendar year through 2024, the number of shares in the reserve increased by an amount equal to the lesser of (i) one percent (1.0%) of the shares of common stock outstanding on the last day of the immediately preceding fiscal year and (ii) such number of shares of common stock as determined by the board of directors (2014 ESPP evergreen provision); provided, however, no more than 2.2 million shares of our common stock could be issued under the ESPP. On June 14, 2024, stockholders approved the Amended and Restated 2014 ESPP (A&R ESPP). The key provisions pursuant to the A&R ESPP include: (1) 3.0 million shares were added to the total existing share reserve and (2) the 2014 ESPP evergreen provision was eliminated and no evergreen increases will be made after June 14, 2024. During the years ended December 31, 2024, 2023 and 2022, we issued approximately 0.5 million, 0.4 million and 0.3 million shares, respectively, at an average share price of $4.64, $1.85 and $0.63, respectively, pursuant to the ESPP. As of December 31, 2024, approximately 3.7 million shares of our common stock were available for future issuance under the A&R ESPP. The following table illustrates the weighted-average assumptions for the Black-Scholes option-pricing model used in determining the fair value of ESPP purchase rights granted to our employees: Year Ended December 31, 2024 2023 2022 Expected term (in years) 0.5 0.5 0.5 Expected volatility 82.8 % 86.0 % 97.2 % Risk-free interest rate 5.0 % 5.3 % 1.9 % Dividend yield — % — % — % Stock-based Compensation Expense Stock-based compensation expense recognized for stock options, RSUs and our ESPP is recorded as operating expenses in our statements of operations and comprehensive loss, as follows: Year Ended December 31, (in thousands) 2024 2023 2022 Selling, general and administrative $ 27,791 $ 9,952 $ 7,525 Research and development 9,590 3,578 3,225 Total $ 37,381 $ 13,530 $ 10,750 A summary of our total unrecognized stock-based compensation expense, net of estimated forfeitures, as of December 31, 2024 is as follows: December 31, 2024 Unrecognized Compensation Expense (in thousands) Average Remaining Vesting Period (in years) Stock option grants $ 55,610 2.71 RSU grants $ 49,930 2.96 ESPP $ 162 0.1

Property and Equipment, Net

Property and Equipment, Net	12 Months Ended
	Dec. 31, 2024
Property, Plant and Equipment [Abstract]
Property and Equipment, Net	PROPERTY AND EQUIPMENT, NET Property and equipment consisted of the following: December 31, (in thousands) 2024 2023 Laboratory equipment $ 46 $ 46 Office equipment and furniture 2,923 2,433 Leasehold improvements 9,144 8,731 Property and equipment, gross 12,113 11,210 Less: Accumulated depreciation (10,618) (10,201) Total property and equipment, net $ 1,495 $ 1,009 We recognized depreciation expense in the amount of $0.5 million, $0.6 million and $0.7 million in 2024, 2023 and 2022, respectively.

Accrued Expenses and Other Curr

Accrued Expenses and Other Current Liabilities	12 Months Ended
	Dec. 31, 2024
Payables and Accruals [Abstract]
Accrued Expenses and Other Current Liabilities	ACCRUED EXPENSES AND OTHER CURRENT LIABILITIES Accrued expenses and other current liabilities consisted of the following: December 31, (in thousands) 2024 2023 Accrued payments due to AstraZeneca $ 12,077 $ 3,680 Accrued gross to net revenue liabilities 10,112 3,258 Accrued sales and marketing expenses 3,696 3,223 Other 8,757 4,880 Total accrued expenses and other current liabilities $ 34,642 $ 15,041

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2024
Income Tax Disclosure [Abstract]
Income Taxes	INCOME TAXES The components of our provision for income taxes were as follows: Year Ended December 31, (in thousands) 2024 2023 2022 Current State $ 266 $ 47 $ 8 Foreign — 500 — Total current 266 547 8 Deferred Federal — — — Total deferred — — — Provision for income taxes $ 266 $ 547 $ 8 A reconciliation of the statutory federal income tax rate to our effective tax rate is as follows: Year Ended December 31, 2024 2023 2022 Income tax at the federal statutory rate 21.0 % 21.0 % 21.0 % State taxes, net of federal benefit 4.0 3.4 1.9 Tax credits 0.6 1.7 1.5 Stock based compensation 5.2 0.1 (2.3) Foreign withholding tax — (0.8) — Executive compensation disallowed under IRC Sec 162(m) (5.8) (1.9) (1.6) Other (0.6) — (0.8) Change in valuation allowance (25.0) (24.3) (19.7) Effective tax rate (0.6) % (0.8) % — % Deferred income tax balances reflect the effects of temporary differences between the carrying amounts of assets and liabilities and their income tax bases, as well as from net operating loss and tax credit carryforwards. Significant components of our deferred tax assets were as follows: December 31, (in thousands) 2024 2023 Deferred tax assets Amortization and depreciation $ 64,237 $ 64,919 Net operating loss carryforwards 103,643 98,702 Tax credits 15,529 15,375 Stock-based compensation 11,226 6,946 Deferred royalty obligation 6,409 4,907 Other 8,122 6,707 Deferred tax assets 209,166 197,556 Valuation allowance (208,568) (196,197) Deferred tax assets net of valuation allowance 598 1,359 Deferred tax liabilities Right-of-use asset (598) (1,359) Deferred tax liabilities (598) (1,359) Net deferred taxes $ — $ — Realization of deferred tax assets is dependent on future taxable income, if any, the timing and the amount of which are uncertain. We assess the available positive and negative evidence to estimate whether sufficient future taxable income will be generated to permit use of the existing deferred tax assets. A significant component of objective negative evidence evaluated was our cumulative loss incurred over the three-year period ended December 31, 2024. Such objective evidence limits the ability to consider other subjective evidence, such as our projections for future growth. On the basis of this evaluation, as of December 31, 2024, 2023 and 2022, a full valuation allowance has been recorded against our deferred tax assets. The valuation allowance increased by $12.4 million in 2024 primarily attributable to net operating loss carryforwards and stock-based compensation. The amount of the deferred tax assets considered realizable could be adjusted if estimates of future taxable income during the carryforward period are reduced or increased, or if objective negative evidence, such as cumulative losses, are no longer present. In such cases, additional weight may be given to subjective evidence, such as our projections for growth. As of December 31, 2024, we had net operating loss carryforwards for federal income tax purposes of approximately $495.0 million, of which approximately $344.8 million can be carried forward indefinitely and the remaining net operating losses begin to expire in 2030, if not utilized. We had approximately $17.8 million of federal research and development tax credit carryforwards and approximately $1.7 million of foreign tax credit carryforwards that begin to expire in 2027, if not utilized. In addition, we had net operating loss carryforwards for California income tax purposes of approximately $94.7 million that begin to expire in 2030, if not utilized, and state research and development tax credit carryforwards of approximately $9.2 million that do not expire. We had approximately $0.1 million of minimum tax credit carryovers for California income tax purposes that do not expire. We had other state net operating losses of approximately $64.0 million that begin to expire in 2031. The future utilization of net operating loss and tax credit carryforwards may be subject to an annual limitation, pursuant to Internal Revenue Code Sections 382 and 383, as a result of ownership changes that may have occurred previously or that could occur in the future. Due to the existence of the valuation allowance, limitations under Section 382 and 383 will not impact our effective tax rate. Effective January 1, 2022, research and development expenses are required to be capitalized and amortized for U.S. tax purposes. The mandatory capitalization requirement did not have a material impact on our deferred tax assets and did not result in a cash tax liability as we have historically elected to capitalize research and development expenses for tax purposes. A reconciliation of the beginning and ending amount of unrecognized tax benefits is as follows: December 31, (in thousands) 2024 2023 2022 Balance at beginning of year $ 23,625 $ 24,075 $ 24,426 Additions based on tax positions related to current year 105 262 460 Additions based on tax positions related to prior year — 99 — Subtractions based on tax positions related to prior year (811) (811) (811) Balance at end of year $ 22,919 $ 23,625 $ 24,075 We recognize a tax benefit from an uncertain tax position when it is more likely than not that the position will be sustained upon examination, including resolutions of any related appeals or litigation processes, based on the technical merits. Income tax positions must meet a more likely than not recognition at the effective date to be recognized. None of our unrecognized tax benefits would impact the effective tax rate if recognized, because the benefit would be offset by an increase in the valuation allowance. We have elected to include interest and penalties as a component of tax expense. During the years ended December 31, 2024, 2023 and 2022, we did not recognize accrued interest and penalties related to unrecognized tax benefits. Although the timing and outcome of an income tax audit is highly uncertain, we do not anticipate that the amount of existing unrecognized tax benefits will significantly change during the next 12 months. We file a U.S. federal income tax return and income tax returns in various state and local jurisdictions. Due to our net operating loss and tax credit carryforwards, the income tax returns remain open to U.S. federal and state tax examinations. We are not currently under examination in any tax jurisdiction.

Segment Reporting

Segment Reporting	12 Months Ended
	Dec. 31, 2024
Segment Reporting [Abstract]
Segment Reporting	SEGMENT REPORTING We operate in a single reportable segment with a mission to discover, develop and commercialize innovative, first-in-class medicines that meet significant unmet medical needs. A centralized research and development organization, supply chain organization and commercial organization are all responsible for the discovery, development, manufacturing, supply and sale of our products. Our business is also supported by centralized corporate functions. We currently operate primarily in the U.S. and earn revenues from sales of IBSRELA and XPHOZAH, both branded products derived from tenapanor, a molecule developed from our unique and innovative platform. Licensing agreements with international partners are utilized for development and commercialization activities outside the U.S. Currently, we maintain such agreements for certain indications of tenapanor in Japan (Kyowa Kirin), China (Fosun Pharma) and Canada (Knight). Refer to Note 7. Collaboration And Licensing Agreements for further detail. We recognize other revenue in the form of product supply revenue and licensing revenue under the Kyowa Kirin and Knight agreements. Revenue streams associated with the Kyowa Kirin Agreement are subject to a separate agreement where such future royalties and commercial milestones were sold to a third-party. Refer to Note 8. Deferred Royalty Obligation Related To The Sale Of Future Royalties for further information. Our Chief Executive Officer (CEO) is our Chief Operating Decision Maker (CODM), responsible for allocating resources and assessing Company performance using aggregated financial information. Utilizing aggregated financial information enables the CODM to determine the most appropriate resource allocation across the commercial organization, research and development projects or other initiatives consistent with our long-term corporate wide strategic goals. The CODM primarily uses aggregated net loss as reported on the statements of operations and comprehensive loss to measure segment loss, supplemented by certain additional significant expense details reflected in the table below. Detailed information regarding our single operating segment’s significant revenues, expenses and operating loss are as follows: Year Ended December 31, (in thousands) 2024 2023 2022 Revenues Product sales, net $ 319,196 $ 82,526 $ 15,600 Other revenues (1) 14,419 41,930 36,558 Total revenues 333,615 124,456 52,158 Less: Cost of product sales 6,851 2,323 566 Other cost of revenue 43,705 15,472 3,551 Total cost of goods sold 50,556 17,795 4,117 Research and development (2) 39,480 29,231 28,777 Selling expenses (2) 162,957 80,028 10,750 General and administrative expenses (2) 52,916 34,020 34,895 Stock-based compensation 37,381 13,530 25,144 Other segment expenses (3) 18,275 13,128 12,234 Total operating expenses 311,009 169,937 111,800 Segment and consolidated loss from operations (27,950) (63,276) (63,759) Other reconciliation items (4) (11,186) (2,791) (3,448) Segment and consolidated net loss $ (39,136) $ (66,067) $ (67,207) (1) “Other revenues” includes revenues from our collaboration partnerships, including license fees, milestone payments, product supply revenue and non-cash royalty revenue related to the sale of future royalties. (2) Research and development, selling and general administrative expenses herein do not include certain allocated items, such as stock-based compensation expenses. (3) “Other segment expenses” primarily consists of allocated facilities, information technology, and employee costs of approximately $16.9 million,$12.3 million and $11.4 million in 2024, 2023 and 2022, respectively. (4) “Other reconciliation items” includes interest expense, non-cash interest expense related to the sale of future royalties, provision for income taxes and other income, net.

Net Loss Per Share

Net Loss Per Share	12 Months Ended
	Dec. 31, 2024
Earnings Per Share [Abstract]
Net Loss Per Share	NET LOSS PER SHARE Basic net loss per share is calculated by dividing net loss by the weighted-average number of common shares outstanding during the period and excludes any dilutive effects of stock-based awards and warrants. Diluted net loss per common share is computed giving effect to all potential dilutive common shares, including common stock issuable upon exercise of stock options, and unvested restricted common stock and stock units. As we had net losses for the years ended December 31, 2024, 2023 and 2022, all potential common shares were determined to be anti-dilutive. The following table sets forth the computation of net loss per common share: Year Ended December 31, (in thousands, except per share amounts) 2024 2023 2022 Numerator: Net loss $ (39,136) $ (66,067) $ (67,207) Denominator: Weighted average common shares outstanding - basic and diluted 235,233 219,331 158,690 Net loss per share of common stock - basic and diluted $ (0.17) $ (0.30) $ (0.42) The total numbers of securities that could potentially dilute net income per share in the future that were not considered in the diluted net loss per share calculations because the effect would have been anti-dilutive were as follows: Year Ended December 31, (in thousands) 2024 2023 2022 Options to purchase common stock 27,800 20,877 13,522 Restricted stock units 7,883 3,086 2,694 ESPP shares issuable 230 249 166 Total 35,913 24,212 16,382 The number of potential common shares that would have been included in diluted income per share had it not been for the anti-dilutive effect caused by the net loss, computed by converting these securities using the treasury stock method during the years ended December 31, 2024, 2023 and 2022, was approximately 9.2 million, 6.3 million and 0.6 million, respectively.

Commitments and Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 2024
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	COMMITMENTS AND CONTINGENCIES Guarantees and Indemnifications We indemnify each of our officers and directors for certain events or occurrences, subject to certain limits, while the officer or director is or was serving at our request in such capacity, as permitted under Delaware law and in accordance with our certificate of incorporation and bylaws. The term of the indemnification period lasts as long as an officer or director may be subject to any proceeding arising out of acts or omissions of such officer or director in such capacity. The maximum amount of potential future indemnification is unlimited; however, we currently hold director and officer liability insurance, which allows the transfer of risk associated with our exposure and may enable us to recover a portion of any future amounts paid. We believe that the fair value of these indemnification obligations is minimal. Accordingly, we have not recognized any liabilities relating to these obligations for any period presented. Legal Proceedings and Claims On July 30 and August 12, 2021, two putative securities class action lawsuits were commenced in the U.S. District Court for the Northern District of California naming as defendants Ardelyx and two current officers captioned Strezsak v. Ardelyx, Inc., et al. , Case No. 4:21-cv-05868-HSG, and Siegel v. Ardelyx, Inc., et al. , Case No. 5:21-cv-06228-HSG (together, the Securities Class Actions). The complaints allege that the defendants violated Sections 10(b) and 20(a) of the Securities Exchange Act of 1934 (the Exchange Act), as amended, and Rule 10b-5 thereunder, by making false and misleading statements and omissions of material fact related to tenapanor. The plaintiffs seek damages and interest, and an award of costs, including attorneys’ fees. On July 19, 2022, the court consolidated the two putative class actions and appointed a lead plaintiff and lead counsel. The lead plaintiff filed a second amended complaint under which the plaintiffs seek to represent all persons who purchased or otherwise acquired Ardelyx securities between March 6, 2020 and July 19, 2021. Defendants filed a motion to dismiss the amended complaint on June 2, 2023. On March 22, 2024, the court granted defendants’ motion to dismiss. The court provided plaintiffs a third opportunity to amend and plaintiffs filed a third amended complaint on April 19, 2024. Defendants filed a motion to dismiss the third amended complaint on June 3, 2024. The case was dismissed with prejudice on September 12, 2024. On October 9, 2024, plaintiff appealed the District Court’s dismissal of the case to the Ninth Circuit. We believe the plaintiffs’ claims are without merit. On December 7, 2021 and March 29, 2022, two verified shareholders derivative lawsuits were filed in the U.S. District Court for the Northern District of California purportedly on behalf of Ardelyx against certain of Ardelyx’s executive officers and members of our board of directors, captioned Go v. Raab, et al., Case No. 4:21-cv-09455-HSG, and Morris v. Raab, et al., Case No. 4:22-cv-01988-JSC. The complaints allege that the defendants' violations of Section 14(a) of the Securities Exchange Act of 1934, as amended, breaches of fiduciary duties, unjust enrichment, abuse of control, gross mismanagement, and waste of corporate assets for personally making and/or causing Ardelyx to make materially false and misleading statements regarding the Company’s business, operations and prospects. The complaint seeks contribution under Sections 10(b) and 21D of the Securities Exchange Act of 1934 from two executive officers. On January 19, and April 27, 2022, the court granted the parties’ stipulation to stay the Go and Morris actions, respectively, until resolution of the anticipated motion(s) to dismiss in the Securities Class Actions. On October 25, 2022, the parties filed a stipulation to consolidate and stay the Go and Morris actions, and on October 27, 2022, the court consolidated the Go and Morris action and stayed the consolidated action pending resolution of the anticipated motion(s) to dismiss in the Securities Class Action. The consolidated case remains stayed pending resolution of the appeal in the Securities Class Action. We believe the plaintiffs’ claims are without merit. On July 17, 2024, in partnership with the AAKP and the NMQF, we filed a lawsuit in the U.S. District Court for the District of Columbia against the CMS, claiming that CMS has violated its statutory and regulatory authority under the MIPPA, which established the ESRD PPS bundled payment system for dialysis services in 2008. Specifically, the lawsuit claims that CMS’s plan to move XPHOZAH, along with all oral-only drugs, into the ESRD PPS is inconsistent with MIPPA’s statutory provision, and contradicts CMS’s own regulations. XPHOZAH and other oral-only drugs, which are currently available to patients under Medicare Part D, are not administered by dialysis providers and cannot be taken during the delivery of maintenance dialysis. The Company, AAKP and NMQF are seeking relief under the Administrative Procedure Act to enjoin CMS from proceeding with its plan to include XPHOZAH in the ESRD PPS and eliminate coverage under Medicare Part D beginning on January 1, 2025. On November 8, 2024, the U.S. District Court for the District of Columbia granted defendants’ Motion to Dismiss and denied plaintiffs Motion for Preliminary Injunction, or in the Alternative, for Expedited Summary Judgment. Following the District Court’s denial of plaintiffs’ Motion to Alter or Amend the Judgment, or in the Alternative, for an Injunction Pending Appeal, plaintiffs filed an Emergency Motion for an Administrative Stay and Injunction Pending Appeal, which was denied by the United States Court of Appeals for the District of Columbia Circuit. Appellants filed a brief in the appeal on February 4, 2025, and Appellee’s brief is due March 6, 2025. Final briefs in the appeal are currently expected to be filed on April 10, 2025. On August 16, 2024, a complaint was filed against us in the U.S. District Court of Massachusetts, captioned Yarborough v. Ardelyx, Inc., et al., No. 24-cv-12119 (D. Mass.). The complaint names the Company, Mike Raab, and Justin Renz as defendants and alleges violations of Sections 10(b) and 20(a) the Exchange Act and Rule 10b-5 promulgated thereunder, related to the our announcement on July 2, 2024 that it had chosen not to file an application for Transitional Drug Add-on Payment Adjustment for XPHOZAH (the “Yarborough Action”). The plaintiffs seek damages and interest, and an award of costs, including attorneys’ fees. Two shareholders filed motions to be appointed lead plaintiff in the Yarborough Action on October 15, 2024. The Court appointed Tate Wood as lead plaintiff on October 30, 2024. Lead Plaintiff filed an amended complaint on January 13, 2025, alleging violations of Sections 10(b) and 20(a) of the Exchange Act and Rule 10b-5 promulgated thereunder related to our announcement on July 2, 2024 regarding TDAPA. Lead Plaintiff purports to bring claims on behalf of all those who acquired Ardelyx common stock between February 23, 2024 and July 1, 2024. Defendants’ motion to dismiss the amended complaint is due March 14, 2025. We believe the plaintiff’s claims are without merit. On September 6 and 13, 2024, certain Ardelyx shareholders filed two verified derivative complaints purportedly on behalf of the Company in the United States District Court for the District of Massachusetts alleging violations of Sections 10(b) and/or 14(a) of the Exchange Act, breaches of fiduciary duty, unjust enrichment, waste, and aiding and abetting breaches of fiduciary duty against certain members of our board of directors and management based on substantially the same factual allegations in the Yarborough Action. The complaints seek unspecified damages and corporate governance reforms, as well as costs and attorneys’ fees. On September 25, 2024, the Court consolidated the two derivative actions into the case In re Ardelyx, Inc. Stockholder Derivative Litigation, Case No. 1:24-cv-12302-LTS (D. Mass.). On November 7, 2024, the Court stayed the consolidated derivative action pending resolution of any and all motion(s) to dismiss in the Yarborough Action. We believe the plaintiffs’ claims are without merit. From time to time, we may be involved in legal proceedings arising in the ordinary course of business. As of December 31, 2024, there is no litigation pending that would reasonably be expected to have a material adverse effect on our results of operations and financial condition.

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Pay vs Performance Disclosure
Net loss	$ (39,136)	$ (66,067)	$ (67,207)

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended	12 Months Ended
	Dec. 31, 2024 shares	Dec. 31, 2024 shares
Trading Arrangements, by Individual
Material Terms of Trading Arrangement		During the three months ended December 31, 2024, our Section 16 officers and directors adopted or terminated contracts, instructions or written plans for the purchase or sale of our securities as noted below: Name and Title of Director or Officer Action Date Trading Arrangement Total Shares Available to be Sold Expiration Date Rule 10b5-1* Non-Rule 10b5-1** Robert Blanks, Chief Regulatory Officer Termination December 20, 2024 X 339,500 June 21, 2024 * Intended to satisfy the affirmative defense conditions of Rule 10b5-1(c) ** Not intended to satisfy the affirmative defense conditions of Rule 10b5-1(c)
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Terminated	false
Robert Blanks [Member]
Trading Arrangements, by Individual
Name	Robert Blanks
Title	Chief Regulatory Officer
Rule 10b5-1 Arrangement Terminated	true
Termination Date	December 20, 2024
Aggregate Available	339,500	339,500

Insider Trading Policies and Pr

Insider Trading Policies and Procedures	12 Months Ended
	Dec. 31, 2024
Insider Trading Policies and Procedures [Line Items]
Insider Trading Policies and Procedures Adopted	true

Cybersecurity Risk Management a

Cybersecurity Risk Management and Strategy Disclosure	12 Months Ended
	Dec. 31, 2024
Cybersecurity Risk Management, Strategy, and Governance [Line Items]
Cybersecurity Risk Management Processes for Assessing, Identifying, and Managing Threats [Text Block]	We have developed and implemented a cybersecurity program intended to manage risk, and protect the confidentiality, integrity, and availability of our critical systems and information. We design, assess and benchmark our program based on the National Institute of Standards and Technology Cybersecurity Framework. Our cybersecurity risk management program is integrated into our overall enterprise risk management program, and shares common methodologies, reporting channels and governance processes that apply across the enterprise risk management program, in areas such as legal, compliance, strategic, operational and financial risk. Key elements of our cybersecurity program include but are not limited to the following: • risk assessments designed to help identify material risks from cybersecurity threats to our critical systems and information; • a security team principally responsible for managing (1) our cybersecurity risk assessment processes, (2) our security controls and (3) our response to cybersecurity incidents; • the use of external service providers, where appropriate, to assess, test or otherwise assist with aspects of our security processes; • cybersecurity awareness training of our employees, including incident response personnel and senior management; • a cybersecurity incident response plan that includes procedures for responding to cybersecurity incidents; and • a third-party risk management process for service providers, suppliers and vendors that have access to our critical systems and information based on our assessment of their criticality to our operations and respective risk profile. We have not identified risks from known cybersecurity threats, including as a result of any prior cybersecurity incidents, that have materially affected us, including our operations, business strategy, results of operations, or financial condition. We face risks from cybersecurity threats that, if realized are reasonably likely to materially affect us, including our operations, business strategy, results of operations or financial condition. For more information, see the section titled “Risk Factors— We and our collaborators, CROs and other contractors and consultants depend on information technology systems, and any failure of these systems could harm our business. Security breaches, loss of data, and other disruptions could compromise sensitive information related to our business or prevent us from accessing critical information and expose us to liability, which could adversely affect our business, results of operations and financial condition .”
Cybersecurity Risk Management Processes Integrated [Flag]	true
Cybersecurity Risk Management Processes Integrated [Text Block]	We have developed and implemented a cybersecurity program intended to manage risk, and protect the confidentiality, integrity, and availability of our critical systems and information. We design, assess and benchmark our program based on the National Institute of Standards and Technology Cybersecurity Framework. Our cybersecurity risk management program is integrated into our overall enterprise risk management program, and shares common methodologies, reporting channels and governance processes that apply across the enterprise risk management program, in areas such as legal, compliance, strategic, operational and financial risk.
Cybersecurity Risk Management Third Party Engaged [Flag]	true
Cybersecurity Risk Third Party Oversight and Identification Processes [Flag]	true
Cybersecurity Risk Materially Affected or Reasonably Likely to Materially Affect Registrant [Flag]	false
Cybersecurity Risk Board of Directors Oversight [Text Block]	Our board of directors considers cybersecurity risk as part of its risk oversight function and has delegated to the Audit and Compliance Committee (Committee) oversight of cybersecurity risks, including oversight of management’s implementation of our cybersecurity risk management program, maintains a strategic role in coordinating cyber risk initiatives and policies, and confirming their efficacy. The Committee receives annual reports from management on our cybersecurity posture. In addition, management updates the Committee where it deems appropriate regarding any cybersecurity incidents it considers to be significant or potentially significant. The Committee reports to the full board of directors regarding its activities, including those related to cybersecurity. The board of directors also receives periodic briefings from management on our cybersecurity program. The board members receive presentations on cybersecurity topics from our Chief Information Officer, internal security staff or external experts as part of the board of directors’ continuing education on topics that impact public companies.
Cybersecurity Risk Board Committee or Subcommittee Responsible for Oversight [Text Block]	Our board of directors considers cybersecurity risk as part of its risk oversight function and has delegated to the Audit and Compliance Committee (Committee) oversight of cybersecurity risks, including oversight of management’s implementation of our cybersecurity risk management program, maintains a strategic role in coordinating cyber risk initiatives and policies, and confirming their efficacy.
Cybersecurity Risk Process for Informing Board Committee or Subcommittee Responsible for Oversight [Text Block]	Our board of directors considers cybersecurity risk as part of its risk oversight function and has delegated to the Audit and Compliance Committee (Committee) oversight of cybersecurity risks, including oversight of management’s implementation of our cybersecurity risk management program, maintains a strategic role in coordinating cyber risk initiatives and policies, and confirming their efficacy. The Committee receives annual reports from management on our cybersecurity posture. In addition, management updates the Committee where it deems appropriate regarding any cybersecurity incidents it considers to be significant or potentially significant. The Committee reports to the full board of directors regarding its activities, including those related to cybersecurity. The board of directors also receives periodic briefings from management on our cybersecurity program. The board members receive presentations on cybersecurity topics from our Chief Information Officer, internal security staff or external experts as part of the board of directors’ continuing education on topics that impact public companies.
Cybersecurity Risk Role of Management [Text Block]	Our Chief Information Officer has over 20 years of experience in overseeing cybersecurity and risk management. In addition, our Chief Legal and Administrative Officer has over 25 years of risk management experience and our Chief Financial and Operations Officer has over 20 years of experience in overseeing risk management and cybersecurity. This team is responsible for assessing and managing our material risks from cybersecurity threats and has primary responsibility for our overall cybersecurity risk management program and supervises both our internal cybersecurity personnel and our retained external cybersecurity consultants. Our management team’s experience includes experience running cybersecurity programs at similarly situated commercial biotechnology organizations and navigating the associated risk landscape. Our management team takes steps to stay informed about and monitor efforts to prevent, detect, mitigate, and remediate cybersecurity risks and incidents through various means, which may include briefings from internal security personnel, threat intelligence and other information obtained from governmental, public or private sources, including external consultants engaged by us and alerts and reports produced by security tools deployed in the IT environment.
Cybersecurity Risk Management Positions or Committees Responsible [Flag]	true
Cybersecurity Risk Management Positions or Committees Responsible [Text Block]	Our board of directors considers cybersecurity risk as part of its risk oversight function and has delegated to the Audit and Compliance Committee (Committee) oversight of cybersecurity risks, including oversight of management’s implementation of our cybersecurity risk management program, maintains a strategic role in coordinating cyber risk initiatives and policies, and confirming their efficacy. The Committee receives annual reports from management on our cybersecurity posture. In addition, management updates the Committee where it deems appropriate regarding any cybersecurity incidents it considers to be significant or potentially significant. The Committee reports to the full board of directors regarding its activities, including those related to cybersecurity. The board of directors also receives periodic briefings from management on our cybersecurity program. The board members receive presentations on cybersecurity topics from our Chief Information Officer, internal security staff or external experts as part of the board of directors’ continuing education on topics that impact public companies. Our Chief Information Officer has over 20 years of experience in overseeing cybersecurity and risk management. In addition, our Chief Legal and Administrative Officer has over 25 years of risk management experience and our Chief Financial and Operations Officer has over 20 years of experience in overseeing risk management and cybersecurity. This team is responsible for assessing and managing our material risks from cybersecurity threats and has primary responsibility for our overall cybersecurity risk management program and supervises both our internal cybersecurity personnel and our retained external cybersecurity consultants. Our management team’s experience includes experience running cybersecurity programs at similarly situated commercial biotechnology organizations and navigating the associated risk landscape.
Cybersecurity Risk Management Expertise of Management Responsible [Text Block]	Our Chief Information Officer has over 20 years of experience in overseeing cybersecurity and risk management. In addition, our Chief Legal and Administrative Officer has over 25 years of risk management experience and our Chief Financial and Operations Officer has over 20 years of experience in overseeing risk management and cybersecurity.
Cybersecurity Risk Process for Informing Management or Committees Responsible [Text Block]	The Committee receives annual reports from management on our cybersecurity posture. In addition, management updates the Committee where it deems appropriate regarding any cybersecurity incidents it considers to be significant or potentially significant. The Committee reports to the full board of directors regarding its activities, including those related to cybersecurity. The board of directors also receives periodic briefings from management on our cybersecurity program. The board members receive presentations on cybersecurity topics from our Chief Information Officer, internal security staff or external experts as part of the board of directors’ continuing education on topics that impact public companies.
Cybersecurity Risk Management Positions or Committees Responsible Report to Board [Flag]	true

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2024
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The accompanying financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America (U.S. GAAP). Certain prior year amounts have been reclassified to conform to the current year presentation.
Use of Estimates	Use of Estimates The preparation of financial statements requires management to make estimates, judgments and assumptions. The most significant assumptions are estimates used in our revenue gross-to-net accruals and other assumptions. Management bases its estimates on historical experience and on various other market-specific and relevant assumptions that management believes to be reasonable under the circumstances. Actual results could materially differ from those estimates.
Cash and Cash Equivalents	Cash and Cash Equivalents Cash and cash equivalents consist of highly liquid investments purchased with an original maturity date of 90 days or less and are recognized at cost, which approximates fair value.
Short-Term Investments	Short-Term Investments Short-term investments consist of debt securities classified as available-for-sale and have maturities greater than 90 days, but less than one year, from the date of acquisition. Short-term investments are carried at fair value based upon quoted market prices or other observable market data. Unrealized (losses) gains on available-for-sale securities are included in accumulated other comprehensive income on our balance sheets. The cost of available-for-sale securities sold is based on the specific-identification method. Marketable debt securities are reviewed for impairment by determining whether the decline in their market value below carrying value is other-than-temporary. This assessment considers the intent and ability to retain the investment for a period of time sufficient for an anticipated recovery in market value, the duration and extent that the market value has been below cost, and the investee’s financial condition. Other-than-temporary impairments and credit losses are recorded in the statements of operations and comprehensive loss.
Concentration of Credit Risk	Concentration of Credit Risk Financial instruments that potentially subject us to significant concentrations of credit risk consist primarily of cash, cash equivalents, short-term investments and accounts receivable. We are exposed to credit risks in the event of default by the counterparties to the extent of the amount recorded in our balance sheets. Cash, cash equivalents and short-term investments are invested through banks and other financial institutions in the U.S.
Foreign Currency	Foreign Currency Our business is conducted in U.S. dollars; however, a portion of our expense and capital activities are transacted in foreign currencies which are subject to exchange rate fluctuations that can affect cash or earnings. Foreign currency transactions are translated into the functional currency using exchange rates prevailing at the dates of the transactions. At the end of each reporting period, monetary assets and liabilities that are denominated in foreign currencies are translated at the rates prevailing at that date. All gains and losses on these foreign currency transactions are recorded in other income, net in our statements of operations and comprehensive loss.
Property and Equipment	Property and Equipment Expenditures for property and equipment are capitalized at cost. Depreciation is computed using the straight-line method over the estimated useful lives of the respective assets, ranging from three
Impairment of Long-Lived Assets	Impairment of Long-Lived Assets
Income Taxes	Income Taxes The asset and liability method of accounting is used for income taxes. Deferred tax assets and liabilities are determined based on the differences between the financial reporting and the tax basis of assets and liabilities and are measured using the enacted tax rates and laws that will be in effect when the differences are expected to reverse. A valuation allowance is provided when it is more likely than not that a portion or all of a deferred tax asset will not be realized.
Accounts Receivable	Accounts Receivable
Inventory	Inventory Inventory costs incurred are capitalized after regulatory approval, or if based on management’s judgment, future commercialization is considered probable and future economic benefit is expected to be realized. We began to capitalize inventory costs associated with IBSRELA during the fourth quarter of 2021, when our intent to commercialize IBSRELA was established and we commenced preparation for the launch of IBSRELA. We began to capitalize inventory costs associated with XPHOZAH during the fourth quarter of 2023, following approval by the U.S. FDA to market XPHOZAH in the U.S. Inventory costs incurred prior to regulatory approval were expensed as research and development. Inventories are stated at the lower of cost or estimated net realizable value with cost determined under the specific identification method. A portion of inventory that represents product that is not expected to be sold or used within the next 12 months is classified as non-current assets on our balance sheets.
Revenue Recognition	Revenue Recognition The application of ASC 606 Revenue from Contracts with Customers substantially impacts our reported results, particularly product sales, net, which requires certain estimates in determining the transaction price. Total revenues are recognized following a five-step model: (i) identify the customer contract; (ii) identify the contract’s performance obligations; (iii) determine the transaction price; (iv) allocate the transaction price to the performance obligations; and (v) recognize revenue when or as a performance obligation is satisfied. Product Sales, Net Recognition The transaction price for product sales, net is reduced for estimates of variable consideration related to GTN adjustments for discounts and chargebacks, rebates, wholesaler and GPO fees, copay assistance and returns. Except for certain wholesaler and GPO fees and discounts, which are based on contracts, these adjustments involve estimation and judgment. The GTN adjustments for rebates, copay assistance and chargebacks are impacted by our estimate of payor mix, which requires significant judgment. We consider legal interpretations of applicable laws and regulations, historical experience, current contract prices under applicable programs, unbilled claims, processing time lags and inventory levels in the distribution channel in determining our estimates. Estimates are assessed each period and adjusted as required to revise information or actual experience. Changes in estimates recorded through December 31, 2024 have not been material. Licensing Revenue Recognition Licensing revenue and product supply revenue result from our collaboration and licensing agreements as discussed in Note 7. Collaboration And Licensing Agreements. Goods and services in these agreements may include the grant of licenses for use of our intellectual property and manufacturing services. Significant judgment is required to determine whether promised goods and services represent distinct performance obligations, which are identified and separated when the other party can benefit from the rights, goods or services either on their own or together with other readily available resources and when the rights, goods or services are not highly interdependent or interrelated. Transaction prices for these arrangements may include non-refundable, up-front license fees; research, development, regulatory and commercial milestone payments; payments for manufacturing supply services; and future royalties on net sales of licensed products. Variable consideration is included in the transaction price only to the extent significant reversal of cumulative revenue recognized is not probable of occurring when the uncertainty associated with the variable consideration is subsequently resolved. Significant judgment is required in estimating variable consideration for each performance obligation identified in the contract. This judgment involves assessing factors outside of our influence, including market conditions, development timelines, likelihood of regulatory success, reimbursement rates for personnel costs, forecasted revenues, potential limitations on the selling price of the product, discount rates, lack of relevant past experience and a large number and broad range of possible amounts. The most likely amount method is used to estimate contingent development, regulatory and sales-based milestones because the ultimate outcomes are binary in nature. The expected value method is used to estimate royalties because a broad range of potential outcomes exists, except in instances where the royalties relate to a license. For arrangements with multiple separable performance obligations, the transaction price assigned to each distinct performance obligation is reflective on the relative stand-along selling price and recognized at a point in time upon the transfer of control. Collaboration agreements typically include: (i) licensing intellectual property to a third party with no further performance obligations and (ii) arrangements that include both a license and an additional performance obligation to supply product upon the request of the third party. Out-licensing arrangements that contain a single performance obligation are satisfied upon execution of the agreement, when development and commercialization rights are transferred to a third party. Upfront fees are immediately recognized as licensing revenue. Contingent development and regulatory milestones are assessed each period for likelihood of achievement, however, they are typically constrained and recognized when uncertainty is subsequently resolved for the full amount of the milestone and included in licensing revenue. Licensing revenue also includes sales-based milestones and royalties, which are recognized when the milestone is achieved or when the subsequent sales occur. Certain collaboration agreements also include contingent performance obligations to supply commercial product to the third party upon its request. The license and supply obligations are accounted for as separate distinct performance obligations as the third party can benefit from the license either on its own or together with the other supply resources readily available to it and the other obligations in the contract. Consideration for the supply obligation is based upon stipulated cost-plus margin contractual terms which represent a standalone selling price. The supply consideration is recognized as product supply revenue at a point in time upon transfer of control of the product to the third party. After considering the stand-alone selling price of these supply arrangements, the upfront fees, contingent development, regulatory and sales-based milestones and royalties are allocated to the license. When two or more contracts are entered into with the same customer at or near the same time, we evaluate the contracts to determine whether the contracts should be accounted for as a single arrangement. Contract modifications due to the addition of distinct promised goods or services with price increases consistent with stand-alone selling prices are accounted for as a separate contract. Contract modifications that are not considered a separate contract and containing remaining goods or services distinct from the goods or services transferred on or before the date of the contract modification are accounted for as a termination of the existing contract and the subsequent creation of a new contract. Contract modifications not considered a separate contract and containing remaining goods or services not distinct are accounted for as an add-on to the existing contract and as an adjustment to revenue on a cumulative catch-up basis.
Accrued Expenses	Accrued Expenses As part of the process of preparing our financial statements, we are required to estimate our accrued expenses, which involves reviewing open contracts and purchase orders, communicating with our personnel to identify services that have been performed on our behalf and estimating the level of service performed and the associated cost incurred for the service when we have not yet been invoiced or otherwise notified of the actual cost. The majority of our service providers invoice us monthly in arrears for services performed or when contractual milestones are met. We make estimates of our accrued expenses as of each balance sheet date based on facts and circumstances known to us at that time. We periodically confirm the accuracy of our estimates with our service providers and make adjustments if necessary. Service fee accruals are estimated based on the period over which each component of service will be performed, with vendor input if appropriate. If the actual timing of the performance of services or the level of effort varies from our estimate, we adjust the accrued or prepaid expense balance, accordingly. Although we do not expect our estimates to be materially different from amounts actually incurred, if our estimates of the status and timing differ from the actual status and timing of services performed, we may report amounts that are too high or too low in any particular period.
Retirement Savings Plan	Retirement Savings Plan
Stock-Based Compensation	Stock-Based Compensation Stock-based compensation expense is recognized for all stock-based payment awards made to employees, non-employees and directors based on estimated fair values. The grant date fair value of the awards is determined using the Black-Scholes option-pricing model. Stock-based compensation expense is recognized on a straight-line basis over the requisite service period and is reduced for estimated forfeitures at the date of grant and revised, if necessary, in subsequent periods if actual forfeitures differ from those estimates.
Non-cash Interest Expense on Deferred Royalty Obligation	Non-cash Interest Expense on Deferred Royalty Obligation Non-cash interest expense related to the sale of future royalties represents imputed interest expense on our deferred royalty obligation related to the sale of future royalties using the effective interest method.
Leases	Leases Operating leases are included in right-of-use assets, current portion of operating lease liability, and operating lease liability, net of current portion on our balance sheets. Right-of-use assets represent our right to use an underlying asset for the lease term and lease liabilities represent our obligation to make lease payments arising from the lease. Operating lease right-of-use assets and liabilities are recognized at the lease commencement date based on the present value of lease payments over the lease term. In determining the present value of lease payments, we use our incremental borrowing rate based on information available at the lease commencement date. Operating lease right-of-use assets also include any lease payments made and exclude lease incentives. Our lease terms may include options to extend or terminate a lease when it is reasonably certain that we will exercise any such option. Lease expense is recognized on a straight-line basis over the expected lease term. We have elected not to separate lease and non-lease components, such as common area maintenance charges, and instead account for these as a single lease component.
Net Loss per Share	Net Loss per Share Basic net loss per common share is calculated by dividing the net loss by the weighted-average number of shares of common stock outstanding during the period, without consideration of potential shares of common stock. Diluted net loss per common share in the periods presented is the same as basic net loss per common share because the effects of potentially dilutive securities are antidilutive due to net loses recognized for each period presented.
Recent Accounting Pronouncements	Recent Accounting Pronouncements New Accounting Pronouncements - Recently Adopted In November 2023, the FASB issued ASU No. 2023-07, Segment Reporting (Topic 280) - Improvements to Reportable Segment Disclosures . This Update requires publicly traded entities to provide enhanced disclosures about significant segment expenses regularly reviewed by the chief operating decision maker, including publicly traded entities with a single reportable segment. The amendments in this update were effective for fiscal years beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024. We adopted the ASU in the fourth quarter of 2024 and determined that its adoption did not have a material impact on our financial statements. Refer to Note 17. Segment Reporting for additional information. Recent Accounting Pronouncements Not Yet Adopted In December 2023, the FASB issued ASU No. 2023-09, Income Taxes (Topic 740) - Improvements to Income Tax Disclosures , an amendment which modifies the measurement and recognition of credit losses for most financial assets and certain other instruments. The amendments in this Update provide more transparency about income tax information through improvements to income tax disclosures primarily related to the rate reconciliation and income taxes paid information. For public business entities, the amendments in this Update are effective for annual periods beginning after December 15, 2024. Early adoption is permitted on a prospective basis for annual financial statements that have not yet been issued or made available for issuance. Management is currently assessing the impact of this standard on our financial statements. In November 2024, the FASB issued ASU No. 2024-03, Income Statement (Topic 220) - Reporting Comprehensive Income - Expense Disaggregation Disclosures, Disaggregation of Income Statement Expenses , which requires public companies to disclose, in interim and reporting periods, additional information about certain expenses in the financial statements. ASU No. 2024-03 is effective for annual periods beginning after December 15, 2026, and interim reporting periods beginning after December 15, 2027. Early adoption is permitted and is effective on either a prospective basis or retrospective basis. Management is currently assessing the impact of this standard on our financial statements.
Fair Value Measurements	Level 1 – Valuations are based on quoted prices in active markets for identical assets or liabilities and readily accessible by us at the reporting date. Level 2 – Valuations based on inputs other than Level 1 that are observable, either directly or indirectly, such as quoted prices for similar assets or liabilities; quoted prices in markets that are not active; or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities. Level 3 – Valuations based on unobservable inputs for which there is little or no market data, which require us to develop our own assumptions.

Cash, Cash Equivalents and Sh_2

Cash, Cash Equivalents and Short-Term Investments (Tables)	12 Months Ended
	Dec. 31, 2024
Cash and Cash Equivalents [Abstract]
Schedule of Securities Classified as Cash, Cash Equivalents and Short-Term Investments	Securities classified as cash, cash equivalents and short-term investments as of December 31, 2024 and 2023 were as follows: December 31, 2024 Gross Unrealized (in thousands) Amortized Cost Gains Losses Fair Value Cash and cash equivalents Cash $ 16,282 $ — $ — $ 16,282 Money market funds 48,650 — — 48,650 Total cash and cash equivalents 64,932 — — 64,932 Short-term investments U.S. treasury securities $ 79,720 $ 58 $ (5) $ 79,773 U.S. government-sponsored agency bonds 45,960 29 (27) 45,962 Commercial paper 37,061 19 (15) 37,065 Corporate bonds 17,415 4 (6) 17,413 Asset-backed securities 2,983 2 — 2,985 Yankee bonds 1,972 — (2) 1,970 Total short-term investments 185,111 112 (55) 185,168 Total cash, cash equivalents and investments $ 250,043 $ 112 $ (55) $ 250,100 December 31, 2023 Gross Unrealized (in thousands) Amortized Cost Gains Losses Fair Value Cash and cash equivalents Cash $ 2,829 $ — $ — $ 2,829 Money market funds 18,641 — — 18,641 Total cash and cash equivalents 21,470 — — 21,470 Short-term investments U.S. government-sponsored agency bonds $ 101,892 $ 235 $ (34) $ 102,093 Commercial paper 49,630 41 (17) 49,654 Asset-backed securities 8,628 2 (5) 8,625 U.S. treasury securities 2,455 2 — 2,457 Total short-term investments 162,605 280 (56) 162,829 Total cash, cash equivalents and investments $ 184,075 $ 280 $ (56) $ 184,299

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	12 Months Ended
	Dec. 31, 2024
Fair Value Disclosures [Abstract]
Schedule of Fair Value of Financial Assets and Liabilities Measured on a Recurring Basis	The following table sets forth the fair value of our financial assets and liabilities that are measured or disclosed on a recurring basis by level within the fair value hierarchy: December 31, 2024 December 31, 2023 (in thousands) Total Fair Value Level 1 Level 2 Level 3 Total Fair Value Level 1 Level 2 Level 3 Assets Money market funds $ 48,650 $ 48,650 $ — $ — $ 18,641 $ 18,641 $ — $ — U.S. government-sponsored agency bonds 45,962 — 45,962 — 102,093 — 102,093 — U.S. treasury securities 79,773 — 79,773 — 2,457 — 2,457 — Commercial paper 37,065 — 37,065 — 49,654 — 49,654 — Corporate bonds 17,413 — 17,413 — — — — — Asset-backed securities 2,985 — 2,985 — 8,625 — 8,625 — Yankee bonds 1,970 — 1,970 — — — — — Total $ 233,818 $ 48,650 $ 185,168 $ — $ 181,470 $ 18,641 $ 162,829 $ — Liabilities Derivative liabilities for exit fee $ — $ — $ — $ — $ 675 $ — $ — $ 675 Total $ — $ — $ — $ — $ 675 $ — $ — $ 675

Inventory (Tables)

Inventory (Tables)	12 Months Ended
	Dec. 31, 2024
Inventory Disclosure [Abstract]
Schedule of Current Inventory	Inventory consisted of the following: December 31, (in thousands) 2024 2023 Raw materials $ 30,792 $ 22,920 Work in process 58,685 24,582 Finished goods 1,707 1,985 Total $ 91,184 $ 49,487 Reported as Inventory $ 21,173 $ 12,448 Inventory, non-current 70,011 37,039 Total $ 91,184 $ 49,487
Schedule of Noncurrent Inventory	Inventory consisted of the following: December 31, (in thousands) 2024 2023 Raw materials $ 30,792 $ 22,920 Work in process 58,685 24,582 Finished goods 1,707 1,985 Total $ 91,184 $ 49,487 Reported as Inventory $ 21,173 $ 12,448 Inventory, non-current 70,011 37,039 Total $ 91,184 $ 49,487

Revenue (Tables)

Revenue (Tables)	12 Months Ended
	Dec. 31, 2024
Revenue from Contract with Customer [Abstract]
Schedule of Revenue	Disaggregation of total revenues by nature is as follows: Year Ended December 31, (in thousands) 2024 2023 2022 Product sales, net $ 319,196 $ 82,526 $ 15,600 Product supply revenue 11,649 6,121 1,527 Licensing revenue 78 35,809 35,031 Non-cash royalty revenue related to the sale of future royalties 2,692 — — Total revenues $ 333,615 $ 124,456 $ 52,158 Total product sales, net was as follows: Year Ended December 31, (in thousands) 2024 2023 2022 Product sales, net IBSRELA $ 158,286 $ 80,062 $ 15,600 XPHOZAH 160,910 2,464 — Total product sales, net $ 319,196 $ 82,526 $ 15,600 The following table summarizes total revenue by collaboration partner: Year Ended December 31, (in thousands) 2024 2023 2022 Licensing revenue Kyowa Kirin $ — $ 30,000 $ 35,000 Fosun Pharma — 5,000 — METiS — 750 — Knight 78 59 31 Total licensing revenue $ 78 $ 35,809 $ 35,031 Product supply revenue Kyowa Kirin 11,649 6,092 1,518 Fosun Pharma — 29 9 Total supply revenue $ 11,649 $ 6,121 $ 1,527 Non-cash royalty revenue related to the sale of future royalties Kyowa Kirin $ 2,692 $ — $ —
Schedule of Gross To Net Adjustments of Revenue	The activities and ending reserve balances for each significant category of GTN adjustments on product sales, net, which constitute variable consideration, were as follows: (in thousands) Discounts and chargebacks Rebates, wholesaler and GPO fees Copay assistance and returns Total Balance as of December 31, 2022 $ 142 $ 1,444 $ 1,258 $ 2,844 Provisions 5,341 15,365 10,629 31,335 Credits/payments (5,005) (12,575) (7,971) (25,551) Balance as of December 31, 2023 478 4,234 3,916 8,628 Provisions 15,099 65,833 28,925 109,857 Credits/payments (13,934) (55,592) (21,671) (91,197) Balance as of December 31, 2024 $ 1,643 $ 14,475 $ 11,170 $ 27,288
Schedule of Revenue by Geographic Areas	A summary of our revenues by geographic area is as follows: Year Ended December 31, (in thousands) 2024 2023 2022 United States (1) $ 319,196 $ 83,276 $ 15,600 International Asia Pacific (2) 14,341 41,121 36,527 North America (3) 78 59 31 Total revenues $ 333,615 $ 124,456 $ 52,158 (1) Revenues from the United States are primarily comprised of amounts earned from sales of IBSRELA and XPHOZAH, as well as the upfront license fee from the METiS Agreement. (2) Revenues from Asia Pacific are primarily comprised of amounts earned in accordance with the Kyowa Kirin Agreement and the Fosun Agreement. (3) Revenues from North America are comprised of amounts earned from Canada in accordance with the Knight Agreement.
Schedule of Revenue from Customers as a Percentage of Total Product Revenue, Net	Gross product sales from Customers and revenues from collaboration partners, each accounting for more than 10% of total revenues, were as follows: Year Ended December 31, 2024 2023 2022 Customers BioRidge Pharma, LLC 75.4 % 24.0 % 3.2 % Cencora 16.4 % 19.1 % 11.1 % Cardinal Health 14.5 % 19.8 % 9.6 % McKesson Corporation 14.1 % 15.7 % 8.9 % Collaboration partners Kyowa Kirin 4.3 % 29.0 % 70.0 %

Collaboration and Licensing A_2

Collaboration and Licensing Agreements (Tables)	12 Months Ended
	Dec. 31, 2024
Collaboration and Licensing Agreements [Abstract]
Schedule of Revenue	Disaggregation of total revenues by nature is as follows: Year Ended December 31, (in thousands) 2024 2023 2022 Product sales, net $ 319,196 $ 82,526 $ 15,600 Product supply revenue 11,649 6,121 1,527 Licensing revenue 78 35,809 35,031 Non-cash royalty revenue related to the sale of future royalties 2,692 — — Total revenues $ 333,615 $ 124,456 $ 52,158 Total product sales, net was as follows: Year Ended December 31, (in thousands) 2024 2023 2022 Product sales, net IBSRELA $ 158,286 $ 80,062 $ 15,600 XPHOZAH 160,910 2,464 — Total product sales, net $ 319,196 $ 82,526 $ 15,600 The following table summarizes total revenue by collaboration partner: Year Ended December 31, (in thousands) 2024 2023 2022 Licensing revenue Kyowa Kirin $ — $ 30,000 $ 35,000 Fosun Pharma — 5,000 — METiS — 750 — Knight 78 59 31 Total licensing revenue $ 78 $ 35,809 $ 35,031 Product supply revenue Kyowa Kirin 11,649 6,092 1,518 Fosun Pharma — 29 9 Total supply revenue $ 11,649 $ 6,121 $ 1,527 Non-cash royalty revenue related to the sale of future royalties Kyowa Kirin $ 2,692 $ — $ —
Schedule of Deferred Revenue Balances	The following table presents changes in our current and non-current deferred revenue balances, which are all attributable to Kyowa Kirin: 2024 2023 (in thousands) Current Non-Current Current Non-Current Balance at January 1, $ 7,182 $ 8,644 $ 4,211 $ 9,025 Prepaid product supply 3,716 8,212 1,547 5,629 Product supply delivered (9,836) — (4,586) — Reclassify amounts to be recognized in the next twelve months 9,624 (9,624) 6,010 (6,010) Balance at December 31, $ 10,686 $ 7,232 $ 7,182 $ 8,644

Deferred Royalty Obligation R_2

Deferred Royalty Obligation Related To The Sale Of Future Royalties (Tables)	12 Months Ended
	Dec. 31, 2024
Advance Royalties [Abstract]
Schedule of Deferred Royalty Obligation	A summary of financial information related to the HCR Agreement is as follows: Year Ended December 31, ($ in thousands) 2024 2023 2022 Non-cash interest expense related to the sale of future royalties $ (7,088) $ (3,924) $ (1,673) Effective interest rate 31.0 % 34.7 % 34.4 % (in thousands) 2024 2023 2022 Beginning deferred royalty obligation $ 20,179 $ 11,254 $ — Upfront payment, net of transaction costs — — 9,581 Regulatory approval milestone — 5,000 — Non-cash interest expense related to sale of future royalties 7,088 3,924 1,673 Royalty distributed to HCR (1,740) — — Other — 1 — Ending deferred royalty obligation $ 25,527 $ 20,179 $ 11,254

Borrowing (Tables)

Borrowing (Tables)	12 Months Ended
	Dec. 31, 2024
Debt Disclosure [Abstract]
Schedule of Long-Term Debt Borrowings	Long-term borrowing was as follows: December 31, (in thousands) 2024 2023 Interest rate Principal Term A Loan $ 27,500 $ 27,500 7.95% + 0.022% + SOFR (subject to a floor of 1.0%) Term B Loan 22,500 22,500 7.95% + 0.022% + SOFR (subject to a floor of 1.0%) Term C Loan 50,000 — 4.25% + 0.022% + SOFR (subject to a floor of 4.7%) Term D Loan 50,000 — 4.00% + 0.022% + SOFR (subject to a floor of 4.7%) Total principal $ 150,000 $ 50,000 Adjustments to principal value Unamortized discount and debt issuance costs (1,136) (912) Accreted value of final fee 1,989 734 Total long-term debt 150,853 49,822 Less: Current portion of long-term debt — — Long-term debt, net of current portion $ 150,853 $ 49,822

Derivative Liabilities (Tables)

Derivative Liabilities (Tables)	12 Months Ended
	Dec. 31, 2024
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Schedule of Changes in Fair Value of Derivative Liabilities	Changes in the fair value of recurring measurements are presented as other income, net in our statements of operations and comprehensive loss and were as follows: (in thousands) 2024 2023 January 1, $ 675 $ 1,656 Changes in estimated fair value 2018 Exit Fee — 292 2022 Exit Fee 325 227 2018 Exit Fee payment — (1,500) 2022 Exit Fee payment (1,000) — Fair value of exit fee derivative liabilities at December 31, $ — $ 675

Leases (Tables)

Leases (Tables)	12 Months Ended
	Dec. 31, 2024
Leases [Abstract]
Summary of Additional Details of the Leases	The following table provides additional details of our facility leases presented in our balance sheets: ($ in thousands) December 31, Facilities 2024 2023 Right-of-use assets $ 2,380 $ 5,589 Current portion of lease liabilities 1,562 4,435 Operating lease liability, net of current portion 1,023 1,725 Total lease liabilities $ 2,585 $ 6,160 Weighted-average remaining term (in years) 1.8 1.6 Weighted-average discount rate 6.5 % 6.8 %
Summary of Lease Costs	The lease costs, which are included in operating expenses in our statements of operations and comprehensive loss, were as follows: Year Ended December 31, (in thousands) 2024 2023 2022 Operating lease expense $ 4,699 $ 3,857 $ 4,257 Cash paid for operating leases $ 4,931 $ 4,481 $ 4,292
Summary of Undiscounted Cash Payment Obligations for Operating Lease Liabilities	The following table summarizes our undiscounted cash payment obligations for our operating lease liabilities as of December 31, 2024: (in thousands) Operating Leases 2025 $ 1,660 2026 702 2027 238 2028 124 Thereafter 21 Total undiscounted operating lease payments 2,745 Imputed interest expenses (160) Total operating lease liabilities 2,585 Less: Current portion of operating lease liability (1,562) Operating lease liability, net of current portion $ 1,023

Equity Incentive Plans (Tables)

Equity Incentive Plans (Tables)	12 Months Ended
	Dec. 31, 2024
Share-Based Payment Arrangement [Abstract]
Schedule of Stock Option Activity	A summary of our stock option activity and related information during the year ended December 31, 2024 is as follows: Options Issued and Outstanding Weighted Average Remaining Contractual Term (in years) Aggregate Intrinsic Value (in thousands) Number of Shares (in thousands) Weighted-Average Exercise Price per Share Balance at December 31, 2023 22,168 $ 4.20 Options granted 9,674 $ 7.95 Options exercised (2,654) $ 2.24 Options canceled (1,103) $ 5.35 Balance at December 31, 2024 28,085 $ 5.63 7.1 $ 31,830 Vested and expected to vest at December 31, 2024 28,085 $ 5.63 7.1 $ 31,830 Exercisable at December 31, 2024 14,968 $ 5.52 5.7 $ 19,161
Schedule of Valuation Assumptions for Stock Options	The estimated grant date fair value of employee stock options was calculated using the Black-Scholes option-pricing model, based on the following weighted-average assumptions: Year Ended December 31, 2024 2023 2022 Expected term (in years) 5.4 5.1 4.9 Expected volatility 100.8 % 97.6 % 92.1 % Risk-free interest rate 4.0 % 3.8 % 2.2 % Dividend yield — % — % — %
Schedule of Restricted Stock Units Activity	A summary of our RSUs activity and related information for the year ended December 31, 2024 is as follows: Number of RSUs (in thousands) Weighted-Average Grant Date Fair Value Per Share Non-vested restricted stock units at December 31, 2023 3,646 $ 3.09 Granted 7,382 $ 7.94 Vested (2,430) $ 5.65 Forfeited (585) $ 5.68 Non-vested restricted stock units at December 31, 2024 8,013 $ 6.59
Schedule of Valuation Assumptions for Employee Stock Purchase Plan	The following table illustrates the weighted-average assumptions for the Black-Scholes option-pricing model used in determining the fair value of ESPP purchase rights granted to our employees: Year Ended December 31, 2024 2023 2022 Expected term (in years) 0.5 0.5 0.5 Expected volatility 82.8 % 86.0 % 97.2 % Risk-free interest rate 5.0 % 5.3 % 1.9 % Dividend yield — % — % — %
Schedule of Stock-Based Compensation Recognized	Stock-based compensation expense recognized for stock options, RSUs and our ESPP is recorded as operating expenses in our statements of operations and comprehensive loss, as follows: Year Ended December 31, (in thousands) 2024 2023 2022 Selling, general and administrative $ 27,791 $ 9,952 $ 7,525 Research and development 9,590 3,578 3,225 Total $ 37,381 $ 13,530 $ 10,750
Schedule of Total Unrecognized Stock-Based Compensation Expense, Net of Estimated Forfeitures	A summary of our total unrecognized stock-based compensation expense, net of estimated forfeitures, as of December 31, 2024 is as follows: December 31, 2024 Unrecognized Compensation Expense (in thousands) Average Remaining Vesting Period (in years) Stock option grants $ 55,610 2.71 RSU grants $ 49,930 2.96 ESPP $ 162 0.1

Property and Equipment, Net (Ta

Property and Equipment, Net (Tables)	12 Months Ended
	Dec. 31, 2024
Property, Plant and Equipment [Abstract]
Schedule of Property and Equipment	Property and equipment consisted of the following: December 31, (in thousands) 2024 2023 Laboratory equipment $ 46 $ 46 Office equipment and furniture 2,923 2,433 Leasehold improvements 9,144 8,731 Property and equipment, gross 12,113 11,210 Less: Accumulated depreciation (10,618) (10,201) Total property and equipment, net $ 1,495 $ 1,009

Accrued Expenses and Other Cu_2

Accrued Expenses and Other Current Liabilities (Tables)	12 Months Ended
	Dec. 31, 2024
Payables and Accruals [Abstract]
Schedule of Accrued Expenses and Other Current Liabilities	Accrued expenses and other current liabilities consisted of the following: December 31, (in thousands) 2024 2023 Accrued payments due to AstraZeneca $ 12,077 $ 3,680 Accrued gross to net revenue liabilities 10,112 3,258 Accrued sales and marketing expenses 3,696 3,223 Other 8,757 4,880 Total accrued expenses and other current liabilities $ 34,642 $ 15,041

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2024
Income Tax Disclosure [Abstract]
Schedule of Components of Provision for Income Taxes	The components of our provision for income taxes were as follows: Year Ended December 31, (in thousands) 2024 2023 2022 Current State $ 266 $ 47 $ 8 Foreign — 500 — Total current 266 547 8 Deferred Federal — — — Total deferred — — — Provision for income taxes $ 266 $ 547 $ 8
Schedule of Reconciliation of Effective Tax Rate	A reconciliation of the statutory federal income tax rate to our effective tax rate is as follows: Year Ended December 31, 2024 2023 2022 Income tax at the federal statutory rate 21.0 % 21.0 % 21.0 % State taxes, net of federal benefit 4.0 3.4 1.9 Tax credits 0.6 1.7 1.5 Stock based compensation 5.2 0.1 (2.3) Foreign withholding tax — (0.8) — Executive compensation disallowed under IRC Sec 162(m) (5.8) (1.9) (1.6) Other (0.6) — (0.8) Change in valuation allowance (25.0) (24.3) (19.7) Effective tax rate (0.6) % (0.8) % — %
Schedule of Components of Deferred Tax Assets	Significant components of our deferred tax assets were as follows: December 31, (in thousands) 2024 2023 Deferred tax assets Amortization and depreciation $ 64,237 $ 64,919 Net operating loss carryforwards 103,643 98,702 Tax credits 15,529 15,375 Stock-based compensation 11,226 6,946 Deferred royalty obligation 6,409 4,907 Other 8,122 6,707 Deferred tax assets 209,166 197,556 Valuation allowance (208,568) (196,197) Deferred tax assets net of valuation allowance 598 1,359 Deferred tax liabilities Right-of-use asset (598) (1,359) Deferred tax liabilities (598) (1,359) Net deferred taxes $ — $ —
Schedule of Reconciliation of Unrecognized Tax Benefits	A reconciliation of the beginning and ending amount of unrecognized tax benefits is as follows: December 31, (in thousands) 2024 2023 2022 Balance at beginning of year $ 23,625 $ 24,075 $ 24,426 Additions based on tax positions related to current year 105 262 460 Additions based on tax positions related to prior year — 99 — Subtractions based on tax positions related to prior year (811) (811) (811) Balance at end of year $ 22,919 $ 23,625 $ 24,075

Segment Reporting (Tables)

Segment Reporting (Tables)	12 Months Ended
	Dec. 31, 2024
Segment Reporting [Abstract]
Schedule of Information Regarding Operating Segment	Detailed information regarding our single operating segment’s significant revenues, expenses and operating loss are as follows: Year Ended December 31, (in thousands) 2024 2023 2022 Revenues Product sales, net $ 319,196 $ 82,526 $ 15,600 Other revenues (1) 14,419 41,930 36,558 Total revenues 333,615 124,456 52,158 Less: Cost of product sales 6,851 2,323 566 Other cost of revenue 43,705 15,472 3,551 Total cost of goods sold 50,556 17,795 4,117 Research and development (2) 39,480 29,231 28,777 Selling expenses (2) 162,957 80,028 10,750 General and administrative expenses (2) 52,916 34,020 34,895 Stock-based compensation 37,381 13,530 25,144 Other segment expenses (3) 18,275 13,128 12,234 Total operating expenses 311,009 169,937 111,800 Segment and consolidated loss from operations (27,950) (63,276) (63,759) Other reconciliation items (4) (11,186) (2,791) (3,448) Segment and consolidated net loss $ (39,136) $ (66,067) $ (67,207) (1) “Other revenues” includes revenues from our collaboration partnerships, including license fees, milestone payments, product supply revenue and non-cash royalty revenue related to the sale of future royalties. (2) Research and development, selling and general administrative expenses herein do not include certain allocated items, such as stock-based compensation expenses. (3) “Other segment expenses” primarily consists of allocated facilities, information technology, and employee costs of approximately $16.9 million,$12.3 million and $11.4 million in 2024, 2023 and 2022, respectively. (4) “Other reconciliation items” includes interest expense, non-cash interest expense related to the sale of future royalties, provision for income taxes and other income, net.

Net Loss Per Share (Tables)

Net Loss Per Share (Tables)	12 Months Ended
	Dec. 31, 2024
Earnings Per Share [Abstract]
Schedule of Computation of Net Loss Per Common Share	The following table sets forth the computation of net loss per common share: Year Ended December 31, (in thousands, except per share amounts) 2024 2023 2022 Numerator: Net loss $ (39,136) $ (66,067) $ (67,207) Denominator: Weighted average common shares outstanding - basic and diluted 235,233 219,331 158,690 Net loss per share of common stock - basic and diluted $ (0.17) $ (0.30) $ (0.42)
Schedule of Anti-Dilutive Securities Not Considered in Diluted Net Loss Per Common Share Calculation	The total numbers of securities that could potentially dilute net income per share in the future that were not considered in the diluted net loss per share calculations because the effect would have been anti-dilutive were as follows: Year Ended December 31, (in thousands) 2024 2023 2022 Options to purchase common stock 27,800 20,877 13,522 Restricted stock units 7,883 3,086 2,694 ESPP shares issuable 230 249 166 Total 35,913 24,212 16,382

Nature of Operations (Details)

Nature of Operations (Details)	12 Months Ended
	Dec. 31, 2024 segment
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Number of operating segments	1

Summary of Significant Accoun_3

Summary of Significant Accounting Policies - Narrative (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023
Summary of significant accounting policies
Accounts receivable	$ 57,705	$ 22,031
Compensation costs from contributions	1,100	200
Collaborators
Summary of significant accounting policies
Accounts receivable	1,000	4,900
Commercial customers
Summary of significant accounting policies
Accounts receivable	$ 56,700	$ 17,100
Minimum
Summary of significant accounting policies
Estimated useful lives	3 years
Maximum
Summary of significant accounting policies
Estimated useful lives	5 years

Cash, Cash Equivalents and Sh_3

Cash, Cash Equivalents and Short-Term Investments - Securities Classified as Cash and Short-Term Investments (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Cash and cash equivalents
Fair value	$ 64,932	$ 21,470
Short-term investments
Amortized Cost	185,111	162,605
Gross Unrealized Gains	112	280
Gross Unrealized Losses	(55)	(56)
Fair Value	185,168	162,829
Total cash, cash equivalents and investments	250,043	184,075
Total cash, cash equivalents and investments, Gross Unrealized Gains	112	280
Total cash, cash equivalents and investments, Gross Unrealized Losses	(55)	(56)
Total cash, cash equivalents and investments, Fair Value	250,100	184,299
U.S. treasury securities
Short-term investments
Amortized Cost	79,720	2,455
Gross Unrealized Gains	58	2
Gross Unrealized Losses	(5)	0
Fair Value	79,773	2,457
U.S. government-sponsored agency bonds
Short-term investments
Amortized Cost	45,960	101,892
Gross Unrealized Gains	29	235
Gross Unrealized Losses	(27)	(34)
Fair Value	45,962	102,093
Commercial paper
Short-term investments
Amortized Cost	37,061	49,630
Gross Unrealized Gains	19	41
Gross Unrealized Losses	(15)	(17)
Fair Value	37,065	49,654
Corporate bonds
Short-term investments
Amortized Cost	17,415
Gross Unrealized Gains	4
Gross Unrealized Losses	(6)
Fair Value	17,413
Asset-backed securities
Short-term investments
Amortized Cost	2,983	8,628
Gross Unrealized Gains	2	2
Gross Unrealized Losses	0	(5)
Fair Value	2,985	8,625
Yankee bonds
Short-term investments
Amortized Cost	1,972
Gross Unrealized Gains	0
Gross Unrealized Losses	(2)
Fair Value	1,970
Cash
Cash and cash equivalents
Fair value	16,282	2,829
Money market funds
Cash and cash equivalents
Fair value	$ 48,650	$ 18,641

Cash, Cash Equivalents and Sh_4

Cash, Cash Equivalents and Short-Term Investments - Narrative (Details) - investment	Dec. 31, 2024	Dec. 31, 2023
Cash and Cash Equivalents [Abstract]
Investment in continuous unrealized loss position for more than one year	0	0

Fair Value Measurements - Finan

Fair Value Measurements - Financial Assets and Liabilities Measured on a Recurring Basis (Details) - Recurring - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Assets
Assets, fair value	$ 233,818	$ 181,470
Liabilities
Liabilities, fair value	0	675
Money market funds
Assets
Assets, fair value	48,650	18,641
U.S. government-sponsored agency bonds
Assets
Assets, fair value	45,962	102,093
U.S. treasury securities
Assets
Assets, fair value	79,773	2,457
Commercial paper
Assets
Assets, fair value	37,065	49,654
Corporate bonds
Assets
Assets, fair value	17,413	0
Asset-backed securities
Assets
Assets, fair value	2,985	8,625
Yankee bonds
Assets
Assets, fair value	1,970	0
Derivative liabilities for exit fee
Liabilities
Liabilities, fair value	0	675
Level 1
Assets
Assets, fair value	48,650	18,641
Liabilities
Liabilities, fair value	0	0
Level 1 | Money market funds
Assets
Assets, fair value	48,650	18,641
Level 1 | U.S. government-sponsored agency bonds
Assets
Assets, fair value	0	0
Level 1 | U.S. treasury securities
Assets
Assets, fair value	0	0
Level 1 | Commercial paper
Assets
Assets, fair value	0	0
Level 1 | Corporate bonds
Assets
Assets, fair value	0	0
Level 1 | Asset-backed securities
Assets
Assets, fair value	0	0
Level 1 | Yankee bonds
Assets
Assets, fair value	0	0
Level 1 | Derivative liabilities for exit fee
Liabilities
Liabilities, fair value	0	0
Level 2
Assets
Assets, fair value	185,168	162,829
Liabilities
Liabilities, fair value	0	0
Level 2 | Money market funds
Assets
Assets, fair value	0	0
Level 2 | U.S. government-sponsored agency bonds
Assets
Assets, fair value	45,962	102,093
Level 2 | U.S. treasury securities
Assets
Assets, fair value	79,773	2,457
Level 2 | Commercial paper
Assets
Assets, fair value	37,065	49,654
Level 2 | Corporate bonds
Assets
Assets, fair value	17,413	0
Level 2 | Asset-backed securities
Assets
Assets, fair value	2,985	8,625
Level 2 | Yankee bonds
Assets
Assets, fair value	1,970	0
Level 2 | Derivative liabilities for exit fee
Liabilities
Liabilities, fair value	0	0
Level 3
Assets
Assets, fair value	0	0
Liabilities
Liabilities, fair value	0	675
Level 3 | Money market funds
Assets
Assets, fair value	0	0
Level 3 | U.S. government-sponsored agency bonds
Assets
Assets, fair value	0	0
Level 3 | U.S. treasury securities
Assets
Assets, fair value	0	0
Level 3 | Commercial paper
Assets
Assets, fair value	0	0
Level 3 | Corporate bonds
Assets
Assets, fair value	0	0
Level 3 | Asset-backed securities
Assets
Assets, fair value	0	0
Level 3 | Yankee bonds
Assets
Assets, fair value	0	0
Level 3 | Derivative liabilities for exit fee
Liabilities
Liabilities, fair value	$ 0	$ 675

Fair Value Measurements - Narra

Fair Value Measurements - Narrative (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
2022 Exit Fee
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Estimated fair value		$ 700
Derivative liabilities for exit fee
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Estimated fair value	$ 0	$ 675	$ 1,656
Derivative liabilities for exit fee | 2022 Exit Fee
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Estimated fair value	$ 1,000

Inventory - Schedule (Details)

Inventory - Schedule (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Inventory Disclosure [Abstract]
Raw materials	$ 30,792	$ 22,920
Work in process	58,685	24,582
Finished goods	1,707	1,985
Inventory	21,173	12,448
Inventory, non-current	70,011	37,039
Total	$ 91,184	$ 49,487

Inventory - Narrative (Details)

Inventory - Narrative (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Inventory Disclosure [Abstract]
Prepaid commercial manufacturing	$ 16,400	$ 23,200
Prepaid commercial manufacturing, non-current	$ 0	$ 4,235

Revenue - Schedule of Revenue (

Revenue - Schedule of Revenue (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Disaggregation of Revenue [Line Items]
Total revenues	$ 333,615	$ 124,456	$ 52,158
Product sales, net
Disaggregation of Revenue [Line Items]
Total revenues	319,196	82,526	15,600
IBSRELA
Disaggregation of Revenue [Line Items]
Total revenues	158,286	80,062	15,600
XPHOZAH
Disaggregation of Revenue [Line Items]
Total revenues	160,910	2,464	0
Product supply revenue
Disaggregation of Revenue [Line Items]
Total revenues	11,649	6,121	1,527
Licensing revenue
Disaggregation of Revenue [Line Items]
Total revenues	78	35,809	35,031
Non-cash royalty revenue related to the sale of future royalties
Disaggregation of Revenue [Line Items]
Total revenues	$ 2,692	$ 0	$ 0

Revenue - Narrative (Details)

Revenue - Narrative (Details)	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Product sales, net | Gross product revenue | Product Concentration Risk
Disaggregation of Revenue [Line Items]
Concentration risk (percent)	95.70%	66.30%	29.90%

Revenue - Chargebacks, Discount

Revenue - Chargebacks, Discounts and Reserve Balances (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023
Gross-to-net sales accruals and reserves
Beginning balance	$ 8,628	$ 2,844
Provisions	109,857	31,335
Credits/payments	(91,197)	(25,551)
Ending balance	27,288	8,628
Discounts and chargebacks
Gross-to-net sales accruals and reserves
Beginning balance	478	142
Provisions	15,099	5,341
Credits/payments	(13,934)	(5,005)
Ending balance	1,643	478
Rebates, wholesaler and GPO fees
Gross-to-net sales accruals and reserves
Beginning balance	4,234	1,444
Provisions	65,833	15,365
Credits/payments	(55,592)	(12,575)
Ending balance	14,475	4,234
Copay assistance and returns
Gross-to-net sales accruals and reserves
Beginning balance	3,916	1,258
Provisions	28,925	10,629
Credits/payments	(21,671)	(7,971)
Ending balance	$ 11,170	$ 3,916

Revenue - Geographic Informatio

Revenue - Geographic Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Disaggregation of Revenue [Line Items]
Total revenues	$ 333,615	$ 124,456	$ 52,158
United States
Disaggregation of Revenue [Line Items]
Total revenues	319,196	83,276	15,600
North America
Disaggregation of Revenue [Line Items]
Total revenues	14,341	41,121	36,527
Asia Pacific
Disaggregation of Revenue [Line Items]
Total revenues	$ 78	$ 59	$ 31

Revenue - Revenue Collaboration

Revenue - Revenue Collaboration Partnership Concentration (Details) - Revenue	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Customers | BioRidge Pharma, LLC
Disaggregation of Revenue [Line Items]
Concentration risk (percent)	75.40%	24%	3.20%
Customers | Cencora
Disaggregation of Revenue [Line Items]
Concentration risk (percent)	16.40%	19.10%	11.10%
Customers | Cardinal Health
Disaggregation of Revenue [Line Items]
Concentration risk (percent)	14.50%	19.80%	9.60%
Customers | McKesson Corporation
Disaggregation of Revenue [Line Items]
Concentration risk (percent)	14.10%	15.70%	8.90%
Collaboration partners | Kyowa Kirin
Disaggregation of Revenue [Line Items]
Concentration risk (percent)	4.30%	29%	70%

Revenue - Revenue from Customer

Revenue - Revenue from Customers as a Percentage of Total Product Revenue, Net (Details)	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Gross product revenue | Product Concentration Risk | Product sales, net
Disaggregation of Revenue [Line Items]
Concentration risk (percent)	95.70%	66.30%	29.90%

Collaboration and Licensing A_3

Collaboration and Licensing Agreements - Recognized Revenue (Details) - USD ($) $ in Thousands	12 Months Ended			86 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2024
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues	$ 333,615	$ 124,456	$ 52,158
2017 KKC Agreement | Kyowa Kirin
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues				$ 35,000
Licensing revenue
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues	78	35,809	35,031
Licensing revenue | METiS Therapeutics Inc
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues	0	750	0
Licensing revenue | 2017 KKC Agreement | Kyowa Kirin
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues	0	30,000	35,000
Licensing revenue | Fosun Agreement | Fosun Pharma
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues	0	5,000	0
Licensing revenue | Knight Agreement | Knight
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues	78	59	31
Product supply revenue
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues	11,649	6,121	1,527
Product supply revenue | 2017 KKC Agreement | Kyowa Kirin
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues	11,649	6,092	1,518
Product supply revenue | Fosun Agreement | Fosun Pharma
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues	0	29	9
Non-cash royalty revenue related to the sale of future royalties
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues	2,692	0	0
Non-cash royalty revenue related to the sale of future royalties | 2017 KKC Agreement | Kyowa Kirin
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues	$ 2,692	$ 0	$ 0

Collaboration and Licensing A_4

Collaboration and Licensing Agreements - Narrative (Details) $ in Thousands, $ in Millions, ¥ in Billions	1 Months Ended			12 Months Ended				86 Months Ended
	Dec. 31, 2017 USD ($)	Nov. 30, 2017 USD ($)	Jun. 30, 2015 USD ($)	Dec. 31, 2024 USD ($) payment_tranche	Dec. 31, 2024 CAD ($)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)	Dec. 31, 2024 USD ($) payment_tranche	Dec. 31, 2024 JPY (¥) payment_tranche	Apr. 30, 2023 USD ($)	Mar. 31, 2018 USD ($)
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues				$ 333,615		$ 124,456	$ 52,158
Licensing revenue
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues				78		35,809	35,031
Kyowa Kirin | 2017 KKC Agreement
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Upfront license fees		$ 30,000
Potential development milestones		$ 55,000
Total revenues								$ 35,000
Potential commercialization milestones				$ 54,000				54,000	¥ 8.5
Period to reduce royalty rate				2 years	2 years
Fee receivable for reduction in royalty rate				$ 40,000				$ 40,000
Number of payment tranches for fee receivable for reduction in royalty rate | payment_tranche				2				2	2
Kyowa Kirin | 2017 KKC Agreement | Licensing revenue
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues				$ 0		30,000	35,000
Fosun Pharma | Fosun Agreement
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Upfront payment received	$ 12,000
Potential development and commercialization milestones				113,000
Proceeds from milestone payments				$ 8,000				$ 8,000
Threshold percentage of net sales for tiered royalties				20%	20%
Fosun Pharma | Fosun Agreement | Licensing revenue
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues				$ 0		5,000	0
Knight | Knight Agreement
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Potential development milestones				700				700
Potential development and commercialization milestones				15,400	$ 22.2
Upfront payment											$ 2,300
Knight | Knight Agreement | Licensing revenue
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues				78		59	31
AstraZeneca | AZ Termination Agreement
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Percentage of royalty revenue			10%
Percentage of non royalty revenue			20%
Maximum potential payment per agreement			$ 75,000
Aggregate cost of revenue recognized				62,300				$ 62,300
Cost of revenue				34,700		12,400	3,600
METiS Therapeutics Inc | Licensing revenue
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues				$ 0		$ 750	$ 0
Proceeds from milestone payments										$ 243,000
Upfront payment										$ 800

Collaboration and Licensing A_5

Collaboration and Licensing Agreements - Deferred Revenue (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023
Current
Beginning balance	$ 7,182
Ending balance	10,686	$ 7,182
Non-Current
Beginning balance	8,644
Ending balance	7,232	8,644
2017 KKC Agreement
Current
Beginning balance	7,182	4,211
Prepaid product supply	3,716	1,547
Product supply delivered	(9,836)	(4,586)
Reclassify amounts to be recognized in the next twelve months	9,624	6,010
Ending balance	10,686	7,182
Non-Current
Beginning balance	8,644	9,025
Prepaid product supply	8,212	5,629
Product supply delivered	0	0
Reclassify amounts to be recognized in the next twelve months	(9,624)	(6,010)
Ending balance	$ 7,232	$ 8,644

Deferred Royalty Obligation R_3

Deferred Royalty Obligation Related To The Sale Of Future Royalties - Narrative (Details) - Healthcare royalty partners IV, L.P - License - USD ($) $ in Millions	1 Months Ended
	Jun. 30, 2022	Dec. 31, 2024	Oct. 31, 2023
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Royalty payments and commercial milestone payments	$ 20
Upfront payment	10		$ 5
Payment to be received	$ 5
Transaction costs		$ 0.4

Deferred Royalty Obligation R_4

Deferred Royalty Obligation Related To The Sale Of Future Royalties - Financial Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Non-cash interest expense related to the sale of future royalties	$ (7,088)	$ (3,924)	$ (1,673)
Healthcare royalty partners IV, L.P | Licensing revenue
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Amortization, effective interest rate, percent	31%	34.70%	34.40%

Deferred Royalty Obligation R_5

Deferred Royalty Obligation Related To The Sale Of Future Royalties - Schedule (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Deferred Royalty Obligation [Roll Forward]
Beginning deferred royalty obligation	$ 20,179
Ending deferred royalty obligation	25,527	$ 20,179
Healthcare royalty partners IV, L.P
Deferred Royalty Obligation [Roll Forward]
Beginning deferred royalty obligation	20,179	11,254	$ 0
Upfront payment, net of transaction costs	0	0	9,581
Regulatory approval milestone	0	5,000	0
Non-cash interest expense related to sale of future royalties	7,088	3,924	1,673
Royalty distributed to HCR	(1,740)	0	0
Other	0	1	0
Ending deferred royalty obligation	$ 25,527	$ 20,179	$ 11,254

Borrowing - Schedule of Borrowi

Borrowing - Schedule of Borrowings (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023
Adjustments to principal value
Unamortized discount and debt issuance costs	$ (1,136)	$ (912)
Final fee	1,989	734
Total long-term debt	150,853	49,822
Less: Current portion of long-term debt	0	0
Long-term debt, net of current portion	150,853	49,822
Term loan
Term Loans
Total principal	150,000	50,000
Term loan | Term A Loan
Term Loans
Total principal	$ 27,500	27,500
Adjustments to principal value
Interest rate	7.95%
Term loan | Term A Loan | Secured Overnight Financing Rate (SOFR)
Adjustments to principal value
Floating per annum rate (percent)	0.022%
Term loan | Term A Loan | Floor Rate
Adjustments to principal value
Floating per annum rate (percent)	1%
Term loan | Term B Loan
Term Loans
Total principal	$ 22,500	22,500
Adjustments to principal value
Interest rate	7.95%
Term loan | Term B Loan | Secured Overnight Financing Rate (SOFR)
Adjustments to principal value
Floating per annum rate (percent)	0.022%
Term loan | Term B Loan | Floor Rate
Adjustments to principal value
Floating per annum rate (percent)	1%
Term loan | Term C Loan
Term Loans
Total principal	$ 50,000	0
Adjustments to principal value
Interest rate	4.25%
Term loan | Term C Loan | Secured Overnight Financing Rate (SOFR)
Adjustments to principal value
Floating per annum rate (percent)	0.022%
Term loan | Term C Loan | Floor Rate
Adjustments to principal value
Floating per annum rate (percent)	4.70%
Term loan | Term D Loan
Term Loans
Total principal	$ 50,000	$ 0
Adjustments to principal value
Interest rate	4%
Term loan | Term D Loan | Secured Overnight Financing Rate (SOFR)
Adjustments to principal value
Floating per annum rate (percent)	0.022%
Term loan | Term D Loan | Floor Rate
Adjustments to principal value
Floating per annum rate (percent)	4.70%

Borrowing - Narrative (Details)

Borrowing - Narrative (Details) - USD ($) $ in Thousands	1 Months Ended	12 Months Ended
	Oct. 31, 2024	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Term Loans
Final fee		$ 1,989	$ 734
Exit fee payment		1,000	1,500	$ 0
Future payment obligation, excluding interest payments		$ 157,400
2022 Exit Fee
Term Loans
Exit fee payment	$ 1,000
2022 Term Loan | Term loan
Term Loans
Final fee due upon maturity, acceleration, prepayment, or termination (percent)		4.95%
Final fee		$ 5,400	$ 1,700
Loan agreement covenant, cash and cash equivalents as percentage of outstanding loan balance, minimum		80%
Loan agreement, covenant, cash and cash equivalents as percentage of outstanding loan balance, calculation period		6 months
Loan agreement covenant, net product revenue as percentage of outstanding loan balance, minimum		60%
2022 Term Loan | Term loan | After first anniversary through second anniversary of closing date
Term Loans
Prepayment premium (as a percent)		2%
2022 Term Loan | Term loan | After second anniversary to maturity date
Term Loans
Prepayment premium (as a percent)		1%
Term A Loan | Term loan
Term Loans
Interest rate		7.95%
Closing fee		$ 200
Term A Loan | Term loan | Secured Overnight Financing Rate (SOFR)
Term Loans
Floating per annum rate (percent)		0.022%
Term A Loan | Term loan | Floor Rate
Term Loans
Floating per annum rate (percent)		1%
Term B Loan | Term loan
Term Loans
Interest rate		7.95%
Closing fee		$ 100
Term B Loan | Term loan | Secured Overnight Financing Rate (SOFR)
Term Loans
Floating per annum rate (percent)		0.022%
Term B Loan | Term loan | Floor Rate
Term Loans
Floating per annum rate (percent)		1%
Term C Loan | Term loan
Term Loans
Interest rate		4.25%
Closing fee		$ 300
Term C Loan | Term loan | Secured Overnight Financing Rate (SOFR)
Term Loans
Floating per annum rate (percent)		0.022%
Term C Loan | Term loan | Floor Rate
Term Loans
Floating per annum rate (percent)		4.70%
Term D Loan | Term loan
Term Loans
Interest rate		4%
Closing fee		$ 300
Term D Loan | Term loan | Secured Overnight Financing Rate (SOFR)
Term Loans
Floating per annum rate (percent)		0.022%
Term D Loan | Term loan | Floor Rate
Term Loans
Floating per annum rate (percent)		4.70%
Term Loan E | Term loan
Term Loans
Proceeds from loan payable, net of issuance costs	$ 50,000
Interest rate	4%
Closing fee percentage	0.50%
Term Loan E | Term loan | Secured Overnight Financing Rate (SOFR)
Term Loans
Floating per annum rate (percent)	0.022%
Term Loan E | Term loan | Floor Rate
Term Loans
Floating per annum rate (percent)	4.70%

Derivative Liabilities - Narrat

Derivative Liabilities - Narrative (Details) - USD ($) $ in Thousands	1 Months Ended	12 Months Ended
	Oct. 31, 2024	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Derivative [Line Items]
Exit fee payment		$ 1,000	$ 1,500	$ 0
2018 Exit Fee
Derivative [Line Items]
Exit fee payment			1,500
2022 Exit Fee
Derivative [Line Items]
Exit fee payment	$ 1,000
Exit fee (percent)		2%
Exit fee, net product revenue threshold		$ 100,000
Estimated fair value			$ 700

Derivative Liabilities - Change

Derivative Liabilities - Changes in Fair Value (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023
2022 Exit Fee
Change in Fair Value of Derivative Liability
Fair value of exit fee derivative liabilities, beginning	$ 700
Fair value of exit fee derivative liabilities, ending		$ 700
Exit fee derivative liability
Change in Fair Value of Derivative Liability
Fair value of exit fee derivative liabilities, beginning	675	1,656
Fair value of exit fee derivative liabilities, ending	0	675
Exit fee derivative liability | 2018 Exit Fee
Change in Fair Value of Derivative Liability
Exit Fee	0	292
Exit Fee payment	0	(1,500)
Exit fee derivative liability | 2022 Exit Fee
Change in Fair Value of Derivative Liability
Exit Fee	325	227
Exit Fee payment	(1,000)	$ 0
Fair value of exit fee derivative liabilities, ending	$ 1,000

Leases - Narrative (Details)

Leases - Narrative (Details)	Dec. 31, 2024 renewal_option
Lessee, Lease, Description [Line Items]
Number of options to extend	1
Term of lease extension	5 years
Minimum
Lessee, Lease, Description [Line Items]
Lease terms	2 months
Maximum
Lessee, Lease, Description [Line Items]
Lease terms	4 years

Leases - Additional Lease Infor

Leases - Additional Lease Information (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Facilities
Right-of-use assets	$ 2,380	$ 5,589
Current portion of lease liabilities	1,562	4,435
Operating lease liability, net of current portion	1,023	1,725
Total operating lease liabilities	$ 2,585	$ 6,160
Additional details
Weighted-average remaining term (in years)	1 year 9 months 18 days	1 year 7 months 6 days
Weighted-average discount rate	6.50%	6.80%

Leases - Lease Costs (Details)

Leases - Lease Costs (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Lease costs
Operating lease expense	$ 4,699	$ 3,857	$ 4,257
Cash paid for operating leases	$ 4,931	$ 4,481	$ 4,292

Leases - Undiscounted Cash Paym

Leases - Undiscounted Cash Payment Obligations (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Undiscounted cash payment obligations
2025	$ 1,660
2026	702
2027	238
2028	124
Thereafter	21
Total undiscounted operating lease payments	2,745
Imputed interest expenses	(160)
Total operating lease liabilities	2,585	$ 6,160
Less: Current portion of operating lease liability	(1,562)	(4,435)
Operating lease liability, net of current portion	$ 1,023	$ 1,725

Stockholders' Equity (Details)

Stockholders' Equity (Details) - USD ($) $ / shares in Units, shares in Millions	1 Months Ended	12 Months Ended			20 Months Ended
	Jan. 31, 2023	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022	Mar. 31, 2023	Aug. 31, 2021
Subsidiary, Sale of Stock [Line Items]
Gross proceeds		$ 0	$ 119,236,000	$ 71,625,000
2021 Open Market Sales Agreement
Subsidiary, Sale of Stock [Line Items]
Total of gross proceeds					$ 150,000,000
Weighted-average share price (in dollars per share)					$ 1.57
2023 Open Market Sales Agreement
Subsidiary, Sale of Stock [Line Items]
Weighted-average share price (in dollars per share)		$ 4.17
Offering sales commission (percent)	3%
Common stock sold and issued (in shares)		16.8
Gross proceeds		$ 70,000,000
Common stock
Subsidiary, Sale of Stock [Line Items]
Maximum aggregate offering price	$ 250,000,000
Common stock | 2021 Open Market Sales Agreement
Subsidiary, Sale of Stock [Line Items]
Maximum aggregate offering price						$ 150,000,000
Common stock | 2023 Open Market Sales Agreement
Subsidiary, Sale of Stock [Line Items]
Maximum aggregate offering price	$ 150,000,000

Equity Incentive Plans - Narrat

Equity Incentive Plans - Narrative (Details) - USD ($) $ / shares in Units, $ in Thousands		1 Months Ended				12 Months Ended
	Jun. 18, 2014	Jan. 31, 2024	Dec. 31, 2022	Jan. 31, 2022	Jan. 31, 2021	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022	Jun. 14, 2024	Jun. 13, 2024	Nov. 30, 2016
Equity Incentive Plans
Common stock closing price (in dollars per share)						$ 5.07
Intrinsic value of options exercised						$ 19,600	$ 1,100	$ 30
Fair value of options vested						$ 61,000	$ 24,900	$ 7,000
Weighted-average grant-date estimated fair value of options granted (in dollars per share)						$ 6.22	$ 2.36	$ 0.63
Issuance of common stock for services						$ 257	$ 337	$ 390
2014 Plan
Equity Incentive Plans
Number of shares added to initial reserve	35,000
Common stock reserved for future issuance (in shares)	1,500,000					18,100,000
Potential increase to shares reserved for inclusion of forfeited or unexercised options from prior plan	1,200,000
Potential increase in shares reserved as a percentage of shares outstanding	4%
Additional shares added (in shares)									19,000,000
Shares that may be issued upon exercise (in shares)									58,500,000	10,700,000
Inducement Plan
Equity Incentive Plans
Number of shares added to initial reserve		5,800,000	3,000,000	2,000,000	500,000
Common stock reserved for future issuance (in shares)						3,900,000					1,000,000
Share of common stock subject to issued inducement grants						8,800,000
ESPP
Equity Incentive Plans
Common stock reserved for future issuance (in shares)	200,000					3,700,000
Potential increase in shares reserved as a percentage of shares outstanding	1%
Additional shares added (in shares)									3,000,000
Weighted-average grant-date estimated fair value of options granted (in dollars per share)						$ 4.64	$ 1.85	$ 0.63
Dividend yield						0%	0%	0%
Issuance of common stock for services (in shares)						500,000	400,000	300,000
Maximum shares to be issued under ESPP	2,200,000
Stock options
Equity Incentive Plans
Dividend yield						0%	0%	0%
RSUs
Equity Incentive Plans
Estimated fair value of RSUs vested						$ 16,400	$ 3,500	$ 2,600
Board of directors
Equity Incentive Plans
Issuance of common stock for services (in shares)						41,000	100,000	700,000
Issuance of common stock for services						$ 300	$ 300	$ 400

Equity Incentive Plans - Stock

Equity Incentive Plans - Stock Options (Details) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2024 USD ($) $ / shares shares
Number of Shares (in thousands)
Options issued and outstanding balance, beginning (shares) | shares	22,168,000
Options granted (shares) | shares	9,674,000
Options exercised (shares) | shares	(2,654,000)
Options canceled (shares) | shares	(1,103,000)
Options issued and outstanding balance, ending (shares) | shares	28,085,000
Options vested and expected to vest (shares) | shares	28,085,000
Options exercisable (shares) | shares	14,968,000
Weighted-Average Exercise Price per Share
Options issued and outstanding balance, beginning (in dollars per share) | $ / shares	$ 4.20
Options granted (in dollars per share) | $ / shares	7.95
Options exercised (in dollars per share) | $ / shares	2.24
Options canceled (in dollars per share) | $ / shares	5.35
Options issued and outstanding balance, ending (in dollars per share) | $ / shares	5.63
Options vested and expected to vest (in dollars per share) | $ / shares	5.63
Options exercisable (in dollars per share) | $ / shares	$ 5.52
Weighted Average Remaining Contractual Term (in years)
Options issued and outstanding (in years)	7 years 1 month 6 days
Options vest and expected to vest (in years)	7 years 1 month 6 days
Options exercisable (in years)	5 years 8 months 12 days
Aggregate Intrinsic Value (in thousands)
Options issued and outstanding | $	$ 31,830
Options vested and expected to vest | $	31,830
Options exercisable | $	$ 19,161

Equity Incentive Plans - Valuat

Equity Incentive Plans - Valuation Assumptions for Stock Options (Details) - Stock options	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term (in years)	5 years 4 months 24 days	5 years 1 month 6 days	4 years 10 months 24 days
Expected volatility	100.80%	97.60%	92.10%
Risk-free interest rate	4%	3.80%	2.20%
Dividend yield	0%	0%	0%

Equity Incentive Plans - Restri

Equity Incentive Plans - Restricted Stock Units (Details) - RSUs shares in Thousands	12 Months Ended
	Dec. 31, 2024 $ / shares shares
Number of RSUs (in thousands)
Nonvested balance, beginning (shares) | shares	3,646
Granted (shares) | shares	7,382
Vested (shares) | shares	(2,430)
Forfeited (shares) | shares	(585)
Nonvested balance, ending (shares) | shares	8,013
Weighted-Average Grant Date Fair Value Per Share
Nonvested balance, beginning (in dollars per share) | $ / shares	$ 3.09
Granted (in dollars per share) | $ / shares	7.94
Vested (in dollars per share) | $ / shares	5.65
Forfeited (in dollars per share) | $ / shares	5.68
Nonvested balance, ending (in dollars per share) | $ / shares	$ 6.59

Equity Incentive Plans - Valu_2

Equity Incentive Plans - Valuation Assumptions for ESPP (Details) - ESPP	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term (in years)	6 months	6 months	6 months
Expected volatility	82.80%	86%	97.20%
Risk-free interest rate	5%	5.30%	1.90%
Dividend yield	0%	0%	0%

Equity Incentive Plans - Stock-

Equity Incentive Plans - Stock-Based Compensation (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Stock-based compensation	$ 37,381	$ 13,530	$ 10,750
Selling, general and administrative
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Stock-based compensation	27,791	9,952	7,525
Research and development
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Stock-based compensation	$ 9,590	$ 3,578	$ 3,225

Equity Incentive Plans - Unreco

Equity Incentive Plans - Unrecognized Stock-Based Compensation (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2024 USD ($)
Stock options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized Compensation Expense (in thousands)	$ 55,610
Average Remaining Vesting Period (in years)	2 years 8 months 15 days
RSUs
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized Compensation Expense (in thousands)	$ 49,930
Average Remaining Vesting Period (in years)	2 years 11 months 15 days
ESPP
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized Compensation Expense (in thousands)	$ 162
Average Remaining Vesting Period (in years)	1 month 6 days

Property and Equipment, Net - B

Property and Equipment, Net - Balances (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 12,113	$ 11,210
Less: Accumulated depreciation	(10,618)	(10,201)
Total property and equipment, net	1,495	1,009
Laboratory equipment
Property, Plant and Equipment [Line Items]
Property and equipment, gross	46	46
Office equipment and furniture
Property, Plant and Equipment [Line Items]
Property and equipment, gross	2,923	2,433
Leasehold improvements
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 9,144	$ 8,731

Property and Equipment, Net - N

Property and Equipment, Net - Narrative (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Property, Plant and Equipment [Abstract]
Depreciation	$ 0.5	$ 0.6	$ 0.7

Accrued Expenses and Other Cu_3

Accrued Expenses and Other Current Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Payables and Accruals [Abstract]
Accrued payments due to AstraZeneca	$ 12,077	$ 3,680
Accrued gross to net revenue liabilities	10,112	3,258
Accrued sales and marketing expenses	3,696	3,223
Other	8,757	4,880
Total accrued expenses and other current liabilities	$ 34,642	$ 15,041

Income Taxes - Components of Pr

Income Taxes - Components of Provision for Income Taxes (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Current
State	$ 266	$ 47	$ 8
Foreign	0	500	0
Total current	266	547	8
Deferred
Federal	0	0	0
Total deferred	0	0	0
Provision for income taxes	$ 266	$ 547	$ 8

Income Taxes - Reconciliation o

Income Taxes - Reconciliation of Effective Tax Rate (Details)	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Income Tax Disclosure [Abstract]
Income tax at the federal statutory rate	21%	21%	21%
State taxes, net of federal benefit	4%	3.40%	1.90%
Tax credits	0.60%	1.70%	1.50%
Stock based compensation	5.20%	0.10%	(2.30%)
Foreign withholding tax	0%	(0.80%)	0%
Executive compensation disallowed under IRC Sec 162(m)	(5.80%)	(1.90%)	(1.60%)
Other	(0.60%)	0%	(0.80%)
Change in valuation allowance	(25.00%)	(24.30%)	(19.70%)
Effective tax rate	(0.60%)	(0.80%)	0%

Income Taxes - Components of De

Income Taxes - Components of Deferred Tax Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Deferred tax assets
Amortization and depreciation	$ 64,237	$ 64,919
Net operating loss carryforwards	103,643	98,702
Tax credits	15,529	15,375
Stock-based compensation	11,226	6,946
Deferred royalty obligation	6,409	4,907
Other	8,122	6,707
Deferred tax assets	209,166	197,556
Valuation allowance	(208,568)	(196,197)
Deferred tax assets net of valuation allowance	598	1,359
Deferred tax liabilities
Right-of-use asset	(598)	(1,359)
Deferred tax liabilities	(598)	(1,359)
Net deferred taxes	$ 0	$ 0

Income Taxes - Narrative (Detai

Income Taxes - Narrative (Details) $ in Millions	12 Months Ended
	Dec. 31, 2024 USD ($)
Income Tax Disclosure [Line Items]
Increase in valuation allowance	$ 12.4
Federal
Income Tax Disclosure [Line Items]
Net operating loss carryforwards	495
Net operating loss carryforwards, indefinite	344.8
Federal | Research and development tax credit
Income Tax Disclosure [Line Items]
Tax credit carryforwards	17.8
Foreign
Income Tax Disclosure [Line Items]
Tax credit carryforwards	1.7
State | California
Income Tax Disclosure [Line Items]
Net operating loss carryforwards	94.7
State | California | Research and development tax credit
Income Tax Disclosure [Line Items]
Tax credit carryforwards	9.2
State | California | Minimum tax credit carryforwards
Income Tax Disclosure [Line Items]
Tax credit carryforwards	0.1
State | Other states
Income Tax Disclosure [Line Items]
Net operating loss carryforwards	$ 64

Income Taxes - Reconciliation_2

Income Taxes - Reconciliation of Unrecognized Tax Benefits (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Reconciliation of Unrecognized Tax Benefits
Balance at beginning of year	$ 23,625	$ 24,075	$ 24,426
Additions based on tax positions related to current year	105	262	460
Additions based on tax positions related to prior year	0	99	0
Subtractions based on tax positions related to prior year	(811)	(811)	(811)
Balance at end of year	$ 22,919	$ 23,625	$ 24,075

Segment Reporting - Schedule of

Segment Reporting - Schedule of Operating Segment (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2024 USD ($) segment	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)
Segment Reporting Information [Line Items]
Number of reportable segments | segment	1
Number of operating segments | segment	1
Revenues
Total revenues	$ 333,615	$ 124,456	$ 52,158
Less:
Total cost of goods sold	50,556	17,795	4,117
Total operating expenses	311,009	169,937	111,800
Loss before provision for income taxes	(38,870)	(65,520)	(67,199)
Net loss	(39,136)	(66,067)	(67,207)
Reportable Segment
Revenues
Total revenues	333,615	124,456	52,158
Less:
Total cost of goods sold	50,556	17,795	4,117
Research and development	39,480	29,231	28,777
Selling expenses	162,957	80,028	10,750
General and administrative expenses	52,916	34,020	34,895
Stock-based compensation	37,381	13,530	25,144
Other segment expenses	18,275	13,128	12,234
Total operating expenses	311,009	169,937	111,800
Loss before provision for income taxes	(27,950)	(63,276)	(63,759)
Other reconciliation items	(11,186)	(2,791)	(3,448)
Net loss	(39,136)	(66,067)	(67,207)
Allocated facilities, information technology, and human resources	16,900	12,300	11,400
Product sales, net
Revenues
Total revenues	319,196	82,526	15,600
Less:
Total cost of goods sold	6,851	2,323	566
Product sales, net | Reportable Segment
Revenues
Total revenues	319,196	82,526	15,600
Less:
Total cost of goods sold	6,851	2,323	566
Other cost of revenue
Less:
Total cost of goods sold	43,705	15,472	3,551
Other cost of revenue | Reportable Segment
Revenues
Total revenues	14,419	41,930	36,558
Less:
Total cost of goods sold	$ 43,705	$ 15,472	$ 3,551

Net Loss Per Share - Computatio

Net Loss Per Share - Computation of Net Loss Per Common Share (Details) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Numerator:
Net loss	$ (39,136)	$ (66,067)	$ (67,207)
Denominator:
Weighted average common shares outstanding - basic (in shares)	235,232,927	219,331,253	158,690,083
Weighted average common shares outstanding - diluted (in shares)	235,232,927	219,331,253	158,690,083
Net loss per share of common stock - basic (in dollars per share)	$ (0.17)	$ (0.30)	$ (0.42)
Net loss per share of common stock - diluted (in dollars per share)	$ (0.17)	$ (0.30)	$ (0.42)

Net Loss Per Share - Anti-Dilut

Net Loss Per Share - Anti-Dilutive Securities and Potential Common Shares (Details) - shares shares in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Anti-dilutive securities not included in computation of diluted net loss per share	35,913	24,212	16,382
Potential common shares that would have been included if not for anti-dilutive effect of securities	9,200	6,300	600
Options to purchase common stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Anti-dilutive securities not included in computation of diluted net loss per share	27,800	20,877	13,522
Restricted stock units
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Anti-dilutive securities not included in computation of diluted net loss per share	7,883	3,086	2,694
ESPP shares issuable
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Anti-dilutive securities not included in computation of diluted net loss per share	230	249	166

Commitments and Contingencies (

Commitments and Contingencies (Details)						4 Months Ended
	Sep. 25, 2024 claim	Sep. 13, 2024 claim	Aug. 16, 2024 shareholder	Jul. 19, 2022 claim	Aug. 12, 2021 defendant claim	Mar. 29, 2022 defendant claim
Strezsak v. Ardelyx, Inc.
Contingencies [Line Items]
Number of lawsuits				2	2
Number of defendants | defendant					2
Go v. Raab
Contingencies [Line Items]
Number of lawsuits						2
Number of defendants | defendant						2
Yarborough v. Ardelyx, Inc.
Contingencies [Line Items]
Number of shareholders who filed | shareholder			2
Ardelyx, Inc. Stockholder Derivative Litigation
Contingencies [Line Items]
Number of lawsuits	2	2