Trevi Therapeutics (TRVI) 10-Q 7 May 20 2020 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2020	May 07, 2020
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2020
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	Q1
Entity Registrant Name	TREVI THERAPEUTICS, INC.
Entity Central Index Key	0001563880
Current Fiscal Year End Date	--12-31
Entity Current Reporting Status	Yes
Entity Filer Category	Non-accelerated Filer
Trading Symbol	TRVI
Entity Common Stock, Shares Outstanding		17,834,570
Entity Shell Company	false
Entity Emerging Growth Company	true
Entity Ex Transition Period	true
Entity Small Business	true
Entity File Number	001-38886
Entity Tax Identification Number	45-0834299
Entity Address, Address Line One	195 Church Street
Entity Address, Address Line Two	14th Floor
Entity Address, City or Town	New Haven
Entity Address, State or Province	CT
Entity Address, Postal Zip Code	06510
City Area Code	203
Local Phone Number	304-2499
Entity Interactive Data Current	Yes
Entity Incorporation, State or Country Code	DE
Document Quarterly Report	true
Document Transition Report	false
Title of 12(b) Security	Common Stock, $0.001 par value per share
Security Exchange Name	NASDAQ

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Current assets:
Cash and cash equivalents	$ 52,640	$ 57,313
Tax credit and other receivables	125	558
Prepaid expenses	1,055	1,681
Total current assets	53,820	59,552
Operating lease right-of-use asset	292	312
Security deposit	19	19
Property, equipment and leasehold improvements, net	107	118
Total assets	54,238	60,001
Current liabilities:
Accounts payable	2,193	1,599
Accrued expenses	4,911	3,501
Operating lease liability - current portion	102	99
Total current liabilities	7,206	5,199
Operating lease liability - long term portion	230	257
Commitments and contingencies (Note 12)
Stockholders’ equity (deficit):
Common stock: $0.001 par value; 200,000,000 shares authorized at March 31, 2020 and December 31, 2019, respectively; and 17,834,570 shares issued and outstanding at March 31, 2020 and December 31, 2019, respectively.	18	18
Preferred stock: $0.001 par value; 5,000,000 shares authorized at March 31, 2020 and December 31, 2019, respectively; no shares issued or outstanding at March 31, 2020 or December 31, 2019.
Additional paid-in capital	169,476	168,746
Accumulated deficit	(122,692)	(114,219)
Total stockholders’ equity	46,802	54,545
Total liabilities and stockholders’ equity	$ 54,238	$ 60,001

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares	Mar. 31, 2020	Dec. 31, 2019
Statement Of Financial Position [Abstract]
Common Stock, Par or Stated Value Per Share	$ 0.001	$ 0.001
Common Stock, Shares Authorized	200,000,000	200,000,000
Common Stock, Shares, Issued	17,834,570	17,834,570
Common Stock, Shares, Outstanding	17,834,570	17,834,570
Preferred Stock, Par or Stated Value Per Share	$ 0.001	$ 0.001
Preferred Stock, Shares Authorized	5,000,000	5,000,000
Preferred Stock, Shares Issued	0	0
Preferred Stock, Shares Outstanding	0	0

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Operating expenses:
Research and development	$ 6,019	$ 3,338
General and administrative	2,620	1,474
Total operating expenses	8,639	4,812
Loss from operations	(8,639)	(4,812)
Other income (expense):
Change in fair value of obligation for loan success fee		(52)
Interest income	157	58
Total other income (expense), net	157	6
Loss before income tax benefit	(8,482)	(4,806)
Income tax benefit	9	4
Net loss	(8,473)	(4,802)
Accretion of redeemable convertible preferred stock		203
Dividends accrued on redeemable convertible preferred stock		(1,553)
Adjusted net loss attributable to common stockholders	$ (8,473)	$ (6,152)
Basic and diluted net loss per common share outstanding	$ (0.48)	$ (13.85)
Weighted average common shares used in net loss per share attributable to common stockholders, basic and diluted	17,834,570	444,132

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Redeemable Convertible Preferred Stock and Stockholders' Equity (Deficit) - USD ($) $ in Thousands	Total	Common Stock [Member]	Additional Paid-in Capital [Member]	Accumulated Deficit [Member]	Series A Redeemable convertible Preferred Stock [Member]	Series B Redeemable convertible Preferred Stock [Member]	Series C Redeemable convertible Preferred Stock [Member]
Beginning Balance at Dec. 31, 2018	$ (109,494)	$ 4		$ (109,498)	$ 21,033	$ 33,686	$ 61,023
Beginning Balance (in shares) at Dec. 31, 2018		438,600			15,387,923	22,608,695	38,097,672
Stock-based compensation	146		$ 146
Issuance of common stock from exercise of stock options	24		24
Issuance of common stock from exercise of stock options (in shares)		7,894
Issuance of Series C redeemable convertible preferred stock, net of issuance costs							$ 11,059
Issuance of Series C redeemable convertible preferred stock, net of issuance costs (in shares)							6,849,315
Dividends accrued on redeemable convertible preferred stock	(1,553)		(170)	(1,383)	$ 228	$ 384	$ 941
Accretion (amortization) of premium (discount) on issuance of redeemable convertible preferred stock	(4)			(4)	(1)	5
Accretion of discount on investor rights/obligation	(34)			(34)	14	20
Adjustment for excess (shortfall) of fair value over liquidation value of redeemable convertible preferred stock	278			278	(106)	(153)	(19)
Accretion of issuance costs on redeemable convertible preferred stock	(37)			(37)	1	1	35
Net loss	(4,802)			(4,802)
Ending Balance at Mar. 31, 2019	(115,476)	$ 4		(115,480)	$ 21,169	$ 33,943	$ 73,039
Ending Balance (in shares) at Mar. 31, 2019		446,494			15,387,923	22,608,695	44,946,987
Beginning Balance at Dec. 31, 2018	(109,494)	$ 4		(109,498)	$ 21,033	$ 33,686	$ 61,023
Beginning Balance (in shares) at Dec. 31, 2018		438,600			15,387,923	22,608,695	38,097,672
Net loss	(26,100)
Ending Balance at Dec. 31, 2019	54,545	$ 18	168,746	(114,219)
Ending Balance (in shares) at Dec. 31, 2019		17,834,570
Stock-based compensation	730		730
Net loss	(8,473)			(8,473)
Ending Balance at Mar. 31, 2020	$ 46,802	$ 18	$ 169,476	$ (122,692)
Ending Balance (in shares) at Mar. 31, 2020		17,834,570

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2020	Mar. 31, 2019	Dec. 31, 2019
Operating activities
Net loss	$ (8,473)	$ (4,802)	$ (26,100)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation	10	9
Changes in fair value of obligation for loan success fee		52
Stock-based compensation	730	146
Changes in operating assets and liabilities:
Receivables	433	34
Prepaid expenses	626	(230)
Accounts payable	594	(185)
Accrued expenses	1,407	880
Net cash used in operating activities	(4,673)	(4,096)
Investing activities
Acquisitions of property, equipment and leasehold improvements		(9)
Net cash used in investing activities		(9)
Financing activities
Proceeds from exercises of stock options		24
Proceeds from sale of Series C redeemable convertible preferred stock, net of issuance costs		9,963
Deferred offering costs		(138)
Net cash provided by financing activities		9,849
Net cash increase (decrease)	(4,673)	5,744
Cash and cash equivalents at beginning of period	57,313	7,202	7,202
Cash and cash equivalents at end of period	$ 52,640	12,946	$ 57,313
Supplemental disclosure of non-cash financing activities
Deferred offering costs		(214)
Dividends accrued on redeemable convertible preferred stock		1,553
Accretion on redeemable convertible preferred stock		$ (203)

Nature of the Business

Nature of the Business	3 Months Ended
	Mar. 31, 2020
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Nature of the Business	1. Trevi Therapeutics, Inc. (“Trevi” or the “Company”) is a clinical-stage biopharmaceutical company focused on the development and commercialization of nalbuphine ER to treat serious neurologically mediated conditions. The Company is currently developing nalbuphine ER for the treatment of chronic pruritus, chronic cough in patients with idiopathic pulmonary fibrosis (“IPF”), and levodopa-induced dyskinesia (“LID”) in patients with Parkinson’s disease. These conditions share a common pathophysiology that is mediated through opioid receptors in the central and peripheral nervous systems. Due to nalbuphine’s mechanism of action as a modulator of opioid receptors, the Company believes nalbuphine ER has the potential to be effective in treating each of these conditions. Nalbuphine ER is an oral extended release formulation of nalbuphine. Nalbuphine is a mixed κ-opioid receptor agonist and μ-opioid receptor antagonist that has been approved and marketed as an injectable for pain indications for more than 20 years in the United States and Europe. The κ- and μ-opioid receptors are known to be critical mediators of itch, cough and certain movement disorders. Nalbuphine’s mechanism of action also mitigates the risk of abuse associated with μ-opioid agonists because it antagonizes, or blocks, the μ-opioid receptor. Nalbuphine is currently the only opioid approved for marketing that is not classified as a controlled substance in the United States and most of Europe. On April 22, 2019, the Company filed an amendment to the Company’s amended and restated certificate of incorporation to effect a one-for 9.5 reverse stock split of the Company’s common stock, which resulted in a proportional adjustment to the existing conversion ratios for each series of the Company’s redeemable convertible preferred stock. Accordingly, all share and per share amounts in the condensed consolidated financial statements have been retrospectively adjusted, where applicable, to reflect the effect of the reverse stock split and adjustments of the redeemable convertible preferred stock conversion for all periods presented. On May 9, 2019, the Company completed its initial public offering (“IPO”) and a concurrent private placement in which it issued and sold an aggregate of 7,000,000 shares of common stock at an offering price of $10.00 per share, for net proceeds of $62.1 million, after deducting aggregate underwriting discounts and commissions and private placement agent fees of $4.9 million and other offering expenses of $3.0 million. The Company’s common stock began trading on The Nasdaq Global Market on May 7, 2019 under the ticker symbol “TRVI”. Upon the closing of the IPO, the Company’s outstanding redeemable convertible preferred stock, including the accrued dividends thereon, automatically converted into shares of the Company’s common stock. Upon such conversion of the redeemable convertible preferred stock, the Company reclassified the carrying values of the redeemable convertible preferred stock to common stock and additional paid-in capital. The accompanying financial statements have been prepared on the basis of continuity of operations, realization of assets and the satisfaction of liabilities and commitments in the ordinary course of business. Since inception, the Company has financed its operations primarily through private placements of its redeemable convertible preferred stock and convertible notes as well as borrowings under a term loan facility, and most recently, with proceeds from the IPO and concurrent private placement completed in May 2019. The Company has incurred recurring losses since inception, including net losses attributable to the Company of $8.5 million for three months ended March 31, 2020 and $26.1 million for the year ended December 31, 2019. In addition, as of March 31, 2020, the Company had an accumulated deficit of $122.7 million. The Company expects to continue to generate operating losses for the foreseeable future. As of May 7, 2020

Summary of Significant Accounti

Summary of Significant Accounting Policies	3 Months Ended
	Mar. 31, 2020
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	2. Basis of Presentation The accompanying unaudited interim condensed consolidated financial statements for the three months ended March 31, 2020 and 2019 included herein, have been prepared in accordance with accounting principles generally accepted in the United States of America (“GAAP”) for interim financial information and to the rules and regulations of the Securities and Exchange Commission (“SEC”) for interim information. Certain information and footnote disclosure typically prepared in accordance with GAAP have been condensed or omitted pursuant to SEC rules and regulations. The accompanying unaudited condensed consolidated financial statements and notes should be read in conjunction with the audited consolidated financial statements and related notes for the year ended December 31, 2019 included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2019 (the “Annual Report on Form 10-K”). In the opinion of management, the unaudited condensed consolidated financial statements reflect all adjustments, which include normal recurring adjustments necessary for the fair presentation of the Company’s interim financial statements presented. The results of operations for the interim periods are not necessarily indicative of the results expected for the full year or any subsequent period. The accompanying Condensed Consolidated Financial Statements include the accounts of Trevi Therapeutics, Inc. and its wholly-owned subsidiary Trevi Therapeutics Limited. Intercompany balances and transactions have been eliminated. All amounts presented are in thousands of dollars, except share and per share amounts, unless noted otherwise. The Company has evaluated events occurring subsequent to March 31, 2020 for potential recognition or disclosure in the Condensed Consolidated Financial Statements and concluded there were no subsequent events that required recognition or disclosure other than those provided. Use of Estimates The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities at the date of the financial statements and the reported amounts of the expenses during the reporting periods. Significant estimates and assumptions reflected in these Condensed Consolidated Financial Statements include, but are not limited to the recognition of research and development (“R&D”) expenses and the valuation of redeemable convertible preferred stock, common stock and stock-based awards. On an ongoing basis, management evaluates its estimates in light of changes in circumstances, facts and experience. Changes in estimates are recorded in the period in which they become known. Actual results could differ from those estimates. Unaudited Interim Financial Information The accompanying interim Condensed Consolidated Balance Sheet as of March 31, 2020, the Condensed Consolidated Statements of Operations and the Condensed Consolidated Statements of Redeemable Convertible Preferred Stock and Stockholders’ Equity (Deficit) for the three months ended March 31, 2020 and 2019, and the Condensed Consolidated Statements of Cash Flows for the three months ended March 31, 2020 and 2019 are unaudited. The unaudited interim Condensed Consolidated Financial Statements have been prepared on the same basis as the audited annual consolidated financial statements and, in the Company’s opinion, reflect all adjustments, which include only normal recurring adjustments, necessary for the fair statements of its financial position as of March 31, 2020, the results of its operations for the three months ended March 31, 2020 and 2019, and its cash flows for the three months ended March 31, 2020 and 2019. The results for the three months ended March 31, 2020 and 2019 are not necessarily indicative of results to be expected for the year ending December 31, 2020, any other interim period, or any future year or period. Fair Value Measurements The Company’s financial instruments have consisted of cash and cash equivalents, tax credit and other receivables, accounts payable, accrued expenses and obligation for loan success fee (Note 6). Fair instruments. Current accounting guidance defines fair value, establishes a framework for measuring fair value in accordance with Accounting Standards Codification (“ASC”) 820, Fair Value Measurements and Disclosures Level 1—Observable inputs—quoted prices in active markets for identical assets and liabilities. Level 2—Observable inputs other than the quoted prices in active markets for identical assets and liabilities—such as quoted prices for similar instruments, quoted prices for identical or similar instruments in inactive markets, or other inputs that are observable or can be corroborated by observable market data. Level 3—Unobservable inputs—includes amounts derived from valuation models where one or more significant inputs are unobservable and require the company to develop relevant assumptions. There were no fair value financial assets or liabilities as of March 31, 2020. The following table represents a roll-forward of the fair value of Level 3 instruments (significant unobservable inputs): Financial liabilities Beginning balance at January 1, 2019 (1) $ 1,556 Unrealized loss on Series C redeemable convertible preferred stock liability — Unrealized loss on obligation for loan success fee 215 Net settlements (2) (1,771 ) Ending balance at December 31, 2019 $ — (1) The balance at January 1, 2019 relates to the $460 obligation for the loan success fee and the $1,096 fair value of the Series C redeemable convertible preferred stock liability at the time of the third tranche of the Series C Preferred Stock financing in January 2019. ( 2 ) The net settlements for the year ended December 31, 2019 relate to the $1,096 fair value of the Series C redeemable convertible preferred stock liability at the time of the third tranche of the Series C Preferred Stock financing in January 2019 and the payment of the $675 obligation for the loan success fee in May 2019. Deferred Offering Costs The Company capitalizes certain legal, professional, accounting and other third-party fees that are directly associated with in-process equity financings as deferred offering costs until such financings are consummated. After consummation of an equity financing, these costs are recorded in stockholders’ equity (deficit) as a reduction of additional paid-in capital generated as a result of the offering. Should the planned equity financing no longer be considered probable of being consummated, the deferred offering costs are expensed immediately as a charge to operating expenses. Basic and Diluted Net Income (Loss) per Common Share Basic and diluted net loss per common share outstanding is determined by dividing net loss, as adjusted for accretion and accrued dividends on redeemable convertible preferred stock, by the weighted average common shares outstanding during the period. For all periods presented, outstanding shares of Series A redeemable convertible preferred stock (“Series A Preferred Stock”), shares of Series B redeemable convertible preferred stock (“Series B Preferred Stock”), shares of Series C Preferred Stock, if any, and shares issuable upon exercise of stock options have been excluded from the calculation because their effects would be anti-dilutive. Therefore, the weighted average common shares used to calculate both basic and diluted net loss per share are the same for each of the periods presented. Recently Adopted Accounting Pronouncements There have been no new accounting pronouncements adopted during the three months ended March 31, 2020. Recently Issued Accounting Pronouncements There have been no new accounting pronouncements during the three months ended March 31, 2020, as compared to the recent accounting pronouncements described in Note 2 to the Company’s audited consolidated financial statements for the year ended December 31, 2019 included in the Annual Report on Form 10-K, which could be expected to materially impact the Company’s unaudited Condensed Consolidated Financial Statements.

Prepaid Expenses

Prepaid Expenses	3 Months Ended
	Mar. 31, 2020
Prepaid Expense Current [Abstract]
Prepaid Expenses	3. Prepaid expenses consist of the following: As of March 31, 2020 As of December 31, 2019 Prepaid R&D payments $ 770 $ 1,113 Prepaid corporate insurance 151 491 Other 134 77 $ 1,055 $ 1,681

Leases

Leases	3 Months Ended
	Mar. 31, 2020
Leases [Abstract]
Leases	4. Leases Effective March 1, 2013, the Company entered into a lease for office space in New Haven, CT and commencing March 1, 2018, the Company entered into the First Amendment to the lease. The leased space approximates 5,600 square feet and the lease has a term of 60 months. The lease requires monthly payments ranging from approximately $10 to $11 through February 1, 2023 and provides for two designated months of free rent. The Company has the option to terminate the lease after 36 months by providing six months notice along with a payment to the landlord in an amount representing the unamortized cost of tenant improvements plus the unamortized broker’s commission, both of which had been paid by the landlord, and as defined in the agreement. Under ASC 842, the Company determines if an arrangement is a lease at its inception. If an operating lease has a term greater than one year, the lease is recognized in the balance sheet as a right-of-use asset and an operating lease liability at lease commencement. The Company elected the short-term lease practical expedient; therefore, if an operating lease has a term less than one year, the Company will not recognize the lease on its balance sheet. The operating right-of-use asset represents the Company’s right of use to an underlying asset for the term of the lease, and the operating liability represents the Company’s obligation to make lease payments arising from the lease. Operating lease right-of-use assets and operating lease liabilities are determined and recognized on the commencement date of the lease based on the present value of lease payments over the term of the lease. As the Company’s leases do not provide an implicit rate within the lease, the Company uses its incremental borrowing rate, which is updated periodically, based on information available at the commencement date of the lease to determine the present value of the lease payments. The incremental borrowing rate used on existing leases as of March 31, 2020 was 13.0%. The right-of-use asset also includes any lease payments related to initial direct costs and prepayments, and excludes lease incentives. Lease expense is recognized on a straight line basis over the lease term. The Company had no new leases during the three months ended March 31, 2020. The Company’s operating leases consist of real estate and equipment, and have remaining terms ranging from approximately 1 to 4 years. The Company has no financing leases. The following table summarizes the Company’s operating leases as presented on its Condensed Consolidated Balance Sheet: As of March 31, 2020 As of December 31, 2019 Assets: Operating lease right-of-use asset $ 292 $ 312 Liabilities: Operating lease liabilities, current portion 102 99 Operating lease liabilities, long term portion 230 257 Total operating lease liabilities $ 332 $ 356 Future minimum lease payments under the operating leases are as follows as of March 31, 2020: As of March 31, 2020 2020 $ 104 2021 138 2022 131 2023 24 Total lease payments 397 Less: imputed discount rate (65 ) Carrying value of operating lease liabilities $ 332 Lease expense under operating leases, including leases of office equipment, was $34 and $31 for the three months ended March 31, 2020 and 2019, respectively. Lease payments made in the three months ended March 31, 2020 and 2019 were $45 and $35, respectively, with such amounts reflected in the Condensed Consolidated Statement of Cash Flows in operating activities.

Accrued Expenses

Accrued Expenses	3 Months Ended
	Mar. 31, 2020
Payables And Accruals [Abstract]
Accrued Expenses	5. Accrued Expenses Accrued expenses consist of the following: As of March 31, 2020 As of December 31, 2019 Accrued research projects $ 3,736 $ 2,084 Accrued professional fees 388 338 Accrued compensation and benefits 565 776 Other 222 303 $ 4,911 $ 3,501

Term Loan Payable

Term Loan Payable	3 Months Ended
	Mar. 31, 2020
Debt Disclosure [Abstract]
Term Loan Payable	6. On December 29, 2014, the Company entered into a loan and security agreement (the “Loan Agreement”) with Solar Capital, Ltd. (“Solar”) and Square 1 Bank (“Square 1”), together (the “Lenders”), which provided $15.0 million in debt financing (the “Term Loan”). On June 29, 2018, the maturity date of the Loan Agreement, the Company made its final payments of principal and interest due to the Lenders in connection with the Term Loan, as well as $450 in full payment of the final fee and $82 in full payment of the amendment fee. As a result, there were no outstanding borrowings under the Term Loan as of March 31, 2020 or December 31, 2019, and the Company’s obligations to the Lenders under the Loan Agreement, other than the obligations under the Success Fee Agreement as described below, were terminated. Under the terms of the Loan Agreement, the Company was obligated to pay the Lenders a Success Fee (“Success Fee”) under a Success Fee Agreement (“Success Fee Agreement”) upon the first occurrence of an Exit Event, as defined. The Exit Event included, among other things, the completion of a public offering of common stock. The amount of the Success Fee was equal to 4.5% of the $15.0 million Term Loan funded. The Success Fee Agreement was scheduled to terminate on the earlier to occur of (a) payment in full of the Success Fee pursuant to its terms, or (b) December 29, 2021. The completion of the IPO on May 9, 2019 (see Note 1) triggered the Success Fee payment obligation and the Company made payments to its Lenders totaling $675 in May 2019. Upon such payments, the Success Fee Agreement terminated. The Success Fee Agreement represented a free-standing financial instrument. Accordingly, the Company accounted for the Success Fee provision as a derivative under ASC 815, Derivatives and Hedging, and therefore recorded an obligation for the Success Fee at its fair value on the closing date of each advance under the Loan Agreement. Upon recording such obligations for the Success Fee, the Company also recorded an offsetting loan discount, which was accreted to interest expense in the Company’s Statements of Operations through the Term Loan’s maturity date. The Company adjusted these liabilities for the Success Fee to fair value at each reporting date they remained outstanding. As discussed above, the Success Fee was paid in May 2019; and therefore, the total fair value of the Success Fee liabilities was $0 at March 31, 2020

Common Stock

Common Stock	3 Months Ended
	Mar. 31, 2020
Common Stock Number Of Shares Par Value And Other Disclosures [Abstract]
Common Stock	7. Common Stock As of March 31, 2020 and December 31, 2019, the Company’s certificate of incorporation, as amended and restated, authorized the Company to issue 200,000,000 shares of common stock, respectively, with a par value of $0.001 per share. As of March 31, 2020 and December 31, 2019, the Company had reserved 3,670,540 shares and 2,778,812 shares of common stock, respectively, for the exercise of outstanding stock options and the number of shares of common stock remaining available for future stock-based awards under the Company’s 2012 Stock Incentive Plan, 2019 Stock Incentive Plan and 2019 Employee Stock Purchase Plan, as shown in the table below ( Note 8 March 31, 2020 December 31, 2019 Shares of common stock reserved for future issuance under the 2012 Stock Incentive Plan 1,043,992 1,043,992 Shares of common stock reserved for future issuance under the 2019 Stock Incentive Plan 2,293,097 1,579,714 Shares of common stock reserved for future issuance under the 2019 Employee Stock Purchase Plan 333,451 155,106 3,670,540 2,778,812

Stock-Based Awards

Stock-Based Awards	3 Months Ended
	Mar. 31, 2020
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Stock-Based Awards	8 . Stock-Based Awards In April 2019, the Company’s board of directors adopted the 2019 Stock Incentive Plan (the “2019 Plan”), which became effective on May 7, 2019. The 2019 Plan provides for the grant of incentive stock options, nonstatutory stock options, stock appreciation rights, restricted stock awards, restricted stock units and other stock-based awards. The Company’s employees, officers, directors, consultants and advisors are eligible to receive awards under the 2019 Plan. The 2019 Plan is administered by the Company’s board of directors. As of March 31, 2020, awards may be made under the 2019 Plan for up to such number of shares of the Company’s common stock as is equal to the sum of i) 1,578,947 shares; plus ii) the number of shares (up to 1,157,894 shares) equal to the number of shares of the Company’s common stock subject to outstanding awards under the Company’s 2012 Stock Incentive Plan (the “2012 Plan”), as amended that expire, terminate or are otherwise cancelled, forfeited or repurchased by the Company at their original issuance price pursuant to a contractual repurchase right; plus iii) an annual increase to be added on the first day of each fiscal year, beginning with 2020 and continuing through 2029, equal to the least of (a) 2,105,623 shares of common stock, (b) 4% of the number of outstanding shares of the Company’s common stock on such date, and (c) an amount determined by the Company’s board of directors. The number of shares reserved for issuance under the 2019 Plan increased, pursuant to the terms of the 2019 Plan, by an additional 713,383 shares, equal to 4% of the Company’s then-outstanding Common Stock, effective as of January 1, 2020. The 2012 Plan was adopted by the Company’s board of directors and stockholders. The Company’s board of directors administers the 2012 Plan. The 2012 Plan provides for the issuance of stock-based awards to the Company’s employees, officers and directors, as well as non-employee/consultants and advisors to the Company. Options granted under the 2019 Plan and the 2012 Plan have a maximum term of ten years. Options vest over four years based on varying vesting schedules including: 25% vesting on the first anniversary date of grant and the balance ratably over the next 36 months or vesting in equal monthly or quarterly installments over four years. As of March 31, 2020 and December 31, 2019, respectively, options to purchase 1,161,543 shares and 631,234 shares of common stock were granted and outstanding, net of cancelations, under the 2019 Plan. As of March 31, 2020 and December 31, 2019, respectively, options to purchase 1,043,992 shares of common stock were granted and outstanding, net of cancelations, under the 2012 Plan. In April 2019, the Company’s board of directors adopted a resolution effective on May 7, 2019 that no further stock options or other equity-based awards may be granted under the 2012 Plan. During the three months ended March 31, 2019, no stock options were granted. During the three months ended March 31, 2019, options granted were exercised for 7,894 shares of common stock. During the three months ended March 31, 2019, stock options to purchase 10,197 shares of the Company’s common stock were forfeited. A summary of the Company’s combined stock option activity for the 2019 Plan and the 2012 Plan for the three months ended March 31, 2020 is as follows: Number of Option Shares Weighted Average Exercise Price Weighted Average Contractual Term Aggregate Intrinsic Value (in years) (in thousands) Outstanding as of December 31, 2019 1,675,226 $ 6.20 7.8 $ 864 Granted 530,309 $ 5.50 Forfeited — $ — Expired — $ — Exercised — $ — Outstanding as of March 31, 2020 2,205,535 $ 6.03 8.1 $ 512 Options exercisable as of March 31, 2020 742,947 $ 3.34 6.0 $ 502 Options unvested as of March 31, 2020 1,462,588 $ 7.40 9.2 $ 10 The following table summarizes the classifications of stock-based compensation expenses for the 2012 Plan and the 2019 Plan recognized in the Condensed Consolidated Statements of Operations: Three Months Ended March 31, 2020 2019 Research and development expense $ 93 $ 22 General and administrative expense 637 124 $ 730 $ 146 In April 2019, the Company’s board of directors adopted the 2019 Employee Stock Purchase Plan (the “2019 ESPP”), which became effective on May 7, 2019. The 2019 ESPP is administered by the Company’s board of directors. As of March 31, 2020, there has been no activity under the 2019 ESPP. As of March 31, 2020, the number of shares of the Company’s common stock that has been reserved to be issued under the 2019 ESPP is equal to the sum of i) 155,106 shares plus ii) an annual increase to be added on the first day of each fiscal year, beginning with the fiscal year ending December 31, 2020 and continuing for each fiscal year until, and including, the fiscal year ending December 31, 2029, equal to the least of (a) 526,315 shares of common stock, (b) 1% of the number of outstanding shares of the Company’s common stock on such date, and (c) an amount determined by the Company’s board of directors. The number of shares of the Company’s common stock reserved for issuance under the 2019 ESPP increased, pursuant to the terms of the 2019 ESPP, by an additional 178,345 shares, equal to 1% of the Company’s then-outstanding common stock, effective as of January 1, 2020. All of the Company’s employees are eligible to participate in the 2019 ESPP, provided that: • such person is customarily employed by the Company for more than 20 hours a week and for more than five months in a calendar year; • such person has been employed by the Company for at least three months prior to enrolling in the 2019 ESPP; and • such person was an employee of the Company on the first day of the applicable offering period under the 2019 ESPP.

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2020
Income Tax Disclosure [Abstract]
Income Taxes	9 . During the three months ended March 31, 2020 and 2019, the Company maintained a full valuation allowance on deferred tax assets. Therefore, the Company has not recorded a provision for income taxes.

Net Loss per Share

Net Loss per Share	3 Months Ended
	Mar. 31, 2020
Earnings Per Share [Abstract]
Earnings Per Share	1 0 . The following table summarizes the computation of basic and diluted net loss per share attributable to common stockholders of the Company: Three Months Ended March 31, 2020 2019 Net loss $ (8,473 ) $ (4,802 ) Plus: Accretion of redeemable convertible preferred stock — 203 Plus: Dividends accrued on redeemable convertible preferred stock — (1,553 ) Adjusted net loss attributable to common stockholders $ (8,473 ) $ (6,152 ) Weighted average common shares used in net loss per share attributable to common stockholders, basic and diluted 17,834,570 444,132 Basic and diluted net loss per common share outstanding $ (0.48 ) $ (13.85 ) Accretion and dividends included in the table above were calculated through the IPO date. The Company’s potential dilutive securities, which include stock options and redeemable convertible preferred stock, have been excluded from the computation of diluted net loss per share attributable to common stockholders whenever the effect of including them would be to reduce the net loss per share. In periods where there is a net loss, the weighted average number of common shares outstanding used to calculate both basic and diluted net loss per share attributable to common stockholders is the same. The following potential common shares, presented based on shares outstanding as of March 31, 2020 and 2019, were excluded from the calculation of diluted net loss per share attributable to common stockholders for the periods indicated because including them would have had an anti-dilutive effect: Shares as of March 31, 2020 2019 Series A redeemable convertible preferred stock — 15,387,923 Series B redeemable convertible preferred stock — 22,608,695 Series C redeemable convertible preferred stock — 44,946,987 Outstanding stock options 2,205,535 1,059,057 2,205,535 84,002,662

Collaborative and Licensing Agr

Collaborative and Licensing Agreements	3 Months Ended
	Mar. 31, 2020
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Collaborative and Licensing Agreements	1 1 . The Company enters into collaborative and licensing agreements with pharmaceutical companies to in-license, develop, manufacture and/or market products that fit within its business strategy. Endo Pharmaceuticals Inc. In May 2011, the Company entered into an agreement with Penwest Pharmaceuticals Co. (“Penwest”) (subsequently merged into its parent, Endo Pharmaceuticals Inc. (“Endo”)) for an exclusive worldwide sublicensable license under certain patent rights and know-how controlled by Penwest to develop and commercialize products incorporating nalbuphine hydrochloride in any formulation, including an extended release formulation such as nalbuphine ER, in all fields and for any use. Under the license agreement, the Company paid Penwest a non-creditable, non-refundable upfront license fee of $25. The Company may also become obligated to make milestone payments to Endo of $250, which would become due upon the successful completion of the first Phase 3 clinical trial of a licensed product candidate, such as the PRISM trial, and $750, which would become due upon the marketing approval of a licensed product in the United States, and to pay mid-single-digit royalties based on net sales of the licensed products by the Company, its affiliates and sublicensees. In addition, the Company is obligated to pay Endo a low-to-mid double-digit percentage of certain income it receives from sublicensees, based on the date of the definitive agreement under which the sublicense was granted. The Company’s royalty obligation with respect to each licensed product in each country commences upon the first commercial sale of the product in that country and extends until the later of the expiration, unenforceability or invalidation of the last valid claim of any licensed patent or application covering the licensed product in the country or the expiration of 10 years after the first commercial sale of the licensed product in the country, which period is referred to as the royalty term. Upon the expiration of the royalty term for a product in a country, the Company is thereafter obligated to pay a low single-digit know-how and trademark royalty. Under the agreement, the Company has granted Endo a non-exclusive, royalty-free (except for pass-through payments to third parties), sublicensable license under its relevant patent rights, to use any improvement the Company makes to Endo’s controlled release technology, for any product other than the products under which it is licensed by Endo. Both the Company and Endo have the right to terminate the agreement if the other party materially breaches the agreement and fails to cure the breach within specified cure periods. Endo also has the right to terminate in the event the Company undergoes specified bankruptcy, insolvency or liquidation events, and the Company has the right to terminate the agreement at its convenience at any time on 180 days’ notice to Endo. Additionally, if the Company or any of the Company’s sublicensees challenge the validity or enforceability of any licensed patent rights covering a licensed product, and that challenge is not terminated within a specified period, the agreement will immediately terminate and all licenses granted under the agreement shall be revoked. Upon termination of the agreement, the Company must transfer to Endo all regulatory filings and approvals relating to the development, manufacture or commercialization of the licensed products and all trademarks, other than the Company’s corporate trademarks, then being used in connection with the licensed products. If the agreement is terminated under certain specified circumstances, the Company will be deemed to have granted Endo a perpetual, royalty-free (except for pass-through payments to third parties), worldwide, exclusive, sublicensable license, under any improvements the Company made to the licensed know-how, and any related patent rights the Company has, to manufacture and commercialize the licensed products. Exclusive License Agreement with Rutgers On November 6, 2018, the Company entered into an agreement with Rutgers, The State University of New Jersey (“Rutgers”) for an exclusive, worldwide, sublicensable license under certain patent rights controlled by Rutgers and for a non-exclusive, worldwide, sublicensable license under certain know-how controlled by Rutgers, in each case to develop and commercialize products incorporating nalbuphine for any human or animal use. Upon entering into the license agreement, the Company paid Rutgers a minimal upfront license issue fee, which was recorded as R&D expense in 2018 and agreed to pay Rutgers a minimal annual license fee. The Company may become obligated to make milestone payments to Rutgers in the aggregate of up to $331 based on the achievement of certain clinical, regulatory and sales milestones. The Company has also agreed to pay Rutgers a low single-digit percentage of certain income it receives from sublicensees and to pay tiered low single-digit royalties based on net sales of licensed products by the Company and its affiliates and sublicensees. The Company’s royalty obligation with respect to each licensed product in each country commences on the date of the first commercial sale of the licensed product in that country following receipt of marketing approval and extends until the later of the date of expiration, unenforceability or invalidation of the last valid claim of any licensed patent or patent application covering the licensed product in the country and 10 years after the first commercial sale of the first licensed product sold anywhere in the world, which period is referred to as the royalty term. Upon the expiration of the royalty term for a licensed product in a country, the license granted to the Company under the agreement shall become perpetual, fully paid-up, irrevocable and royalty-free in such country. The royalty is subject to reduction in certain circumstances. Restructuring Agreement with MentiNova, LLC On November 6, 2018, concurrent with the signing of the agreement with Rutgers described above, the Company entered into a restructuring agreement with MentiNova, LLC (“MentiNova”) for the purchase of specified information and know-how, specified contractual rights and benefits, and all books and records of MentiNova related thereto (collectively, the “Acquired Assets”). Upon entering into the license agreement, the Company paid MentiNova an aggregate upfront payment of $119, which was recorded as R&D expense in 2018, subject to specified closing adjustments. The Company may become obligated to make milestone payments to MentiNova in the aggregate of up to $1,188 based on the achievement of certain clinical and regulatory milestones as well as tiered low single-digit royalties based on net sales of products containing nalbuphine as the sole active pharmaceutical ingredient that are developed by the Company using the Acquired Assets or the intellectual property licensed to the Company under the Rutgers agreement described above (the “Rutgers IP”) for indications that are within the scope of the Rutgers IP. The royalty is subject to reduction in certain circumstances.

Commitments and Contingencies

Commitments and Contingencies	3 Months Ended
	Mar. 31, 2020
Commitments And Contingencies Disclosure [Abstract]
Commitments and Contingencies	1 2 . Commitments and Contingencies A significant portion of the Company’s development activities are outsourced to third parties under agreements, including with clinical research organizations, and contract manufacturers in connection with the production of clinical trial materials. These arrangements may require the Company to pay termination costs to the third parties for reimbursement of costs and expenses incurred in the event of the orderly termination of contractual services. The Company also has commitments under lease and licensing agreements (Note 4 and Note 11).

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2020
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The accompanying unaudited interim condensed consolidated financial statements for the three months ended March 31, 2020 and 2019 included herein, have been prepared in accordance with accounting principles generally accepted in the United States of America (“GAAP”) for interim financial information and to the rules and regulations of the Securities and Exchange Commission (“SEC”) for interim information. Certain information and footnote disclosure typically prepared in accordance with GAAP have been condensed or omitted pursuant to SEC rules and regulations. The accompanying unaudited condensed consolidated financial statements and notes should be read in conjunction with the audited consolidated financial statements and related notes for the year ended December 31, 2019 included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2019 (the “Annual Report on Form 10-K”). In the opinion of management, the unaudited condensed consolidated financial statements reflect all adjustments, which include normal recurring adjustments necessary for the fair presentation of the Company’s interim financial statements presented. The results of operations for the interim periods are not necessarily indicative of the results expected for the full year or any subsequent period. The accompanying Condensed Consolidated Financial Statements include the accounts of Trevi Therapeutics, Inc. and its wholly-owned subsidiary Trevi Therapeutics Limited. Intercompany balances and transactions have been eliminated. All amounts presented are in thousands of dollars, except share and per share amounts, unless noted otherwise. The Company has evaluated events occurring subsequent to March 31, 2020 for potential recognition or disclosure in the Condensed Consolidated Financial Statements and concluded there were no subsequent events that required recognition or disclosure other than those provided.
Use of Estimates	Use of Estimates The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities at the date of the financial statements and the reported amounts of the expenses during the reporting periods. Significant estimates and assumptions reflected in these Condensed Consolidated Financial Statements include, but are not limited to the recognition of research and development (“R&D”) expenses and the valuation of redeemable convertible preferred stock, common stock and stock-based awards. On an ongoing basis, management evaluates its estimates in light of changes in circumstances, facts and experience. Changes in estimates are recorded in the period in which they become known. Actual results could differ from those estimates.
Unaudited Interim Financial Information	Unaudited Interim Financial Information The accompanying interim Condensed Consolidated Balance Sheet as of March 31, 2020, the Condensed Consolidated Statements of Operations and the Condensed Consolidated Statements of Redeemable Convertible Preferred Stock and Stockholders’ Equity (Deficit) for the three months ended March 31, 2020 and 2019, and the Condensed Consolidated Statements of Cash Flows for the three months ended March 31, 2020 and 2019 are unaudited. The unaudited interim Condensed Consolidated Financial Statements have been prepared on the same basis as the audited annual consolidated financial statements and, in the Company’s opinion, reflect all adjustments, which include only normal recurring adjustments, necessary for the fair statements of its financial position as of March 31, 2020, the results of its operations for the three months ended March 31, 2020 and 2019, and its cash flows for the three months ended March 31, 2020 and 2019. The results for the three months ended March 31, 2020 and 2019 are not necessarily indicative of results to be expected for the year ending December 31, 2020, any other interim period, or any future year or period.
Fair Value Measurements	Fair Value Measurements The Company’s financial instruments have consisted of cash and cash equivalents, tax credit and other receivables, accounts payable, accrued expenses and obligation for loan success fee (Note 6). Fair instruments. Current accounting guidance defines fair value, establishes a framework for measuring fair value in accordance with Accounting Standards Codification (“ASC”) 820, Fair Value Measurements and Disclosures Level 1—Observable inputs—quoted prices in active markets for identical assets and liabilities. Level 2—Observable inputs other than the quoted prices in active markets for identical assets and liabilities—such as quoted prices for similar instruments, quoted prices for identical or similar instruments in inactive markets, or other inputs that are observable or can be corroborated by observable market data. Level 3—Unobservable inputs—includes amounts derived from valuation models where one or more significant inputs are unobservable and require the company to develop relevant assumptions. There were no fair value financial assets or liabilities as of March 31, 2020. The following table represents a roll-forward of the fair value of Level 3 instruments (significant unobservable inputs): Financial liabilities Beginning balance at January 1, 2019 (1) $ 1,556 Unrealized loss on Series C redeemable convertible preferred stock liability — Unrealized loss on obligation for loan success fee 215 Net settlements (2) (1,771 ) Ending balance at December 31, 2019 $ — (1) The balance at January 1, 2019 relates to the $460 obligation for the loan success fee and the $1,096 fair value of the Series C redeemable convertible preferred stock liability at the time of the third tranche of the Series C Preferred Stock financing in January 2019. ( 2 ) The net settlements for the year ended December 31, 2019 relate to the $1,096 fair value of the Series C redeemable convertible preferred stock liability at the time of the third tranche of the Series C Preferred Stock financing in January 2019 and the payment of the $675 obligation for the loan success fee in May 2019.
Deferred Offering Costs	Deferred Offering Costs The Company capitalizes certain legal, professional, accounting and other third-party fees that are directly associated with in-process equity financings as deferred offering costs until such financings are consummated. After consummation of an equity financing, these costs are recorded in stockholders’ equity (deficit) as a reduction of additional paid-in capital generated as a result of the offering. Should the planned equity financing no longer be considered probable of being consummated, the deferred offering costs are expensed immediately as a charge to operating expenses.
Basic and Diluted Net Income (Loss) per Common Share	Basic and Diluted Net Income (Loss) per Common Share Basic and diluted net loss per common share outstanding is determined by dividing net loss, as adjusted for accretion and accrued dividends on redeemable convertible preferred stock, by the weighted average common shares outstanding during the period. For all periods presented, outstanding shares of Series A redeemable convertible preferred stock (“Series A Preferred Stock”), shares of Series B redeemable convertible preferred stock (“Series B Preferred Stock”), shares of Series C Preferred Stock, if any, and shares issuable upon exercise of stock options have been excluded from the calculation because their effects would be anti-dilutive. Therefore, the weighted average common shares used to calculate both basic and diluted net loss per share are the same for each of the periods presented.
Recently Adopted Accounting Pronouncements	Recently Adopted Accounting Pronouncements There have been no new accounting pronouncements adopted during the three months ended March 31, 2020. Recently Issued Accounting Pronouncements There have been no new accounting pronouncements during the three months ended March 31, 2020, as compared to the recent accounting pronouncements described in Note 2 to the Company’s audited consolidated financial statements for the year ended December 31, 2019 included in the Annual Report on Form 10-K, which could be expected to materially impact the Company’s unaudited Condensed Consolidated Financial Statements.

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	3 Months Ended
	Mar. 31, 2020
Accounting Policies [Abstract]
Schedule of Fair Value, Financial Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation	The following table represents a roll-forward of the fair value of Level 3 instruments (significant unobservable inputs): Financial liabilities Beginning balance at January 1, 2019 (1) $ 1,556 Unrealized loss on Series C redeemable convertible preferred stock liability — Unrealized loss on obligation for loan success fee 215 Net settlements (2) (1,771 ) Ending balance at December 31, 2019 $ — (1) The balance at January 1, 2019 relates to the $460 obligation for the loan success fee and the $1,096 fair value of the Series C redeemable convertible preferred stock liability at the time of the third tranche of the Series C Preferred Stock financing in January 2019. ( 2 ) The net settlements for the year ended December 31, 2019 relate to the $1,096 fair value of the Series C redeemable convertible preferred stock liability at the time of the third tranche of the Series C Preferred Stock financing in January 2019 and the payment of the $675 obligation for the loan success fee in May 2019.

Prepaid Expenses (Tables)

Prepaid Expenses (Tables)	3 Months Ended
	Mar. 31, 2020
Prepaid Expense Current [Abstract]
Schedule of Prepaid Expenses	Prepaid expenses consist of the following: As of March 31, 2020 As of December 31, 2019 Prepaid R&D payments $ 770 $ 1,113 Prepaid corporate insurance 151 491 Other 134 77 $ 1,055 $ 1,681

Leases (Tables)

Leases (Tables)	3 Months Ended
	Mar. 31, 2020
Leases [Abstract]
Schedule of Balance Sheet Information Related to Operating Leases	The following table summarizes the Company’s operating leases as presented on its Condensed Consolidated Balance Sheet: As of March 31, 2020 As of December 31, 2019 Assets: Operating lease right-of-use asset $ 292 $ 312 Liabilities: Operating lease liabilities, current portion 102 99 Operating lease liabilities, long term portion 230 257 Total operating lease liabilities $ 332 $ 356
Future Minimum Lease Payments for Non-cancellable Operating Leases	Future minimum lease payments under the operating leases are as follows as of March 31, 2020: As of March 31, 2020 2020 $ 104 2021 138 2022 131 2023 24 Total lease payments 397 Less: imputed discount rate (65 ) Carrying value of operating lease liabilities $ 332

Accrued Expenses (Tables)

Accrued Expenses (Tables)	3 Months Ended
	Mar. 31, 2020
Payables And Accruals [Abstract]
Schedule of Accrued Expenses	Accrued expenses consist of the following: As of March 31, 2020 As of December 31, 2019 Accrued research projects $ 3,736 $ 2,084 Accrued professional fees 388 338 Accrued compensation and benefits 565 776 Other 222 303 $ 4,911 $ 3,501

Common Stock (Tables)

Common Stock (Tables)	3 Months Ended
	Mar. 31, 2020
Common Stock Number Of Shares Par Value And Other Disclosures [Abstract]
Schedule of Common Stock Reserved for Future Issuance	As of March 31, 2020 and December 31, 2019, the Company had reserved 3,670,540 shares and 2,778,812 shares of common stock, respectively, for the exercise of outstanding stock options and the number of shares of common stock remaining available for future stock-based awards under the Company’s 2012 Stock Incentive Plan, 2019 Stock Incentive Plan and 2019 Employee Stock Purchase Plan, as shown in the table below ( Note 8 March 31, 2020 December 31, 2019 Shares of common stock reserved for future issuance under the 2012 Stock Incentive Plan 1,043,992 1,043,992 Shares of common stock reserved for future issuance under the 2019 Stock Incentive Plan 2,293,097 1,579,714 Shares of common stock reserved for future issuance under the 2019 Employee Stock Purchase Plan 333,451 155,106 3,670,540 2,778,812

Stock-Based Awards (Tables)

Stock-Based Awards (Tables)	3 Months Ended
	Mar. 31, 2020
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Schedule of Share-based Compensation, Stock Options, Activity	A summary of the Company’s combined stock option activity for the 2019 Plan and the 2012 Plan for the three months ended March 31, 2020 is as follows: Number of Option Shares Weighted Average Exercise Price Weighted Average Contractual Term Aggregate Intrinsic Value (in years) (in thousands) Outstanding as of December 31, 2019 1,675,226 $ 6.20 7.8 $ 864 Granted 530,309 $ 5.50 Forfeited — $ — Expired — $ — Exercised — $ — Outstanding as of March 31, 2020 2,205,535 $ 6.03 8.1 $ 512 Options exercisable as of March 31, 2020 742,947 $ 3.34 6.0 $ 502 Options unvested as of March 31, 2020 1,462,588 $ 7.40 9.2 $ 10
Schedule of Stock-based Compensation Expenses Recognized	The following table summarizes the classifications of stock-based compensation expenses for the 2012 Plan and the 2019 Plan recognized in the Condensed Consolidated Statements of Operations: Three Months Ended March 31, 2020 2019 Research and development expense $ 93 $ 22 General and administrative expense 637 124 $ 730 $ 146

Net Loss per Share (Tables)

Net Loss per Share (Tables)	3 Months Ended
	Mar. 31, 2020
Earnings Per Share [Abstract]
Schedule of Earnings Per Share, Basic and Diluted	The following table summarizes the computation of basic and diluted net loss per share attributable to common stockholders of the Company: Three Months Ended March 31, 2020 2019 Net loss $ (8,473 ) $ (4,802 ) Plus: Accretion of redeemable convertible preferred stock — 203 Plus: Dividends accrued on redeemable convertible preferred stock — (1,553 ) Adjusted net loss attributable to common stockholders $ (8,473 ) $ (6,152 ) Weighted average common shares used in net loss per share attributable to common stockholders, basic and diluted 17,834,570 444,132 Basic and diluted net loss per common share outstanding $ (0.48 ) $ (13.85 )
Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share	The following potential common shares, presented based on shares outstanding as of March 31, 2020 and 2019, were excluded from the calculation of diluted net loss per share attributable to common stockholders for the periods indicated because including them would have had an anti-dilutive effect: Shares as of March 31, 2020 2019 Series A redeemable convertible preferred stock — 15,387,923 Series B redeemable convertible preferred stock — 22,608,695 Series C redeemable convertible preferred stock — 44,946,987 Outstanding stock options 2,205,535 1,059,057 2,205,535 84,002,662

Nature of the Business - Additi

Nature of the Business - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Thousands	May 09, 2019	Apr. 22, 2019	Mar. 31, 2020	Mar. 31, 2019	Dec. 31, 2019
Stockholders equity reverse stock split		one-for 9.5
Net income loss			$ (8,473)	$ (4,802)	$ (26,100)
Retained earnings accumulated deficit			(122,692)		(114,219)
Cash and cash equivalents, at carrying value			$ 52,640		$ 57,313
IPO [Member]
Sale of stock during the period	7,000,000
Share price	$ 10
Proceeds from public offering	$ 62,100
Underwriting discounts and commissions	4,900
Other offering expenses	$ 3,000

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Additional Information (Detail) - USD ($)		Dec. 31, 2018	May 31, 2019	Dec. 31, 2019	Mar. 31, 2020
Fair Value, Assets and Liabilities Measured on Recurring Basis [Line Items]
Loan success fee payable		$ 460,000	$ 675,000
Series C Convertible Preferred Stock [Member]
Fair Value, Assets and Liabilities Measured on Recurring Basis [Line Items]
Settlements of fair value liability		$ 1,096,000		$ 1,096,000
Fair Value, Measurements, Recurring [Member]
Fair Value, Assets and Liabilities Measured on Recurring Basis [Line Items]
Financial assets					$ 0
Financial liabilities					$ 0
Settlements of fair value liability	[1]			$ (1,771,000)
[1]	The net settlements for the year ended December 31, 2019 relate to the $1,096 fair value of the Series C redeemable convertible preferred stock liability at the time of the third tranche of the Series C Preferred Stock financing in January 2019 and the payment of the $675 obligation for the loan success fee in May 2019.

Summary of Significant Accoun_5

Summary of Significant Accounting Policies - Schedule of Fair Value, Financial Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation (Detail) - Fair Value, Measurements, Recurring [Member] $ in Thousands	12 Months Ended
	Dec. 31, 2019USD ($)
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Beginning balance at January 1, 2019	$ 1,556	[1]
Net settlements	(1,771)	[2]
Ending balance at December 31, 2019
Obligations [Member]
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Unrealized loss on financial liabilities	$ 215
[1]	The balance at January 1, 2019 relates to the $460 obligation for the loan success fee and the $1,096 fair value of the Series C redeemable convertible preferred stock liability at the time of the third tranche of the Series C Preferred Stock financing in January 2019.
[2]	The net settlements for the year ended December 31, 2019 relate to the $1,096 fair value of the Series C redeemable convertible preferred stock liability at the time of the third tranche of the Series C Preferred Stock financing in January 2019 and the payment of the $675 obligation for the loan success fee in May 2019.

Prepaid Expenses - Schedule of

Prepaid Expenses - Schedule of Prepaid Expenses (Detail) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Prepaid Expense Current [Abstract]
Prepaid R&D payments	$ 770	$ 1,113
Prepaid corporate insurance	151	491
Other	134	77
Prepaid expense	$ 1,055	$ 1,681

Leases - Additional Information

Leases - Additional Information (Detail) $ in Thousands	Mar. 01, 2018USD ($)ft²	Mar. 31, 2020USD ($)Lease	Mar. 31, 2019USD ($)
Operating lease, weighted average discount rate, percent		13.00%
Number of new leases | Lease		0
Operating Lease, Payments		$ 45	$ 35
Minimum [Member]
Remaining terms ranging		1 year
Maximum [Member]
Remaining terms ranging		4 years
Building [Member]
Leased spaced area | ft²	5,600
Operating lease term	60 months
Lessee, operating lease, existence of option to terminate		true
Operating lease option to terminate		The Company has the option to terminate the lease after 36 months by providing six months notice along with a payment to the landlord in an amount representing the unamortized cost of tenant improvements plus the unamortized broker’s commission, both of which had been paid by the landlord, and as defined in the agreement.
Building [Member] | Minimum [Member]
Operating lease rent expense	$ 10
Building [Member] | Maximum [Member]
Operating lease rent expense	$ 11
Office Equipment [Member]
Operating lease rent expense		$ 34	$ 31

Leases - Schedule of Balance Sh

Leases - Schedule of Balance Sheet Operating Leases (Detail) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Assets:
Operating lease right-of-use asset	$ 292	$ 312
Liabilities:
Operating lease liabilities, current portion	102	99
Operating lease liabilities, long term portion	230	257
Total operating lease liabilities	$ 332	$ 356

Leases - Future Minimum Lease P

Leases - Future Minimum Lease Payments (Detail) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Leases [Abstract]
2020	$ 104
2021	138
2022	131
2023	24
Total lease payments	397
Less: imputed discount rate	(65)
Carrying value of operating lease liabilities	$ 332	$ 356

Accrued Expenses - Schedule of

Accrued Expenses - Schedule of Accrued Expenses (Detail) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Payables And Accruals [Abstract]
Accrued research projects	$ 3,736	$ 2,084
Accrued professional fees	388	338
Accrued compensation and benefits	565	776
Other	222	303
Total Accrued expenses	$ 4,911	$ 3,501

Term Loan Payable - Additional

Term Loan Payable - Additional Information (Detail) - USD ($)	Dec. 31, 2018	Jun. 29, 2018	Dec. 29, 2014	May 31, 2019	Mar. 31, 2020	Mar. 31, 2019	Dec. 31, 2019
Loan success fee payable	$ 460,000			$ 675,000
Fair value of success fee liabilities					$ 0	$ 512,000
Non cash charges					0	$ 52,000
Term Loan [Member]
Line of credit facility, maximum borrowing capacity			$ 15,000,000
Payment of final fee		$ 450,000
Payment of amendment fee		$ 82,000
Line of credit facility, outstanding borrowings					$ 0		$ 0
Loan success fee, as percentage of term loan funded			4.50%
Term loan A [Member]
Loan success fee payable				$ 675,000

Common Stock - Additional Infor

Common Stock - Additional Information (Detail) - $ / shares	Mar. 31, 2020	Dec. 31, 2019
Common Stock Number Of Shares Par Value And Other Disclosures [Abstract]
Common stock, shares authorized	200,000,000	200,000,000
Common stock, par or stated value per share	$ 0.001	$ 0.001
Common stock, capital shares reserved for future issuance	3,670,540	2,778,812

Common Stock - Shares Reserved

Common Stock - Shares Reserved For Future Issuances (Detail) - shares	Mar. 31, 2020	Dec. 31, 2019
Common Stock Reserved For Issuances In The Future Upon Conversion Of Preferred Stock [Line Items]
Common Stock, Capital Shares Reserved for Future Issuance	3,670,540	2,778,812
2012 Stock Option And Grant Plan [Member] | 2012 Stock Incentive Plan [Member]
Common Stock Reserved For Issuances In The Future Upon Conversion Of Preferred Stock [Line Items]
Common Stock, Capital Shares Reserved for Future Issuance	1,043,992	1,043,992
2019 Stock Option And Grant Plan [Member] | 2019 Stock Incentive Plan [Member]
Common Stock Reserved For Issuances In The Future Upon Conversion Of Preferred Stock [Line Items]
Common Stock, Capital Shares Reserved for Future Issuance	2,293,097	1,579,714
2019 Stock Option And Grant Plan [Member] | 2019 Employee Stock Purchase Plan [Member]
Common Stock Reserved For Issuances In The Future Upon Conversion Of Preferred Stock [Line Items]
Common Stock, Capital Shares Reserved for Future Issuance	333,451	155,106

Stock-Based Awards - Additional

Stock-Based Awards - Additional Information (Detail) - shares	Jan. 01, 2020	Apr. 30, 2019	Mar. 31, 2020	Mar. 31, 2019	Dec. 31, 2019
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Common stock, capital shares reserved for future issuance			3,670,540		2,778,812
Share based compensation options to purchase no of common stock			2,205,535		1,675,226
Share based compensation options grants in the period			530,309
Common Stock [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Share based compensation options granted, exercise in the period				7,894
2019 Stock Incentive Plan [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Share based compensation, award description			As of March 31, 2020, awards may be made under the 2019 Plan for up to such number of shares of the Company’s common stock as is equal to the sum of i) 1,578,947 shares; plus ii) the number of shares (up to 1,157,894 shares) equal to the number of shares of the Company’s common stock subject to outstanding awards under the Company’s 2012 Stock Incentive Plan (the “2012 Plan”), as amended that expire, terminate or are otherwise cancelled, forfeited or repurchased by the Company at their original issuance price pursuant to a contractual repurchase right; plus iii) an annual increase to be added on the first day of each fiscal year, beginning with 2020 and continuing through 2029, equal to the least of (a) 2,105,623 shares of common stock, (b) 4% of the number of outstanding shares of the Company’s common stock on such date, and (c) an amount determined by the Company’s board of directors. The number of shares reserved for issuance under the 2019 Plan increased, pursuant to the terms of the 2019 Plan, by an additional 713,383 shares, equal to 4% of the Company’s then-outstanding Common Stock, effective as of January 1, 2020.
Common stock, capital shares reserved for future issuance			1,578,947
Common stock, capital shares reserved for future issuance, annual increase	713,383
Share based compensation options to purchase no of common stock			1,161,543		631,234
Share based compensation grant period			10 years
Share based compensation vesting period			4 years
Share based compensation vesting description			Options vest over four years based on varying vesting schedules including: 25% vesting on the first anniversary date of grant and the balance ratably over the next 36 months or vesting in equal monthly or quarterly installments over four years.
2019 Stock Incentive Plan [Member] | Vesting First Anniversary Date of Grant [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Share based compensation vesting Percentage			25.00%
2019 Stock Incentive Plan [Member] | Common Stock [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Increase in additional number of shares to be issued			2,105,623
Percentage of number of common stock, shares outstanding	4.00%		4.00%
2012 Stock Incentive Plan [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Share based compensation options to purchase no of common stock			1,043,992		1,043,992
Share based compensation grant period			10 years
Share based compensation vesting period			4 years
Share based compensation vesting description			Options vest over four years based on varying vesting schedules including: 25% vesting on the first anniversary date of grant and the balance ratably over the next 36 months or vesting in equal monthly or quarterly installments over four years.
Share based compensation options grants in the period				0
Share based compensation options granted, exercise in the period				7,894
Share based compensation options granted, forfeited in the period				10,197
2012 Stock Incentive Plan [Member] | Stock Option [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Share based compensation options grants in the period		0
2012 Stock Incentive Plan [Member] | Other Equity-Based Award [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Share based compensation options grants in the period		0
2012 Stock Incentive Plan [Member] | Vesting First Anniversary Date of Grant [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Share based compensation vesting Percentage			25.00%
2012 Stock Incentive Plan [Member] | Common Stock [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Share based compensation options to purchase no of common stock			1,157,894
2019 Employee Stock Purchase Plan [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Share based compensation, award description			As of March 31, 2020, the number of shares of the Company’s common stock that has been reserved to be issued under the 2019 ESPP is equal to the sum of i) 155,106 shares plus ii) an annual increase to be added on the first day of each fiscal year, beginning with the fiscal year ending December 31, 2020 and continuing for each fiscal year until, and including, the fiscal year ending December 31, 2029, equal to the least of (a) 526,315 shares of common stock, (b) 1% of the number of outstanding shares of the Company’s common stock on such date, and (c) an amount determined by the Company’s board of directors. The number of shares of the Company’s common stock reserved for issuance under the 2019 ESPP increased, pursuant to the terms of the 2019 ESPP, by an additional 178,345 shares, equal to 1% of the Company’s then-outstanding common stock, effective as of January 1, 2020.
Common stock, capital shares reserved for future issuance			155,106
Common stock, capital shares reserved for future issuance, annual increase	178,345
2019 Employee Stock Purchase Plan [Member] | Common Stock [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Increase in additional number of shares to be issued			526,315
Percentage of number of common stock, shares outstanding	1.00%		1.00%

Stock-Based Awards - Stock Opti

Stock-Based Awards - Stock Options, Activity (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2020	Dec. 31, 2019
Number of Option Shares
Outstanding, Beginning	1,675,226
Granted	530,309
Outstanding, Ending	2,205,535	1,675,226
Options exercisable	742,947
Options unvested	1,462,588
Weighted Average Exercise Price
Outstanding, Beginning	$ 6.20
Granted	5.50
Outstanding, Ending	6.03	$ 6.20
Options exercisable	3.34
Options unvested	$ 7.40
Weighted Average Contractual Term, Outstanding	8 years 1 month 6 days	7 years 9 months 18 days
Weighted Average Contractual Term, Options exercisable	6 years
Weighted Average Contractual Term, Options unvested	9 years 2 months 12 days
Aggregate Intrinsic Value, Outstanding	$ 512	$ 864
Aggregate Intrinsic Value, Options exercisable	502
Aggregate Intrinsic Value, Options unvested	$ 10

Stock-Based Awards - Stock-base

Stock-Based Awards - Stock-based Compensation Expenses (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Stock-based compensation	$ 730	$ 146
Research and Development Expense [Member]
Stock-based compensation	93	22
General and Administrative Expense [Member]
Stock-based compensation	$ 637	$ 124

Net Loss per Share - Computatio

Net Loss per Share - Computation of Basic and Diluted Net Loss Per Share Attributable to Common Stockholders (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2020	Mar. 31, 2019	Dec. 31, 2019
Earnings Per Share [Abstract]
Net loss	$ (8,473)	$ (4,802)	$ (26,100)
Plus: Accretion of redeemable convertible preferred stock		203
Plus: Dividends accrued on redeemable convertible preferred stock		(1,553)
Adjusted net loss attributable to common stockholders	$ (8,473)	$ (6,152)
Weighted average common shares used in net loss per share attributable to common stockholders, basic and diluted	17,834,570	444,132
Basic and diluted net loss per common share outstanding	$ (0.48)	$ (13.85)

Net Loss per Share - Calculatio

Net Loss per Share - Calculation of Diluted Net Loss Per Share Attributable to Common Stockholders (Detail) - shares	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Antidilutive securities excluded from computation of earnings per share, amount	2,205,535	84,002,662
Series A Redeemable convertible Preferred Stock [Member]
Antidilutive securities excluded from computation of earnings per share, amount		15,387,923
Series B Redeemable convertible Preferred Stock [Member]
Antidilutive securities excluded from computation of earnings per share, amount		22,608,695
Series C Redeemable convertible Preferred Stock [Member]
Antidilutive securities excluded from computation of earnings per share, amount		44,946,987
Stock Option [Member]
Antidilutive securities excluded from computation of earnings per share, amount	2,205,535	1,059,057

Collaborative and Licensing A_2

Collaborative and Licensing Agreements - Additional Information (Detail) - USD ($) $ in Thousands	Nov. 06, 2018	May 31, 2011	Mar. 31, 2020
Endo Pharmaceuticals Inc [Member]
Upfront license fee		$ 25
Royalty terms			first commercial sale of the product in that country and extends until the later of the expiration, unenforceability or invalidation of the last valid claim of any licensed patent or application covering the licensed product in the country or the expiration of 10 years after the first commercial sale of the licensed product in the country, which period is referred to as the royalty term. Upon the expiration of the royalty term for a product in a country
Endo Pharmaceuticals Inc [Member] | Completion Of Stage One [Member]
Milestone payment			$ 250
Endo Pharmaceuticals Inc [Member] | Completion Of Stage Two [Member]
Milestone payment			750
Rutgers [Member]
Milestone payment			$ 331
Royalty terms			first commercial sale of the licensed product in that country following receipt of marketing approval and extends until the later of the date of expiration, unenforceability or invalidation of the last valid claim of any licensed patent or patent application covering the licensed product in the country and 10 years after the first commercial sale of the first licensed product sold anywhere in the world, which period is referred to as the royalty term. Upon the expiration of the royalty term for a licensed product in a country, the license granted to the Company under the agreement shall become perpetual, fully paid-up, irrevocable and royalty-free in such country.
MentiNova Inc [Member]
Upfront license fee	$ 119
MentiNova Inc [Member] | Completion Of Stage One [Member]
Milestone payment			$ 1,188