Trevi Therapeutics (TRVI) 10-Q 12 Nov 20 2020 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
	Sep. 30, 2020	Nov. 11, 2020
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2020
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	Q3
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		18,380,790
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	Sep. 30, 2020	Dec. 31, 2019
Current assets:
Cash and cash equivalents	$ 53,293	$ 57,313
Tax credit and other receivables	59	558
Prepaid expenses	1,857	1,681
Total current assets	55,209	59,552
Deferred offering costs	291
Operating lease right-of-use asset	250	312
Security deposit	19	19
Property, equipment and leasehold improvements, net	110	118
Total assets	55,879	60,001
Current liabilities:
Accounts payable	1,258	1,599
Accrued expenses	4,735	3,501
Operating lease liability - current portion	110	99
Total current liabilities	6,103	5,199
Term loan	13,798
Term loan derivative liability	187
Operating lease liability - long term portion	173	257
Commitments and contingencies (Note 11)
Stockholders’ equity (deficit):
Common stock: $0.001 par value; 200,000,000 shares authorized at September 30, 2020 and December 31, 2019, respectively; and 18,321,068 and 17,834,570 shares issued and outstanding at September 30, 2020 and December 31, 2019, respectively.	18	18
Preferred stock: $0.001 par value; 5,000,000 shares authorized at September 30, 2020 and December 31, 2019, respectively; no shares issued or outstanding at September 30, 2020 or December 31, 2019.
Additional paid-in capital	173,054	168,746
Accumulated deficit	(137,454)	(114,219)
Total stockholders’ equity	35,618	54,545
Total liabilities and stockholders’ equity	$ 55,879	$ 60,001

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares	Sep. 30, 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	18,321,068	17,834,570
Common Stock, Shares, Outstanding	18,321,068	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		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Operating expenses:
Research and development	$ 4,828	$ 5,650	$ 15,768	$ 14,516
General and administrative	2,416	2,000	7,528	5,363
Total operating expenses	7,244	7,650	23,296	19,879
Loss from operations	(7,244)	(7,650)	(23,296)	(19,879)
Other income (expense):
Change in fair value of obligation for loan success fee				(215)
Interest income	3	280	174	567
Interest expense	(148)		(148)
Total other income (expense), net	(145)	280	26	352
Loss before income tax benefit	(7,389)	(7,370)	(23,270)	(19,527)
Income tax benefit	11	5	35	14
Net loss	(7,378)	(7,365)	(23,235)	(19,513)
Accretion of redeemable convertible preferred stock				1,535
Dividends accrued on redeemable convertible preferred stock				(2,239)
Adjusted net loss attributable to common stockholders	$ (7,378)	$ (7,365)	$ (23,235)	$ (20,217)
Basic and diluted net loss per common share outstanding	$ (0.41)	$ (0.41)	$ (1.30)	$ (2.09)
Weighted average common shares used in net loss per share attributable to common stockholders, basic and diluted	18,134,886	17,834,570	17,935,865	9,680,512

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Redeemable Convertible Preferred Stock and Stockholders' Equity (Deficit) - USD ($) $ in Thousands	Total	ATM Sales Agreement [Member]	Private Placement [Member]	Initial Public Offering [Member]	Common Stock [Member]	Common Stock [Member]ATM Sales Agreement [Member]	Common Stock [Member]Private Placement [Member]	Common Stock [Member]Initial Public Offering [Member]	Additional Paid-in Capital [Member]	Additional Paid-in Capital [Member]ATM Sales Agreement [Member]	Additional Paid-in Capital [Member]Private Placement [Member]	Additional Paid-in Capital [Member]Initial Public Offering [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	754								$ 754
Issuance of common stock from exercise of stock options	$ 38								38
Issuance of common stock from exercise of stock options (in shares)	14,736				14,736
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	$ (2,239)												(2,239)	$ 326	$ 551	$ 1,362
Dividends accrued on redeemable convertible preferred stock, (in shares)														5,406,844	6,478,999	3,792,386
Accretion (amortization) of premium (discount) on issuance of redeemable convertible preferred stock	(24)												(24)	$ (7)	$ 31
Accretion of discount on investor rights/obligation	(201)												(201)	84	117
Adjustment for excess (shortfall) of fair value over liquidation value of redeemable convertible preferred stock	1,994												1,994	(651)	(940)	$ (403)
Accretion of issuance costs on redeemable convertible preferred stock	(234)												(234)	7	4	223
Conversion of redeemable convertible preferred stock to common stock in connection with initial public offering	127,504				$ 7				105,464				22,033	$ (20,792)	$ (33,449)	$ (73,264)
Conversion of redeemable convertible preferred stock to common stock in connection with initial public offering, (in shares)					10,381,234									(20,794,767)	(29,087,694)	(48,739,373)
Issuance of common stock value, net of underwriting discounts and commissions and issuance costs			$ 13,950	$ 48,174			$ 2	$ 5			$ 13,948	$ 48,169
Issuance of common stock shares, net of underwriting discounts and commissions and issuance costs (in shares)							1,500,000	5,500,000
Net loss	(19,513)												(19,513)
Ending Balance at Sep. 30, 2019	60,709				$ 18				168,373				(107,682)
Ending Balance (in shares) at Sep. 30, 2019					17,834,570
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
Beginning Balance at Jun. 30, 2019	67,703				$ 18				168,002				(100,317)
Beginning Balance (in shares) at Jun. 30, 2019					17,834,570
Stock-based compensation	371								371
Net loss	(7,365)												(7,365)
Ending Balance at Sep. 30, 2019	60,709				$ 18				168,373				(107,682)
Ending Balance (in shares) at Sep. 30, 2019					17,834,570
Beginning Balance at Dec. 31, 2019	54,545				$ 18				168,746				(114,219)
Beginning Balance (in shares) at Dec. 31, 2019					17,834,570
Stock-based compensation	1,907								1,907
Issuance of common stock from exercise of stock options	$ 34								34
Issuance of common stock from exercise of stock options (in shares)	18,343				18,343
Issuance of common stock from Employee Stock Purchase Plan	$ 3								3
Issuance of common stock from Employee Stock Purchase Plan (in shares)					1,397
Issuance of common stock value, net of underwriting discounts and commissions and issuance costs		$ 2,364								$ 2,364
Issuance of common stock shares, net of underwriting discounts and commissions and issuance costs (in shares)						466,758
Net loss	(23,235)												(23,235)
Ending Balance at Sep. 30, 2020	35,618				$ 18				173,054				(137,454)
Ending Balance (in shares) at Sep. 30, 2020					18,321,068
Beginning Balance at Jun. 30, 2020	40,037				$ 18				170,095				(130,076)
Beginning Balance (in shares) at Jun. 30, 2020					17,851,152
Stock-based compensation	588								588
Issuance of common stock from exercise of stock options	7								7
Issuance of common stock from exercise of stock options (in shares)					3,158
Issuance of common stock value, net of underwriting discounts and commissions and issuance costs		$ 2,364								$ 2,364
Issuance of common stock shares, net of underwriting discounts and commissions and issuance costs (in shares)						466,758
Net loss	(7,378)												(7,378)
Ending Balance at Sep. 30, 2020	$ 35,618				$ 18				$ 173,054				$ (137,454)
Ending Balance (in shares) at Sep. 30, 2020					18,321,068

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019	Dec. 31, 2019
Operating activities
Net loss	$ (7,378)	$ (7,365)	$ (23,235)	$ (19,513)	$ (26,100)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation			34	30
Changes in fair value of obligation for loan success fee				215
Accretion/accrual of term loan discounts and debt issuance			68
Stock-based compensation	588	371	1,907	754
Changes in operating assets and liabilities:
Receivables			499	(19)
Prepaid expenses			(176)	(388)
Accounts payable			(341)	(332)
Accrued expenses and other expenses			1,168	2,362
Net cash used in operating activities			(20,076)	(16,891)
Investing activities
Acquisitions of property, equipment and leasehold improvements			27	9
Net cash used in investing activities			(27)	(9)
Financing activities
Payment of loan success fee				(675)
Proceeds from term loan			14,000
Financing costs of term loan			(53)
Proceeds from at-the-market sales, net commissions and fees			2,442
Proceeds from exercises of stock options			34	38
Proceeds from the employee stock purchase plan			3
Proceeds from sale of Series C redeemable convertible preferred stock, net of issuance costs				9,963
Proceeds from issuance of common stock upon completion of initial public offering, net of underwriting commissions and discounts				51,150
Proceeds from private placement, net of private placement agent fees				13,950
Payments of offering costs			(343)	(1,213)
Net cash provided by financing activities			16,083	73,213
Net cash increase (decrease)			(4,020)	56,313
Cash and cash equivalents at beginning of period			57,313	7,202	7,202
Cash and cash equivalents at end of period	$ 53,293	$ 63,515	53,293	63,515	$ 57,313
Supplemental disclosure of cash flow information
Interest paid			30
Supplemental disclosure of non-cash financing activities
Offering costs included in accounts payable and accrued expenses			26
Financing costs included in accounts payable and accrued expenses			$ 31
Accretion on redeemable convertible preferred stock				(1,535)
Dividends accrued on redeemable convertible preferred stock				$ 2,239

Nature of the Business

Nature of the Business	9 Months Ended
	Sep. 30, 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 Haduvio (nalbuphine ER) to treat serious neurologically mediated conditions. The Company is currently developing Haduvio 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 Haduvio has the potential to be effective in treating each of these conditions. Haduvio 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. 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 term loan facilities, with proceeds from the Company’s initial public offering (“IPO”) and concurrent private placement completed in May 2019, and with sales of common stock under the Company’s sales agreement with SVB Leerink LLC (the “ATM Sales Agreement”). The Company has incurred recurring losses since inception, including net losses attributable to the Company of $23.2 million for the nine months ended September 30, 2020 and $26.1 million for the year ended December 31, 2019. In addition, as of September 30, 2020, the Company had an accumulated deficit of $137.5 million. The Company expects to continue to generate operating losses for the foreseeable future. As of November 12, 2020

Summary of Significant Accounti

Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2020
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	2. Basis of Presentation The accompanying unaudited interim Condensed Consolidated Financial Statements for the three and nine months ended September 30, 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 September 30, 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 September 30, 2020, the Condensed Consolidated Statements of Operations and the Condensed Consolidated Statements of Redeemable Convertible Preferred Stock and Stockholders’ Equity (Deficit) for the three and nine months ended September 30, 2020 and 2019, and the Condensed Consolidated Statements of Cash Flows for the nine months ended September 30, 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 September 30, 2020, the results of its operations for the three and nine months ended September 30, 2020 and 2019, and its cash flows for the nine months ended September 30, 2020 and 2019. The results for the three and nine months ended September 30, 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, term loans, term loan derivative liability and obligation for loan success fee (Note 6). Fair instruments. The fair value of the term loan derivative liability is estimated utilizing a probability-weighted cash flow approach (Note 6). 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. 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. The following table summarizes the financial liabilities measured at fair value on a recurring basis as of September 30, 2020 and the basis for that measurement, by level within the fair value hierarchy (Note 6). There were no such financial liabilities as of December 31, 2019: Balance September 30, 2020 Level 1 Level 2 Level 3 Financial liabilities Term loan derivative liability $ 187 $ — $ — $ 187 $ 187 $ — $ — $ 187 The following table represents a roll-forward of the fair value of Level 3 instruments (significant unobservable inputs): September 30, December 31, 2020 2019 Financial liabilities Balance at beginning of year (1) $ — $ 1,556 Term loan derivative liability 187 — 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 $ 187 $ — (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. Deferred offering costs relating to the Company’s ATM Sales Agreement were $291 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, shares of Series B redeemable convertible 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 nine months ended September 30, 2020. Recently Issued Accounting Pronouncements There have been no new accounting pronouncements during the nine months ended September 30, 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	9 Months Ended
	Sep. 30, 2020
Prepaid Expense Current [Abstract]
Prepaid Expenses	3. Prepaid expenses consist of the following: As of September 30, 2020 As of December 31, 2019 Prepaid R&D payments $ 741 $ 1,113 Prepaid corporate insurance 958 491 Other 158 77 $ 1,857 $ 1,681

Leases

Leases	9 Months Ended
	Sep. 30, 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. 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 September 30, 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 nine months ended September 30, 2020. The Company’s operating leases consist of real estate and equipment, and have remaining terms ranging from approximately 3 months As of September 30, 2020 As of December 31, 2019 Assets: Operating lease right-of-use asset $ 250 $ 312 Liabilities: Operating lease liabilities, current portion 110 99 Operating lease liabilities, long term portion 173 257 Total operating lease liabilities $ 283 $ 356 Future minimum lease payments under the operating leases are as follows as of September 30, 2020: As of September 30, 2020 2020 $ 35 2021 138 2022 131 2023 24 Total lease payments 328 Less: imputed discount rate (45 ) Carrying value of operating lease liabilities $ 283 Lease expense under operating leases, including leases of office equipment, was $31 for each of the three-month periods ended September 30, 2020 and 2019, and $93 for each of the nine-month periods ended September 30, 2020 and 2019. Lease payments made in the three months ended September 30, 2020 and 2019 were $23 and $34, respectively, and $103 and $91 for the nine months ended September 30, 2020 and 2019, respectively, with such amounts reflected in the Condensed Consolidated Statement of Cash Flows in operating activities.

Accrued Expenses

Accrued Expenses	9 Months Ended
	Sep. 30, 2020
Payables And Accruals [Abstract]
Accrued Expenses	5. Accrued Expenses Accrued expenses consist of the following: As of September 30, 2020 As of December 31, 2019 Accrued research projects $ 2,901 $ 2,084 Accrued consulting and professional fees 879 338 Accrued compensation and benefits 824 776 Other 131 303 $ 4,735 $ 3,501

Debt

Debt	9 Months Ended
	Sep. 30, 2020
Debt Disclosure [Abstract]
Debt	6. Debt Silicon Valley Bank Term Loan On August 13, 2020 (the “Effective Date”), the Company entered into a loan and security agreement (the “SVB Loan Agreement”) with Silicon Valley Bank, as lender (“SVB”), pursuant to which SVB provided a term loan to the Company in the original principal amount of $14.0 million (the “SVB Term Loan”). The Company may use the proceeds from the SVB Term Loan for working capital and general corporate purposes. The SVB Term Loan bears interest at a floating rate per annum equal to the greater of (A) the prime rate plus 1.00% and (B) 4.25%. If SVB receives evidence satisfactory to it that the Company has (i) received positive data for the Phase 2b/3 clinical trial of Haduvio sufficient to advance Haduvio into a second Phase 3 clinical trial for prurigo nodularis, and (ii) raised sufficient financing to fund such Phase 3 clinical trial and the Company’s operations, (together, the “Phase 3 Event”), the interest rate under the SVB Term Loan will be adjusted to a floating rate equal to the greater of (A) the prime rate plus 3.00% and (B) 6.25% (see term loan derivative liability discussion below). On the first business day of each month, the Company will be required to make monthly interest payments and commencing on March 1, 2022, the Company will be required to repay the SVB Term Loan in 24 consecutive installments of principal plus monthly payments of accrued interest. All outstanding principal and accrued and unpaid interest under the SVB Term Loan and all other outstanding obligations with respect to the SVB Term Loan are due and payable in full on February 1, 2024. The SVB Loan Agreement permits voluntary prepayment of all, but not less than all, of the SVB Term Loan, subject to a prepayment premium. Such prepayment premium would be 3.00% of the principal amount of the SVB Term Loan if prepaid prior to the first anniversary of the Effective Date, 2.00% of the principal amount of the SVB Term Loan if prepaid on or after the first anniversary of the Effective Date but prior to the second anniversary of the Effective Date, and 1.00% of the principal amount of the SVB Term Loan if prepaid on or after the second anniversary of the Effective Date but prior to February 1, 2024. Upon repayment in full of the SVB Term Loan, the Company will be required to pay a final payment fee equal to $1.2 million. The SVB Term Loan and related obligations under the SVB Loan Agreement are secured by substantially all of the Company’s properties, rights and assets, except for its intellectual property (which is subject to a negative pledge under the SVB Loan Agreement). If the Company fails to meet certain equity raise requirements under the SVB Loan Agreement, it will be required to deposit unrestricted and unencumbered cash equal to 100% of the principal amount of the SVB Term Loan then outstanding in a cash collateral account with SVB, which can be used by SVB to prepay the SVB Term Loan at any time. The SVB Loan Agreement contains customary representations, warranties, events of default and covenants. The occurrence and continuation of an event of default could cause interest to be charged at the rate that is otherwise applicable plus 5.00% (unless SVB elects to impose a smaller increase) and would provide SVB with the right to accelerate all obligations under the SVB Loan Agreement, and exercise remedies against the Company and the collateral securing the SVB Term Loan and other obligations under the SVB Loan Agreement, including foreclosure against assets securing the SVB Term Loan and other obligations under the SVB Loan Agreement, including the Company’s cash. In August 2020, in connection with the SVB Term Loan, the Company paid $56 in financing costs to a third party, which were recorded as deferred charges—loan and will be amortized over the life of the SVB Term Loan using the effective interest method. Amortization of these deferred financing charges totaled $3 for each of the three and nine-month periods ended September 30, 2020, and is included in interest expense in the Company’s Condensed Consolidated Statements of Operations. Loan discount—unamortized deferred charges totaled $53 for the nine months ended September 30, 2020, and is included as a direct reduction of the carrying value of the term loan payable on the Company’s Condensed Consolidated Balance Sheet. In August 2020, in connection with the execution of the SVB Loan Agreement, the Company paid $27 in financing costs to SVB, which were recorded as loan discounts. These loan discounts are included as a reduction in the balance of the term loan payable on the Company’s Condensed Consolidated Balance Sheet and will be accreted over the life of the SVB Term Loan using the effective interest method. Accretion of these loan discounts totaled $1 for each of the three and nine-month periods ended September 30, 2020, and is included in interest expense in the Company’s Condensed Consolidated Statements of Operations. At September 30, 2020 the loan discount-financing costs balance was $26. In connection with the SVB Loan Agreement, the Company is obligated to pay a final payment fee of $1.2 million upon repayment in full of the SVB Term Loan. The final payment fee is being accrued over the life of the SVB Term Loan using the effective interest method and is included as an increase in the balance of the term loan payable on the Company’s Condensed Consolidated Balance Sheet. For the nine months ended September 30, 2020, $64 was accrued for the final payment fee, with such amount included in interest expense in the Company’s Condensed Consolidated Statements of Operations. Upon the occurrence of the Phase 3 Event, the interest rate on the SVB Term Loan will increase by 2.00% (the “Contingent Interest Rate Increase”) as described above. The Contingent Interest Rate Increase represents a free-standing financial instrument. Accordingly, the Company accounted for the Contingent Interest Rate Increase as a derivative under ASC 815, Derivatives and Hedging, and therefore, recorded a term loan derivative liability for the Contingent Interest Rate Increase at its fair value of $187 on the Effective Date of the SVB Loan Agreement. The Company adjusts this liability to fair value at each reporting date it remains outstanding, with such adjustments recorded as non-cash charges in other income (expense) in the Company’s Condensed Consolidated Statements of Operations. The change in fair value of the term loan derivative liability as of September 30, 2020 as compared to the fair value at its last measurement date (its date of inception) was not significant. Upon recording such term loan derivative liability, the Company also recorded an offsetting term loan discount – interest, to be amortized to interest expense in the Company’s Condensed Consolidated Statements of Operations through the SVB Term Loan’s maturity date. Such amortization was insignificant in the three and nine month periods ended September 30, 2020. The term loan discount – interest is included as a reduction in the balance of the term loan payable on the Company’s Condensed Consolidated Balance Sheet as of September 30, 2020. The term loan derivative liability is presented as a non-current liability in the Company’s Condensed Consolidated Balance Sheet as of September 30, 2020. Fair values of the term loan derivative liability are estimated utilizing a probability-weighted cash flow approach, including variables for the timing of the Phase 3 Event and other probability estimates. For the fair value calculations of the term loan derivative liability at its inception and at September 30, 2020, significant inputs included the Contingent Interest Rate Increase of 2.00%, a discount rate of 12.0%; and the SVB Term Loan maturity date of February 1, 2024. For each of the three and nine-month periods ended September 30, 2020, interest expense under the SVB Term Loan totaled $148, which includes amortization of deferred financing charges, accretion of loan discount-financing costs, accrual of the final payment fee, amortization of the term loan discount-interest and the stated interest on the SVB Term Loan, all as described above. There was no such interest expense on the SVB Term Loan for either of the three and nine-month periods ended September 30, 2019. As of September 30, 2020, the Company had outstanding borrowings of $14.0 million under the SVB Term Loan and the term loan payable balance as presented in the Company’s Condensed Consolidated Balance Sheet as of September 30, 2020 was comprised as shown below. There were no outstanding borrowings under the SVB Term Loan as of December 31, 2019. September 30, 2020 Principal outstanding under term loan $ 14,000 Term loan discount-interest (187 ) Term loan discount-unamortized deferred charges (53 ) Term loan discount-financing costs, net of accretion (26 ) Term loan-final payment fee 64 13,798 Less current portion — Term loan payable, non-current $ 13,798 Interest expense on SVB Term Loan, which is comprised of interest payments, amortization of financing costs and the accrual of the final payment fee, is shown below for the three and nine months ended September 30, 2020. There was no such expense under the SVB Term Loan for the three and nine months ended September 30, 2019. Three Months Ended September 30, Nine Months Ended September 30, 2020 2020 Interest payments $ 80 $ 80 Amortization of financing costs 4 4 Accrual of the final payment fee 64 64 $ 148 $ 148 Solar Capital Term Loan On December 29, 2014, the Company entered into a loan and security agreement (the “Solar Loan Agreement”) with Solar Capital, Ltd. and Square 1 Bank (together, “Solar”), which provided $15.0 million in debt financing (the “Solar Term Loan”). On June 29, 2018, the maturity date of the Solar Loan Agreement, the Company made its final payments of principal and interest due to Solar in connection with the Solar 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 Solar Term Loan as of September 30, 2020 or December 31, 2019, and the Company’s obligations to Solar under the Solar Loan Agreement were terminated. Under the terms of the Solar Loan Agreement, the Company was obligated to pay Solar 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 Solar 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 7) triggered the Success Fee payment obligation and the Company made payments to Solar 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 Solar 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 Solar 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 each of September 30, 2020 and December 31, 2019. The Company recorded non-cash charges in the amount of $0 for each of the three months ended September 30, 2020 and 2019, and $0 and $215 for the nine months ended September 30, 2020 and 2019, respectively, representing the changes in the fair value of these liabilities since their last measurement date. The fair values of the obligation for the Success Fee were estimated utilizing a probability-weighted cash flow approach, including variables for the timing of the Exit Event and other probability estimates. The non-cash charges are included in other income (expense) in the Company’s Condensed Consolidated Statements of Operations.

Stockholders_ Equity

Stockholders’ Equity	9 Months Ended
	Sep. 30, 2020
Stockholders Equity Note [Abstract]
Stockholders' Equity	7. Redeemable Convertible Preferred Stock Upon the closing of the IPO, the Company’s outstanding redeemable convertible preferred stock, including the accrued dividends thereon, automatically converted into an aggregate of 10,381,234 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. Common Stock As of September 30, 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 September 30, 2020 and December 31, 2019, the Company had reserved 3,674,484 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: September 30, 2020 December 31, 2019 Shares of common stock reserved for future issuance under the 2012 Stock Incentive Plan 1,025,649 1,043,992 Shares of common stock reserved for future issuance under the 2019 Stock Incentive Plan 2,316,781 1,579,714 Shares of common stock reserved for future issuance under the 2019 Employee Stock Purchase Plan 332,054 155,106 3,674,484 2,778,812 Initial Public Offering and Concurrent Private Placement On May 9, 2019, the Company completed its 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”. At-the-Market Offering In June 2020, the Company entered into the ATM Sales Agreement with SVB Leerink LLC, under which the Company may issue and sell shares of its common stock, from time to time, having an aggregate offering price of up to $12.0 million. Sales of common stock under the ATM Sales Agreement may be made by any method that is deemed an “at the market” offering as defined in Rule 415(a)(4) under the Securities Act of 1933, as amended. The Company is not obligated to make any sales of its common stock under the ATM Sales Agreement. The Company began making sales pursuant to the ATM Sales Agreement in July 2020, and as of September 30, 2020, the Company had issued and sold an aggregate of 466,758 shares of common stock for gross proceeds of $2.5 million, before deducting estimated commissions and fees of $0.2 million. 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 September 30, 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 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 ye ars. 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 nine months ended September 30, 2019, stock options to purchase 674,602 shares of the Company’s common stock were granted. During the nine months ended September 30, 2019, stock options were exercised for 14,736 shares of common stock. During the nine months ended September 30, 2019, stock options to purchase 35,745 shares of the Company’s common stock were forfeited. During the nine months ended September 30, 2019, stock options to purchase 6,359 shares of the Company’s common stock expired. A summary of the Company’s combined stock option activity for the 2019 Plan and the 2012 Plan for the nine months ended September 30, 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 694,583 $ 5.24 Forfeited (11,842 ) $ 10.00 Expired (11,842 ) $ 10.00 Exercised (18,343 ) $ 1.82 Outstanding as of September 30, 2020 2,327,782 $ 5.91 7.8 $ 1,056 Options exercisable as of September 30, 2020 1,018,591 $ 4.85 6.3 $ 957 Options unvested as of September 30, 2020 1,309,191 $ 6.73 8.9 $ 99 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. During the nine months ended September 30, 2020, 1,397 shares of common stock were issued and sold under the 2019 ESPP. The Company recognized $1 and $2 of stock-based compensation expense for the 2019 ESPP during the three and nine months ended September 30, 2020, respectively. As of September 30, 2020, the aggregate number of shares of the Company’s common stock that may 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 aggregate number of shares of the Company’s common stock that may be issued 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. The following table summarizes the classifications of stock-based compensation expenses for the 2012 Plan, the 2019 Plan and the 2019 ESPP recognized in the Condensed Consolidated Statements of Operations: Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Research and development expense $ 82 $ 45 $ 259 $ 97 General and administrative expense 506 326 1,648 657 $ 588 $ 371 $ 1,907 $ 754

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2020
Income Tax Disclosure [Abstract]
Income Taxes	8 . During the three and nine months ended September 30, 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	9 Months Ended
	Sep. 30, 2020
Earnings Per Share [Abstract]
Earnings Per Share	9 . The following table summarizes the computation of basic and diluted net loss per share attributable to common stockholders of the Company: Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Net loss $ (7,378 ) $ (7,365 ) $ (23,235 ) $ (19,513 ) Plus: Accretion of redeemable convertible preferred stock — — — 1,535 Plus: Dividends accrued on redeemable convertible preferred stock — — — (2,239 ) Adjusted net loss attributable to common stockholders $ (7,378 ) $ (7,365 ) $ (23,235 ) $ (20,217 ) Weighted average common shares used in net loss per share attributable to common stockholders, basic and diluted 18,134,886 17,834,570 17,935,865 9,680,512 Basic and diluted net loss per common share outstanding $ (0.41 ) $ (0.41 ) $ (1.30 ) $ (2.09 ) 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 shares of common stock, presented based on shares outstanding as of September 30, 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 September 30, 2020 2019 Outstanding stock options 2,327,782 1,694,910 2,327,782 1,694,910

Collaborative and Licensing Agr

Collaborative and Licensing Agreements	9 Months Ended
	Sep. 30, 2020
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Collaborative and Licensing Agreements	10 . 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 Haduvio, 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	9 Months Ended
	Sep. 30, 2020
Commitments And Contingencies Disclosure [Abstract]
Commitments and Contingencies	1 1 . 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 10).

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2020
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The accompanying unaudited interim Condensed Consolidated Financial Statements for the three and nine months ended September 30, 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 September 30, 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 September 30, 2020, the Condensed Consolidated Statements of Operations and the Condensed Consolidated Statements of Redeemable Convertible Preferred Stock and Stockholders’ Equity (Deficit) for the three and nine months ended September 30, 2020 and 2019, and the Condensed Consolidated Statements of Cash Flows for the nine months ended September 30, 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 September 30, 2020, the results of its operations for the three and nine months ended September 30, 2020 and 2019, and its cash flows for the nine months ended September 30, 2020 and 2019. The results for the three and nine months ended September 30, 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, term loans, term loan derivative liability and obligation for loan success fee (Note 6). Fair instruments. The fair value of the term loan derivative liability is estimated utilizing a probability-weighted cash flow approach (Note 6). 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. 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. The following table summarizes the financial liabilities measured at fair value on a recurring basis as of September 30, 2020 and the basis for that measurement, by level within the fair value hierarchy (Note 6). There were no such financial liabilities as of December 31, 2019: Balance September 30, 2020 Level 1 Level 2 Level 3 Financial liabilities Term loan derivative liability $ 187 $ — $ — $ 187 $ 187 $ — $ — $ 187 The following table represents a roll-forward of the fair value of Level 3 instruments (significant unobservable inputs): September 30, December 31, 2020 2019 Financial liabilities Balance at beginning of year (1) $ — $ 1,556 Term loan derivative liability 187 — 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 $ 187 $ — (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. Deferred offering costs relating to the Company’s ATM Sales Agreement were $291
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, shares of Series B redeemable convertible 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 nine months ended September 30, 2020. Recently Issued Accounting Pronouncements There have been no new accounting pronouncements during the nine months ended September 30, 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)	9 Months Ended
	Sep. 30, 2020
Accounting Policies [Abstract]
Schedule of Financial Liabilities Measured at Fair Value on Recurring Basis	The following table summarizes the financial liabilities measured at fair value on a recurring basis as of September 30, 2020 and the basis for that measurement, by level within the fair value hierarchy (Note 6). There were no such financial liabilities as of December 31, 2019: Balance September 30, 2020 Level 1 Level 2 Level 3 Financial liabilities Term loan derivative liability $ 187 $ — $ — $ 187 $ 187 $ — $ — $ 187
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): September 30, December 31, 2020 2019 Financial liabilities Balance at beginning of year (1) $ — $ 1,556 Term loan derivative liability 187 — 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 $ 187 $ — (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)	9 Months Ended
	Sep. 30, 2020
Prepaid Expense Current [Abstract]
Schedule of Prepaid Expenses	Prepaid expenses consist of the following: As of September 30, 2020 As of December 31, 2019 Prepaid R&D payments $ 741 $ 1,113 Prepaid corporate insurance 958 491 Other 158 77 $ 1,857 $ 1,681

Leases (Tables)

Leases (Tables)	9 Months Ended
	Sep. 30, 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 September 30, 2020 As of December 31, 2019 Assets: Operating lease right-of-use asset $ 250 $ 312 Liabilities: Operating lease liabilities, current portion 110 99 Operating lease liabilities, long term portion 173 257 Total operating lease liabilities $ 283 $ 356
Future Minimum Lease Payments for Non-cancellable Operating Leases	Future minimum lease payments under the operating leases are as follows as of September 30, 2020: As of September 30, 2020 2020 $ 35 2021 138 2022 131 2023 24 Total lease payments 328 Less: imputed discount rate (45 ) Carrying value of operating lease liabilities $ 283

Accrued Expenses (Tables)

Accrued Expenses (Tables)	9 Months Ended
	Sep. 30, 2020
Payables And Accruals [Abstract]
Schedule of Accrued Expenses	Accrued expenses consist of the following: As of September 30, 2020 As of December 31, 2019 Accrued research projects $ 2,901 $ 2,084 Accrued consulting and professional fees 879 338 Accrued compensation and benefits 824 776 Other 131 303 $ 4,735 $ 3,501

Debt (Tables)

Debt (Tables)	9 Months Ended
	Sep. 30, 2020
Debt Disclosure [Abstract]
Schedule of Outstanding Borrowings under SVB Term Loan	There were no outstanding borrowings under the SVB Term Loan as of December 31, 2019. September 30, 2020 Principal outstanding under term loan $ 14,000 Term loan discount-interest (187 ) Term loan discount-unamortized deferred charges (53 ) Term loan discount-financing costs, net of accretion (26 ) Term loan-final payment fee 64 13,798 Less current portion — Term loan payable, non-current $ 13,798
Schedule of Components of Interest Expense of Term Loan	Interest expense on SVB Term Loan, which is comprised of interest payments, amortization of financing costs and the accrual of the final payment fee, is shown below for the three and nine months ended September 30, 2020. There was no such expense under the SVB Term Loan for the three and nine months ended September 30, 2019. Three Months Ended September 30, Nine Months Ended September 30, 2020 2020 Interest payments $ 80 $ 80 Amortization of financing costs 4 4 Accrual of the final payment fee 64 64 $ 148 $ 148

Stockholders_ Equity (Tables)

Stockholders’ Equity (Tables)	9 Months Ended
	Sep. 30, 2020
Stockholders Equity Note [Abstract]
Schedule of Common Stock Reserved for Future Issuance	As of September 30, 2020 and December 31, 2019, the Company had reserved 3,674,484 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: September 30, 2020 December 31, 2019 Shares of common stock reserved for future issuance under the 2012 Stock Incentive Plan 1,025,649 1,043,992 Shares of common stock reserved for future issuance under the 2019 Stock Incentive Plan 2,316,781 1,579,714 Shares of common stock reserved for future issuance under the 2019 Employee Stock Purchase Plan 332,054 155,106 3,674,484 2,778,812
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 nine months ended September 30, 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 694,583 $ 5.24 Forfeited (11,842 ) $ 10.00 Expired (11,842 ) $ 10.00 Exercised (18,343 ) $ 1.82 Outstanding as of September 30, 2020 2,327,782 $ 5.91 7.8 $ 1,056 Options exercisable as of September 30, 2020 1,018,591 $ 4.85 6.3 $ 957 Options unvested as of September 30, 2020 1,309,191 $ 6.73 8.9 $ 99
Schedule of Stock-based Compensation Expenses Recognized	The following table summarizes the classifications of stock-based compensation expenses for the 2012 Plan, the 2019 Plan and the 2019 ESPP recognized in the Condensed Consolidated Statements of Operations: Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Research and development expense $ 82 $ 45 $ 259 $ 97 General and administrative expense 506 326 1,648 657 $ 588 $ 371 $ 1,907 $ 754

Net Loss per Share (Tables)

Net Loss per Share (Tables)	9 Months Ended
	Sep. 30, 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 September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Net loss $ (7,378 ) $ (7,365 ) $ (23,235 ) $ (19,513 ) Plus: Accretion of redeemable convertible preferred stock — — — 1,535 Plus: Dividends accrued on redeemable convertible preferred stock — — — (2,239 ) Adjusted net loss attributable to common stockholders $ (7,378 ) $ (7,365 ) $ (23,235 ) $ (20,217 ) Weighted average common shares used in net loss per share attributable to common stockholders, basic and diluted 18,134,886 17,834,570 17,935,865 9,680,512 Basic and diluted net loss per common share outstanding $ (0.41 ) $ (0.41 ) $ (1.30 ) $ (2.09 )
Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share	The following potential shares of common stock, presented based on shares outstanding as of September 30, 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 September 30, 2020 2019 Outstanding stock options 2,327,782 1,694,910 2,327,782 1,694,910

Nature of the Business - Additi

Nature of the Business - Additional Information (Detail) - USD ($) $ in Thousands	Apr. 22, 2019	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019	Dec. 31, 2019
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Stockholders equity reverse stock split	one-for 9.5
Net income loss		$ (7,378)	$ (7,365)	$ (23,235)	$ (19,513)	$ (26,100)
Retained earnings accumulated deficit		(137,454)		(137,454)		(114,219)
Cash and cash equivalents, at carrying value		$ 53,293		$ 53,293		$ 57,313

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Additional Information (Detail) - USD ($)		1 Months Ended	9 Months Ended	12 Months Ended
		May 31, 2019	Sep. 30, 2020	Dec. 31, 2019	Dec. 31, 2018
Fair Value, Assets and Liabilities Measured on Recurring Basis [Line Items]
Loan success fee payable		$ 675,000			$ 460,000
ATM Sales Agreement [Member]
Fair Value, Assets and Liabilities Measured on Recurring Basis [Line Items]
Deferred offering costs			$ 291,000	$ 0
Reduction in stockholders' equity (deficit)			$ 77,000
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
Series C redeemable convertible preferred stock liability					$ 1,096,000
Fair Value, Measurements, Recurring [Member]
Fair Value, Assets and Liabilities Measured on Recurring Basis [Line Items]
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 Financial Liabilities Measured at Fair Value on Recurring Basis (Detail) - USD ($)	Sep. 30, 2020	Dec. 31, 2019
Financial liabilities
Term loan derivative liability	$ 187,000
Fair Value, Measurements, Recurring [Member]
Financial liabilities
Financial liabilities		$ 0
Fair Value, Measurements, Recurring [Member] | Term Loan Derivative Liability [Member]
Financial liabilities
Term loan derivative liability	187,000
Financial liabilities	187,000
Fair Value, Measurements, Recurring [Member] | Term Loan Derivative Liability [Member] | Level 3 [Member]
Financial liabilities
Term loan derivative liability	187,000
Financial liabilities	$ 187,000

Summary of Significant Accoun_6

Summary of Significant Accounting Policies - Schedule of Fair Value, Financial Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation (Detail) - Fair Value, Measurements, Recurring [Member] - USD ($) $ in Thousands		9 Months Ended	12 Months Ended
		Sep. 30, 2020	Dec. 31, 2019
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Balance at beginning of year(1)			$ 1,556
Net settlements	[1]		(1,771)
Ending balance		187
Term Loan Derivative Liability [Member]
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Term loan derivative liability		$ 187
Obligations [Member]
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Unrealized loss on financial liabilities			$ 215
[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.

Prepaid Expenses - Schedule of

Prepaid Expenses - Schedule of Prepaid Expenses (Detail) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Prepaid Expense Current [Abstract]
Prepaid R&D payments	$ 741	$ 1,113
Prepaid corporate insurance	958	491
Other	158	77
Prepaid expense	$ 1,857	$ 1,681

Leases - Additional Information

Leases - Additional Information (Detail) $ in Thousands	Mar. 01, 2018USD ($)ft²	Sep. 30, 2020USD ($)	Sep. 30, 2019USD ($)	Sep. 30, 2020USD ($)Lease	Sep. 30, 2019USD ($)
Operating lease, weighted average discount rate, percent		13.00%		13.00%
Number of new leases | Lease				0
Operating Lease, Payments		$ 23	$ 34	$ 103	$ 91
Minimum [Member]
Remaining terms ranging		3 months		3 months
Maximum [Member]
Remaining terms ranging		2 years 6 months		2 years 6 months
Building [Member]
Leased spaced area | ft²	5,600
Operating lease term	60 months
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		$ 31	$ 31	$ 93	$ 93

Leases - Schedule of Balance Sh

Leases - Schedule of Balance Sheet Operating Leases (Detail) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Assets:
Operating lease right-of-use asset	$ 250	$ 312
Liabilities:
Operating lease liabilities, current portion	110	99
Operating lease liabilities, long term portion	173	257
Total operating lease liabilities	$ 283	$ 356

Leases - Future Minimum Lease P

Leases - Future Minimum Lease Payments (Detail) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Leases [Abstract]
2020	$ 35
2021	138
2022	131
2023	24
Total lease payments	328
Less: imputed discount rate	(45)
Carrying value of operating lease liabilities	$ 283	$ 356

Accrued Expenses - Schedule of

Accrued Expenses - Schedule of Accrued Expenses (Detail) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Accrued Expenses [Abstract]
Accrued research projects	$ 2,901	$ 2,084
Accrued consulting and professional fees	879	338
Accrued compensation and benefits	824	776
Other	131	303
Total Accrued expenses	$ 4,735	$ 3,501

Debt - Additional Information (

Debt - Additional Information (Detail)	Aug. 13, 2020USD ($)Installment	Jun. 29, 2018USD ($)	Dec. 29, 2014USD ($)	May 31, 2019USD ($)	Sep. 30, 2020USD ($)	Sep. 30, 2019USD ($)	Sep. 30, 2020USD ($)	Sep. 30, 2019USD ($)	Dec. 31, 2019USD ($)	Dec. 31, 2018USD ($)	Aug. 31, 2020USD ($)
Interest expense					$ 148,000		$ 148,000
Carrying value of outstanding term loan					13,798,000		13,798,000
Loan success fee payable				$ 675,000						$ 460,000
Fair value of success fee liabilities							0		$ 0
Non cash charges					0	$ 0	0	$ 215,000
SVB Term Loan [Member]
Debt instrument, principal amount	$ 14,000,000				14,000,000		14,000,000
Interest-only payment period	24 months
Loan payment, number of consecutive equal monthly installments of principal including accrued interest | Installment	24
Debt instrument, maturity date	Feb. 1, 2024
Debt instrument, final payment fee amount	$ 1,200,000				1,200,000		$ 1,200,000
Debt instruments percentage of required to deposit unrestricted and unencumbered cash collateral	100.00%
Equity raise requirements, description							If the Company fails to meet certain equity raise requirements under the SVB Loan Agreement, it will be required to deposit unrestricted and unencumbered cash equal to 100% of the principal amount of the SVB Term Loan then outstanding in a cash collateral account with SVB, which can be used by SVB to prepay the SVB Term Loan at any time.
Debt default additional interest charge	5.00%
Debt finance costs											$ 56,000
Amortization of deferred financing charges					3,000		$ 3,000
Unamortized deferred charges					53,000		53,000
Financing costs paid											$ 27,000
Accretion loan discounts					1,000		1,000
Loan discounts-financing costs					26,000		26,000
Debt instrument, accrued final payment fee					64,000		$ 64,000
Contingent interest rate increase							2.00%
Interest expense					148,000	$ 0	$ 148,000	$ 0
Carrying value of outstanding term loan					13,798,000		13,798,000		0
SVB Term Loan [Member] | Term Loan Derivative Liability [Member]
Term loan derivative liability					$ 187,000		$ 187,000
SVB Term Loan [Member] | Term Loan Derivative Liability [Member] | Contingent Interest Rate Increase [Member]
Derivative liability, measurement input					2		2
SVB Term Loan [Member] | Term Loan Derivative Liability [Member] | Discount Rate [Member]
Derivative liability, measurement input					12		12
SVB Term Loan [Member] | Minimum [Member]
Interest rate, floating	4.25%
Long term debt percentage bearing adjusted floating interest rate	6.25%
SVB Term Loan [Member] | Prepayment Prior to First Anniversary of Effective Date [Member]
Prepayment premium percentage on principal amount	3.00%
SVB Term Loan [Member] | Prepayment After First Anniversary of Effective Date and Prior To Second Anniversary of Effective Date [Member]
Prepayment premium percentage on principal amount	2.00%
SVB Term Loan [Member] | Prepayment After Second Anniversary of the Effective Date and Prior to February 1, 2024 [Member]
Prepayment premium percentage on principal amount	1.00%
SVB Term Loan [Member] | Prime Rate [Member]
Variable interest rate	1.00%
SVB Term Loan [Member] | Adjusted Prime Rate [Member]
Variable interest rate	3.00%
Solar Capital 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		$ 0
Loan success fee, as percentage of term loan funded			4.50%
Solar Capital Term Loan A [Member]
Loan success fee payable				$ 675,000

Debt - Schedule of Outstanding

Debt - Schedule of Outstanding Borrowings under SVB Term Loan (Detail) - USD ($)	Sep. 30, 2020	Aug. 13, 2020	Dec. 31, 2019
Carrying value of outstanding term loan	$ 13,798,000
SVB Term Loan [Member]
Principal outstanding under term loan	14,000,000	$ 14,000,000
Term loan discount-interest	(187,000)
Term loan discount-unamortized deferred charges	(53,000)
Term loan discount-financing costs, net of accretion	(26,000)
Debt instrument, accrued final payment fee	64,000
Loans Payable, Noncurrent	13,798,000
Carrying value of outstanding term loan	$ 13,798,000		$ 0

Debt - Schedule of Components o

Debt - Schedule of Components of Interest Expense of Term Loan (Detail) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Debt Instrument [Line Items]
Interest Expense	$ 148,000		$ 148,000
SVB Term Loan [Member]
Debt Instrument [Line Items]
Interest payments	80,000		80,000
Amortization of financing costs	4,000		4,000
Accrual of the final payment fee	64,000		64,000
Interest Expense	$ 148,000	$ 0	$ 148,000	$ 0

Stockholders Equity - Additiona

Stockholders Equity - Additional Information (Detail) - USD ($)	Jan. 01, 2020	May 09, 2019	Jun. 30, 2020	Apr. 30, 2019	Sep. 30, 2020	Sep. 30, 2020	Sep. 30, 2019	Dec. 31, 2019
Stockholders Equity [Line Items]
Redeemable convertible preferred stock to common stock and additional paid-in capital		10,381,234
Common stock, shares authorized					200,000,000	200,000,000		200,000,000
Common stock, par or stated value per share					$ 0.001	$ 0.001		$ 0.001
Common stock, capital shares reserved for future issuance					3,674,484	3,674,484		2,778,812
Proceeds from public offering							$ 51,150,000
Estimated commissions and fees						$ 343,000	$ 1,213,000
Share based compensation options to purchase no of common stock					2,327,782	2,327,782		1,675,226
Share based compensation options grants in the period						694,583	674,602
Share based compensation options, exercise in the period						18,343	14,736
Share based compensation options granted, forfeited in the period						11,842	35,745
Share based compensation options granted, expired in the period						11,842	6,359
Common Stock [Member]
Stockholders Equity [Line Items]
Share based compensation options, exercise in the period					3,158	18,343	14,736
Common stock issued and sold						1,397
2019 Stock Incentive Plan [Member]
Stockholders Equity [Line Items]
Common stock, capital shares reserved for future issuance					1,578,947	1,578,947
Share based compensation, award description						As of September 30, 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, annual increase	713,383
Share based compensation options to purchase no of common stock					1,302,133	1,302,133		631,234
Share based compensation grant period						10 years
Share based compensation vesting period						4 years
Share based compensation vesting description						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.
2019 Stock Incentive Plan [Member] | Vesting First Anniversary Date of Grant [Member]
Stockholders Equity [Line Items]
Share based compensation vesting Percentage						25.00%
2019 Stock Incentive Plan [Member] | Common Stock [Member]
Stockholders Equity [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]
Stockholders Equity [Line Items]
Share based compensation options to purchase no of common stock					1,025,649	1,025,649		1,043,992
Share based compensation grant period						10 years
Share based compensation vesting period						4 years
Share based compensation vesting description						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.
2012 Stock Incentive Plan [Member] | Stock Option [Member]
Stockholders Equity [Line Items]
Share based compensation options grants in the period				0
2012 Stock Incentive Plan [Member] | Other Equity-Based Award [Member]
Stockholders Equity [Line Items]
Share based compensation options grants in the period				0
2012 Stock Incentive Plan [Member] | Vesting First Anniversary Date of Grant [Member]
Stockholders Equity [Line Items]
Share based compensation vesting Percentage						25.00%
2012 Stock Incentive Plan [Member] | Common Stock [Member]
Stockholders Equity [Line Items]
Share based compensation options to purchase no of common stock					1,157,894	1,157,894
2019 Employee Stock Purchase Plan [Member]
Stockholders Equity [Line Items]
Common stock, capital shares reserved for future issuance					155,106	155,106
Share based compensation, award description						As of September 30, 2020, the aggregate number of shares of the Company’s common stock that may 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 aggregate number of shares of the Company’s common stock that may be issued 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, annual increase	178,345
Common stock issued and sold						1,397
Stock-based compensation expense					$ 1,000	$ 2,000
2019 Employee Stock Purchase Plan [Member] | Common Stock [Member]
Stockholders Equity [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%
ATM Sales Agreement [Member]
Stockholders Equity [Line Items]
Sale of stock during the period						466,758
Aggregate offering price of common stock which may issue and sell under agreement			$ 12,000,000
Proceeds from issuance of common stock						$ 2,500,000
Estimated commissions and fees						$ 200,000
Initial Public Offering [Member]
Stockholders Equity [Line Items]
Sale of stock during the period		7,000,000
Share Price		$ 10
Proceeds from public offering		$ 62,100,000
Underwriting discounts and commissions		4,900,000
Other offering expenses		$ 3,000,000
Initial Public Offering [Member] | Common Stock [Member]
Stockholders Equity [Line Items]
Sale of stock during the period							5,500,000

Stockholders Equity - Shares Re

Stockholders Equity - Shares Reserved For Future Issuances (Detail) - shares	Sep. 30, 2020	Dec. 31, 2019
Class Of Stock [Line Items]
Common Stock, Capital Shares Reserved for Future Issuance	3,674,484	2,778,812
2012 Stock Option And Grant Plan [Member] | 2012 Stock Incentive Plan [Member]
Class Of Stock [Line Items]
Common Stock, Capital Shares Reserved for Future Issuance	1,025,649	1,043,992
2019 Stock Option And Grant Plan [Member] | 2019 Stock Incentive Plan [Member]
Class Of Stock [Line Items]
Common Stock, Capital Shares Reserved for Future Issuance	2,316,781	1,579,714
2019 Stock Option And Grant Plan [Member] | 2019 Employee Stock Purchase Plan [Member]
Class Of Stock [Line Items]
Common Stock, Capital Shares Reserved for Future Issuance	332,054	155,106

Stockholders Equity - Stock Opt

Stockholders Equity - Stock Options, Activity (Detail) - USD ($) $ / shares in Units, $ in Thousands	9 Months Ended		12 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Dec. 31, 2019
Number of Option Shares
Outstanding, Beginning	1,675,226
Granted	694,583	674,602
Forfeited	(11,842)	(35,745)
Expired	(11,842)	(6,359)
Exercised	(18,343)	(14,736)
Outstanding, Ending	2,327,782		1,675,226
Options exercisable	1,018,591
Options unvested	1,309,191
Weighted Average Exercise Price
Outstanding, Beginning	$ 6.20
Granted	5.24
Forfeited	10
Expired	10
Exercised	1.82
Outstanding, Ending	5.91		$ 6.20
Options exercisable	4.85
Options unvested	$ 6.73
Weighted Average Contractual Term, Outstanding	7 years 9 months 18 days		7 years 9 months 18 days
Weighted Average Contractual Term, Options exercisable	6 years 3 months 18 days
Weighted Average Contractual Term, Options unvested	8 years 10 months 24 days
Aggregate Intrinsic Value, Outstanding	$ 1,056		$ 864
Aggregate Intrinsic Value, Options exercisable	957
Aggregate Intrinsic Value, Options unvested	$ 99

Stockholders Equity - Stock-bas

Stockholders Equity - Stock-based Compensation Expenses (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Stock-based compensation	$ 588	$ 371	$ 1,907	$ 754
Research and Development Expense [Member]
Stock-based compensation	82	45	259	97
General and Administrative Expense [Member]
Stock-based compensation	$ 506	$ 326	$ 1,648	$ 657

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		9 Months Ended		12 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019	Dec. 31, 2019
Earnings Per Share [Abstract]
Net loss	$ (7,378)	$ (7,365)	$ (23,235)	$ (19,513)	$ (26,100)
Plus: Accretion of redeemable convertible preferred stock				1,535
Plus: Dividends accrued on redeemable convertible preferred stock				(2,239)
Adjusted net loss attributable to common stockholders	$ (7,378)	$ (7,365)	$ (23,235)	$ (20,217)
Weighted average common shares used in net loss per share attributable to common stockholders, basic and diluted	18,134,886	17,834,570	17,935,865	9,680,512
Basic and diluted net loss per common share outstanding	$ (0.41)	$ (0.41)	$ (1.30)	$ (2.09)

Net Loss per Share - Calculatio

Net Loss per Share - Calculation of Diluted Net Loss Per Share Attributable to Common Stockholders (Detail) - shares	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019
Antidilutive securities excluded from computation of earnings per share, amount	2,327,782	1,694,910
Stock Option [Member]
Antidilutive securities excluded from computation of earnings per share, amount	2,327,782	1,694,910

Collaborative and Licensing A_2

Collaborative and Licensing Agreements - Additional Information (Detail) - USD ($) $ in Thousands	Nov. 06, 2018	May 23, 2011	Sep. 30, 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 payments to be paid			$ 250
Endo Pharmaceuticals Inc [Member] | Completion Of Stage Two [Member]
Milestone payments to be paid			750
Rutgers [Member]
Milestone payments to be paid			$ 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, LLC [Member]
Upfront license fee	$ 119
MentiNova, LLC [Member] | Completion Of Stage One [Member]
Milestone payments to be paid			$ 1,188