scPharmaceuticals (SCPH) 10-Q 13 Nov 24 2024 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
	Sep. 30, 2024	Nov. 12, 2024
Document Information [Line Items]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2024
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	Q3
Trading Symbol	SCPH
Entity Registrant Name	SCPHARMACEUTICALS INC.
Entity Central Index Key	0001604950
Current Fiscal Year End Date	--12-31
Entity Filer Category	Non-accelerated Filer
Entity Current Reporting Status	Yes
Entity Small Business	true
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Interactive Data Current	Yes
Title of 12(b) Security	Common stock, par value $0.0001 per share
Security Exchange Name	NASDAQ
Entity File Number	001-38293
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	46-5184075
Entity Address, Address Line One	25 Mall Road
Entity Address, Address Line Two	Suite 203
Entity Address, City or Town	Burlington
Entity Address, State or Province	MA
Entity Address, Postal Zip Code	01803
City Area Code	617
Local Phone Number	517-0730
Document Quarterly Report	true
Document Transition Report	false
Entity Common Stock, Shares Outstanding		50,040,134

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS (Unaudited) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Current assets
Cash and cash equivalents	$ 91,484	$ 46,814
Short-term investments		29,199
Accounts receivable, net	9,217	4,489
Inventory, net	18,107	8,840
Prepaid expenses	3,373	2,436
Deposits and other current assets	1,148	1,160
Total current assets	123,329	92,938
Property and equipment, net	51	58
Right-of-use lease assets - operating, net	1,330	1,401
Deposits and other assets	359	82
Total assets	125,069	94,479
Current liabilities
Accounts payable	5,003	4,001
Accrued expenses	9,868	8,901
Lease obligation - operating, short-term	231	176
Other current liabilities	162	56
Total current liabilities	15,264	13,134
Term loan, long-term	51,099	38,811
Revenue purchase and sale liability	26,830	0
Derivative liability	0	3,857
Lease obligation - operating, long-term	1,167	1,282
Other liabilities	0	177
Total liabilities	94,360	57,261
Commitments and contingencies (Note 12)
Stockholders’ equity
Preferred stock, $0.0001 par value; 10,000,000 shares authorized and no shares issued and outstanding
Common stock, $0.0001 par value; 150,000,000 shares authorized as of September 30, 2024; 35,968,510 and 50,040,134 shares issued and outstanding as of December 31, 2023 and September 30, 2024, respectively	5	4
Additional paid-in capital	378,353	318,561
Accumulated deficit	(347,649)	(281,346)
Accumulated other comprehensive income		(1)
Total stockholders’ equity	30,709	37,218
Total liabilities and stockholders’ equity	$ 125,069	$ 94,479

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Unaudited) (Parenthetical) - $ / shares	Sep. 30, 2024	Dec. 31, 2023
Statement of Financial Position [Abstract]
Preferred stock, par value	$ 0.0001	$ 0.0001
Preferred stock, shares authorized	10,000,000	10,000,000
Preferred stock, shares issued	0	0
Preferred stock, shares outstanding	0	0
Common stock, par value	$ 0.0001	$ 0.0001
Common stock, shares authorized	150,000,000	150,000,000
Common stock, shares issued	50,040,134	35,968,510
Common stock, shares outstanding	50,040,134	35,968,510

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE LOSS (Unaudited) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Income Statement [Abstract]
Product revenues, net	$ 10,026	$ 3,796	$ 24,182	$ 7,497
Revenue from Contract with Customer, Product and Service [Extensible Enumeration]	us-gaap:ProductMember	us-gaap:ProductMember	us-gaap:ProductMember	us-gaap:ProductMember
Operating expenses:
Cost of product revenues	$ 3,311	$ 1,079	$ 7,396	$ 2,038
Research and development	3,541	3,421	8,944	8,471
Selling, general and administrative	21,320	14,135	56,275	37,127
Total operating expenses	28,172	18,635	72,615	47,636
Loss from operations	(18,146)	(14,839)	(48,433)	(40,139)
Loss on extinguishment of debt	(13,032)		(13,032)
Change in fair value of term loan	(2,954)		(2,954)
Change in fair value of revenue purchase and sale liability	(1,830)		(1,830)
Other (expense) income	1,804	(36)	3,587	1,193
Interest income	903	1,301	2,444	3,979
Interest expense	(1,850)	(2,060)	(6,085)	(6,031)
Net loss	$ (35,105)	$ (15,634)	$ (66,303)	$ (40,998)
Net loss per share - basic	$ (0.75)	$ (0.41)	$ (1.6)	$ (1.07)
Net loss per share - diluted	$ (0.75)	$ (0.41)	$ (1.6)	$ (1.07)
Weighted average common shares outstanding - basic	46,558,474	38,760,895	41,516,917	38,421,676
Weighted average common shares outstanding - diluted	46,558,474	38,760,895	41,516,917	38,421,676
Other comprehensive loss:
Unrealized gain (loss) on short term investments		$ 4	$ 1	$ (34)
Comprehensive loss	$ (35,105)	$ (15,630)	$ (66,302)	$ (41,032)

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY (Unaudited) - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-in Capital	Accumulated Deficit	Other Comprehensive Income (Loss)
Beginning Balance at Dec. 31, 2022	$ 72,433	$ 3	$ 298,934	$ (226,536)	$ 32
Beginning Balance, Shares at Dec. 31, 2022		34,257,916
Net loss	(11,210)			(11,210)
Issuance of common stock under at-the-market offering, net of issuance costs	13,628	$ 1	13,627
Issuance of common stock under at-the-market offering, net of issuance costs, Shares		1,511,157
Stock-based compensation	980		980
Unrealized gain (loss) on short term investments	(24)				(24)
Ending Balance at Mar. 31, 2023	75,807	$ 4	313,541	(237,746)	8
Ending Balance, Shares at Mar. 31, 2023		35,769,073
Beginning Balance at Dec. 31, 2022	72,433	$ 3	298,934	(226,536)	32
Beginning Balance, Shares at Dec. 31, 2022		34,257,916
Net loss	(40,998)
Unrealized gain (loss) on short term investments	(34)
Ending Balance at Sep. 30, 2023	49,146	$ 4	316,678	(267,534)	(2)
Ending Balance, Shares at Sep. 30, 2023		35,859,045
Beginning Balance at Mar. 31, 2023	75,807	$ 4	313,541	(237,746)	8
Beginning Balance, Shares at Mar. 31, 2023		35,769,073
Net loss	(14,154)			(14,154)
Issuance of common stock upon exercise of stock options	101		101
Issuance of common stock upon exercise of stock options, Shares		18,000
Issuance of common stock under at-the-market offering, net of issuance costs	332		332
Issuance of common stock under at-the-market offering, net of issuance costs, Shares		33,333
Stock-based compensation	1,179		1,179
Unrealized gain (loss) on short term investments	(14)				(14)
Issuance of common stock through employee stock purchase plan	176		176
Issuance of common stock through employee stock purchase plan, Shares		29,076
Ending Balance at Jun. 30, 2023	63,427	$ 4	315,329	(251,900)	(6)
Ending Balance, Shares at Jun. 30, 2023		35,849,482
Net loss	(15,634)			(15,634)
Issuance of common stock upon exercise of stock options	68		68
Issuance of common stock upon exercise of stock options, Shares		9,563
Stock-based compensation	1,281		1,281
Unrealized gain (loss) on short term investments	4				4
Ending Balance at Sep. 30, 2023	49,146	$ 4	316,678	(267,534)	(2)
Ending Balance, Shares at Sep. 30, 2023		35,859,045
Beginning Balance at Dec. 31, 2023	37,218	$ 4	318,561	(281,346)	(1)
Beginning Balance, Shares at Dec. 31, 2023		35,968,510
Net loss	(14,108)			(14,108)
Issuance of common stock upon exercise of stock options	181		181
Issuance of common stock upon exercise of stock options, Shares		32,754
Vesting of restricted stock	(166)		(166)
Vesting of restricted stock, Shares		53,145
Stock-based compensation	1,440		1,440
Unrealized gain (loss) on short term investments	1				1
Ending Balance at Mar. 31, 2024	24,566	$ 4	320,016	(295,454)
Ending Balance, Shares at Mar. 31, 2024		36,054,409
Beginning Balance at Dec. 31, 2023	37,218	$ 4	318,561	(281,346)	$ (1)
Beginning Balance, Shares at Dec. 31, 2023		35,968,510
Net loss	$ (66,303)
Issuance of common stock upon exercise of stock options, Shares	30,203
Unrealized gain (loss) on short term investments	$ 1
Ending Balance at Sep. 30, 2024	30,709	$ 5	378,353	(347,649)
Ending Balance, Shares at Sep. 30, 2024		50,040,134
Beginning Balance at Mar. 31, 2024	24,566	$ 4	320,016	(295,454)
Beginning Balance, Shares at Mar. 31, 2024		36,054,409
Net loss	(17,090)			(17,090)
Stock-based compensation	1,491		1,491
Issuance of common stock through employee stock purchase plan	283		283
Issuance of common stock through employee stock purchase plan, Shares		85,393
Ending Balance at Jun. 30, 2024	9,250	$ 4	321,790	(312,544)
Ending Balance, Shares at Jun. 30, 2024		36,139,802
Net loss	(35,105)			(35,105)
Issuance of warrants	1,744		1,744
Issuance of common stock and pre-funded warrants in common stock offering, net of issuance costs	53,547	$ 1	53,546
Issuance of common stock and pre-funded warrants in common stock offering, net of issuance costs, Shares		13,875,000
Issuance of common stock upon exercise of stock options	47		47
Issuance of common stock upon exercise of stock options, Shares		21,792
Vesting of restricted stock, Shares		3,540
Stock-based compensation	1,226		1,226
Ending Balance at Sep. 30, 2024	$ 30,709	$ 5	$ 378,353	$ (347,649)
Ending Balance, Shares at Sep. 30, 2024		50,040,134

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($)	3 Months Ended				9 Months Ended		12 Months Ended
	Sep. 30, 2024	Mar. 31, 2024	Sep. 30, 2023	Mar. 31, 2023	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2023
Cash flows from operating activities
Net loss	$ (35,105,000)	$ (14,108,000)	$ (15,634,000)	$ (11,210,000)	$ (66,303,000)	$ (40,998,000)
Adjustments to reconcile net loss to cash used in operating activities
Depreciation expense	5,000		6,000		16,000	18,000
Reduction in carrying value of operating right-of-use lease assets					71,000	468,000
Accretion on short-term investments					(120,000)	(1,570,000)
Allowance for excess, damaged and obsolete inventory					75,000		$ 0
Stock-based compensation					4,157,000	3,440,000
Non-cash interest expense					1,562,000	1,576,000
Fair value adjustment to derivative liability					(3,857,000)	(1,214,000)
Fair value adjustment to term loan	2,954,000				2,954,000
Fair value adjustment to revenue purchase and sale liability	1,830,000				1,830,000
Debt issuance costs					4,487,000
Loss on extinguishment of debt	13,032,000				13,032,000
Changes in operating assets and liabilities
Accounts receivable					(4,728,000)	(4,175,000)
Inventory					(9,343,000)	(5,893,000)
Prepaid expenses and other assets					(1,203,000)	867,000
Accounts payable, accrued expenses and other liabilities					2,018,000	3,395,000
Net cash used in operating activities					(55,352,000)	(44,086,000)
Cash flows from investing activities
Purchases of property and equipment					(9,000)	(3,000)
Maturities of short-term investments					29,320,000	44,100,000
Purchases of short-term investments						(50,595,000)
Net cash (used in) provided by investing activities					29,311,000	(6,498,000)
Cash flows from financing activities
Proceeds from common stock offering, net of underwriter discounts and offering costs					53,547,000
Proceeds from term loan, net					46,772,000
Proceeds from revenue participation agreement, net					23,629,000
Proceeds from employee stock purchase plan					283,000	176,000
Proceeds from the exercise of vested stock options					228,000	169,000
Proceeds from at-the-market offering, net						14,038,000
Principal payments on term loan					(50,000,000)
Prepayment and legal fees					(2,582,000)
Payment of term loan final fee					(1,000,000)
Settlement of restricted stock units for tax withholding obligations					(166,000)
Net cash provided by financing activities					70,711,000	14,383,000
Net (decrease) increase in cash and cash equivalents					44,670,000	(36,201,000)
Cash and cash equivalents at beginning of period		$ 46,814,000		$ 71,243,000	46,814,000	71,243,000	71,243,000
Cash and cash equivalents at end of period	$ 91,484,000		$ 35,042,000		91,484,000	35,042,000	$ 46,814,000
Supplemental cash flow information
Interest paid					4,556,000	4,455,000
Taxes paid					174,000	196,000
Supplemental disclosure of non-cash activities
Fair value of warrants issued					1,855,000
Transfer of issuance costs from other noncurrent assets to equity						79,000
Operating right-of-use asset received in exchange for lease obligations					$ 71,000	$ 1,437,000

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Pay vs Performance Disclosure
Net Income (Loss)	$ (35,105)	$ (15,634)	$ (66,303)	$ (40,998)

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Sep. 30, 2024
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

Description of Business and Bas

Description of Business and Basis of Presentation	9 Months Ended
	Sep. 30, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Description of Business and Basis of Presentation	1. Description of Business and Basis of Presentation Description of Business scPharmaceuticals LLC was formed as a limited liability company under the laws of the State of Delaware on February 19, 2013. On March 24, 2014, scPharmaceuticals LLC was converted to a Delaware corporation and changed its name to scPharmaceuticals Inc. (“the Company”). The Company is a pharmaceutical company focused on developing and commercializing products that have the potential to optimize the delivery of infused therapies, advance patient care and reduce healthcare costs. The Company’s strategy is designed to enable the subcutaneous administration of therapies that have previously been limited to intravenous (“IV”) delivery. The Company’s headquarters and primary place of business is Burlington, Massachusetts. Basis of Presentation The accompanying condensed consolidated financial statements have been prepared in conformity with accounting principles generally accepted in the United States (“U.S. GAAP”) for interim financial information and have been prepared on a basis which assumes that the Company will continue as a going concern, which contemplates the realization of assets and the satisfaction of liabilities and commitments in the normal course of business. The condensed consolidated financial statements reflect the operations of the Company and its wholly-owned subsidiary, scPharmaceuticals Securities Corporation. Certain information and disclosures normally included in financial statements in accordance with U.S. GAAP have been condensed or omitted. Accordingly, these condensed consolidated financial statements should be read in conjunction with the Company’s audited financial statements and related notes for the year ended December 31, 2023 included in the Company’s Annual Report on Form 10-K filed with the Securities and Exchange Commission (the “SEC”) on March 13, 2024. The Company has determined that it operates in one segment. The accompanying condensed consolidated balance sheet as of September 30, 2024, the condensed consolidated statements of operations and comprehensive loss and stockholders’ equity for the three and nine months ended September 30, 2023 and 2024 and condensed consolidated statements of cash flows for the nine months ended September 30, 2023 and 2024 are unaudited. The unaudited condensed consolidated financial statements have been prepared on a basis consistent with that used to prepare the Company’s audited annual financial statements and include, in the opinion of management, adjustments, consisting of normal recurring items, necessary for the fair statement of the condensed consolidated financial statements. The operating results for the three and nine months ended September 30, 2024 are not necessarily indicative of the results expected for the full year ending December 31, 2024. Liquidity As of September 30, 2024 , the Company had an accumulated deficit of approximately $ 347.6 million. Management expects to continue to incur operating losses for the foreseeable future. The Company has financed its operations to date from proceeds from the sale of common stock, preferred stock and the incurrence of debt. As of September 30, 2024, the Company had cash and cash equivalents of $ 91.5 million. On October 13, 2022, the Company entered into a Credit Agreement and Guaranty (the "Oaktree Agreement") with, among others, the lenders from time to time party thereto and Oaktree Fund Administration, LLC, in its capacity as administrative agent for the lenders (Note 9). On August 9, 2024 (the "Closing Date"), the Company entered into a Credit Agreement and Guaranty (the "Credit Agreement") with the guarantors from time to time party thereto, the lenders from time to time party thereto (the "Lenders"), and Perceptive Credit Holdings IV, LP, in its capacity as administrative agent for the Lenders (in such capacity, the "Agent") (Note 9). On the Closing Date, the Company also entered into a Revenue Participation Right Purchase and Sale Agreement (the "Revenue Purchase and Sale Agreement") with Perceptive Credit Holdings IV, LP (the "Purchaser") (Note 9). The Company used the proceeds of the Credit Agreement and the Revenue Purchase and Sale Agreement to, on the Closing Date, prepay all outstanding obligations under the Oaktree Agreement, including the payment of fees and expenses associated with the Oaktree Agreement. In addition, on August 13, 2024, the Company completed an underwritten public offering of shares of its common stock (and, in lieu of such shares of common stock to selected investors, pre-funded warrants to purchase shares of its common stock) with net proceeds of $ 53.5 million (Note 10). The Company's existing cash and cash equivalents will be sufficient to meet its cash commitments for at least the next 12 months after the date that the interim condensed consolidated financial statements are issued. Additionally, the Company expects to have access to funds pursuant to an at-the-market offering program with Cowen and Company, LLC (Note 10), or could otherwise seek additional funding through a combination of public or private equity offerings if it believes additional resources are needed. Additional financing may not be available on a timely basis on terms acceptable to the Company, or at all.

Significant Accounting Policies

Significant Accounting Policies	9 Months Ended
	Sep. 30, 2024
Accounting Policies [Abstract]
Significant Accounting Policies	2. Significant Accounting Policies Use of Estimates The preparation of financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and the disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of expenses during the reported periods. Actual results could differ from those estimates. Cash and Cash Equivalents Cash and cash equivalents consists of bank deposits and money market accounts with financial institutions. Cash equivalents are carried at cost which approximates fair value due to their short-term nature and which the Company believes do not have a material exposure to credit risk. The Company considers all highly liquid investments with maturities of three months or less from the date of purchase to be cash equivalents. The Company’s cash and cash equivalent accounts, at times, may exceed federally insured limits. The Company has not experienced any losses in such accounts. Accounts Receivable Accounts receivable are recorded net of any estimated expected credit losses. The Company's measurement of expected credit losses is based on relevant information about past events, current conditions, and reasonable and supportable forecasts that affect the collectability of the reported amount. The Company does not currently have a material credit loss allowance for uncollectible trade receivables. Concentration of Credit Risk Financial instruments that subject the Company to credit risk primarily consist of cash and cash equivalents. The Company maintains its cash and cash equivalent balances with high-quality financial institutions and, consequently, the Company believes that such funds are subject to minimal credit risk. The Company has adopted an investment policy that limits the amounts the Company may invest in any one type of investment and requires all investments held by the Company to hold a minimum rating, thereby reducing credit risk exposure . Customer and Supplier Concentration The Company has a limited number of specialty pharmacy customers and distributo rs. As of December 31, 2023 and September 30, 2024 , three customers represented 99 % and two customers represented 98 % of accounts receivable, respectively. For the three and nine months ended September 30, 2024 , two customers represented 98 % and three customers represented 99 % of revenue, respectively. For the three and nine months ended September 30, 2023, two customers represented 92 % and one customer represented 88 % of revenue, respectively. The Company has a limited number of suppliers and contract manufacturers utilized in the production of its product. As of December 31, 2023 and September 30, 2024 , one supplier represented 47 % and three suppliers represented 49 % of accounts payable, respectively. For the three and nine months ended September 30, 2024 , two suppliers represented 45 % and 49 % of purchases, respectively. For the three and nine months ended September 30, 2023, one supplier represented 29 % and two suppliers represented 40 % of purchases, respectively. The Company depends on suppliers for raw materials, active pharmaceutical ingredients, and other components that are subject to stringent FDA requirements. Some of these materials may only be available from one or a limited number of sources. Establishing additional or replacement suppliers may take a substantial period of time, as suppliers must be approved by the FDA. If the Company is unable to secure, on a timely basis, sufficient quantities of the materials it depends on to manufacture its products, it could have a materially adverse effect on the Company's business, financial condition and results of operations. Investments The Company invests excess cash balances in available-for-sale debt securities. The Company determines the appropriate classification of these securities at the time they are acquired and evaluates the appropriateness of such classifications at each balance sheet date. The Company reports available-for-sale investments at fair value at each balance sheet date and includes any unrealized gains and losses in accumulated other comprehensive income (loss), a component of stockholders’ equity. Realized gains and losses are determined using the specific identification method and are included in other income. If any adjustment to fair value reflects a decline in the value of the investment, the Company considers all available evidence to evaluate the extent to which the decline is “other than temporary,” including the intention to sell and, if so, marks the investment to market through a charge to the Company’s consolidated statements of operations and comprehensive loss . Inventory Inventory is stated at the lower of cost and net realizable value and consists of raw materials, work-in-process and finished goods. The Company began capitalizing inventory costs following U.S. Food and Drug Administration ("FDA") approval of FUROSCIX on October 7, 2022. Inventory is sold on a first in, first out ("FIFO") basis. The Company periodically reviews inventory for expiry and obsolescence and writes it down accordingly, if necessary. Prior to FDA approval of FUROSCIX, the Company expensed all inventory-related costs, including that used for clinical development, to research and development ("R&D") costs in the period incurred. Leases The Company determines if an arrangement is a lease at inception. Operating leases are included in right-of-use (“ROU”) lease assets, current portion of lease obligations, and long-term lease obligations on the Company’s balance sheets. ROU lease assets represent the Company’s right to use an underlying asset for the lease term and lease obligations represent the Company’s obligation to make lease payments arising from the lease. Operating ROU lease assets and obligations are recognized at the commencement date based on the present value of lease payments over the lease term. As most of the Company’s leases do not provide an implicit rate, the Company uses its incremental borrowing rate based on the information available at the commencement date in determining the present value of lease payments. The ROU lease asset excludes lease incentives. The Company’s lease terms may include options to extend or terminate the lease when it is reasonably certain that the Company will exercise that option. Lease expense for lease payments is recognized on a straight-line basis over the lease term . Debt Issuance Costs Debt issuance costs have been amortized to interest expense using the effective interest rate method over the term of the debt. Debt issuance costs paid to the lender and third parties are reflected as a discount to the debt in the consolidated balance sheet as of December 31, 2023. Fair Value Option As permitted under Financial Accounting Standards Board's ("FASB") Accounting Standards Codification ("ASC") Topic 825, Financial Instruments (“ASC 825”), the Company elected the fair value option to account for the Credit Agreement and the Revenue Purchase and Sale Agreement (collectively, the "Perceptive Financing"). In accordance with ASC 825, the Company records these instruments at fair value with changes in fair value recorded in the Condensed Consolidated Statement of Operations and Comprehensive Loss. As a result of applying the fair value option, direct costs and fees related to the Perceptive Financing were expensed as incurred and were not deferred. The Company elected to account for the Perceptive Financing using the fair value option, which allows for valuing the Credit Agreement and the Revenue Purchase and Sale Agreement in their entirety versus bifurcation of the embedded derivatives. Revenue Recognition The Company recognizes revenue when its customer obtains control of promised goods or services, in an amount that reflects the consideration which the entity expects to receive in exchange for those goods or services. To determine revenue recognition for arrangements that the Company determines are within the scope of ASC Topic 606, Revenue from Contracts with Customer (“Topic 606”), the Company performs the following five steps: (i) identify the contract(s) with a customer; (ii) identify the performance obligations in the contract; (iii) determine the transaction price; (iv) allocate the transaction price to the performance obligations in the contract; and (v) recognize revenue when the Company satisfies a performance obligation. The Company only applies the five-step model to contracts when it is probable that it will collect the consideration it is entitled to in exchange for the goods or services it transfers to the customer. At contract inception, once the contract is determined to be within the scope of Topic 606, the Company assesses the goods or services promised within each contract and determines those that are performance obligations and assesses whether each promised good or service is distinct. The Company then recognizes as revenue the amount of the transaction price that is allocated to the respective performance obligation when the performance obligation is satisfied. The Company has identified one performance obligation, the delivery of FUROSCIX to its customers. The Company has not incurred any incremental costs associated with obtaining contracts with customers. The Company’s revenues consist solely of the sale of FUROSCIX to customers in the United States. Product Net Sales FUROSCIX was approved by the FDA on October 7, 2022. The Company launched sales of FUROSCIX in the first quarter of 2023 and its customers consist of specialty pharmacies (“SPs”) and specialty distributors ("SDs"). The Company recognizes revenue from product sales at a point in time, typically upon receipt of product at the SPs and SDs, the date at which the rights, title, interest and risk of loss are transferred. Revenues from product sales are recorded at the net sales price, which includes estimates of variable consideration that result from (a) sales discounts, (b) rebates (c) co-pay assistance, and (d) product returns. Reserves are established for the estimates of variable consideration based on the amounts earned or to be claimed on the related sales. The reserves for variable consideration are reflected as either as a reduction to the related account receivable or as an accrued liability, depending on how the consideration is settled. The amount of variable consideration that is included in the transaction price may be constrained and is included in net product revenues only to the extent that it is probable that a significant reversal in the amount of the cumulative revenue recognized will not occur in a future period. Actual amounts of consideration ultimately received may differ from the Company's estimates. If actual results vary from its estimates, the Company adjusts these estimates, which would affect net product revenue and earnings in the period such variances become known. Sales Discounts : Sales discounts are agreed-upon discounts, from negotiated contracts, taken directly off the Company’s sales invoices. Sales discounts are recorded as an offset to revenue based on contractual terms at the time revenue from the sale is recognized. Rebates : Allowance for rebates include mandated discounts under the Medicaid Drug Rebate Program and the Medicare Part D prescription drug benefit, TRICARE program and contractual rebates with commercial payers. Rebates are amounts owed after the final dispensing of the product to a benefit plan participant and are based upon contractual agreements or statutory requirements. The allowance for rebates is based on contracted or statutory discount rates and expected utilization by benefit plan participants. The Company’s estimates for expected utilization of rebates are based on utilization data received from the SPs since product launch. Rebates are generally invoiced and paid in arrears so that the accrual balance consists of an estimate of the amount expected to be incurred for the current quarter’s activity, plus an accrual balance for prior quarters’ unpaid rebates. If actual future rebates vary from estimates, the Company may need to adjust prior period accruals, which would affect revenue in the period of adjustment. Co-Payment Assistance: The Company offers co-payment assistance to commercially insured patients meeting certain eligibility requirements. Co-payment assistance is accrued at the time of product sale to SPs based on estimated patient participation and average co-pay benefit to be paid per a claim. The Company’s estimated amounts are compared to actual program participation and co-pay amounts paid using data provided by third-party administrators. If actual amounts differ from the original estimates the assumptions being applied are updated and adjustment for prior period accruals will be adjusted in the current period. Product Returns: Consistent with industry practice, the Company offers SPs and SDs limited product return rights for damages, shipment errors, and expiring product, provided that the return is within a specified period around the product expiration date as set forth in the applicable individual distribution agreement. The Company does not allow product returns for product that has been dispensed to a patient. As the Company receives inventory reports from the SPs and has the ability to control the amount of product that is sold to the SPs, it is able to make a reasonable estimate of future potential product returns based on this on-hand channel inventory data and sell-through data obtained from the SPs. Currently, sales to SDs are limited and there is no access to on-hand channel inventory or sell through data. As these arrangements mature, the Company will utilize any data that they can provide as part of this analysis. In arriving at its estimate, the Company also considers historical product returns, the underlying product demand, and industry data specific to the specialty pharmaceutical distribution industry. Research and Development Costs Research and development costs are expensed as incurred. Nonrefundable advance payments, if any, for goods or services used in research and development are initially recorded as an asset and then recognized as an expense as the related goods are delivered or services are performed. Research and development expenses include contract services, consulting, salaries, materials and supplies and overhead . Income Taxes The Company accounts for income taxes in accordance with the FASB ASC 740, Income Taxes. Deferred tax assets and liabilities are recorded to reflect the impact of temporary differences between amounts of assets and liabilities for financial reporting purposes and such amounts as measured under enacted tax laws. A valuation allowance is required to offset any net deferred tax assets if, based upon the available evidence, it is more likely than not that some or all of the deferred tax asset will not be realized. The Company provides reserves for potential payments of tax to various tax authorities related to uncertain tax positions. The tax benefits recorded are based on a determination of whether and how much of a tax benefit taken by the Company in its tax filings or positions is “more likely than not” to be realized following resolution of any uncertainty related to the tax benefit, assuming that the matter in question will be raised by the tax authorities. Potential interest and penalties associated with such uncertain tax positions are recorded as a component of income tax expense. At September 30, 2024 , the Company had no such accruals. As part of the Tax Cuts and Jobs Act of 2017 ("TCJA"), beginning with the Company’s fiscal year ended December 31, 2022, the Company is required to capitalize research and development expenses, as defined under section 174 of the Internal Revenue Code of 1986, as amended. For expenses that are incurred for research and development in the United States, the amounts will be amortized over 5 years, and expenses that are incurred for research and experimentation outside the United States will be amortized over 15 years.

Net Loss per Share

Net Loss per Share	9 Months Ended
	Sep. 30, 2024
Earnings Per Share [Abstract]
Net Loss per Share	3. Net Loss per Share Net Loss per Share Attributable to Common Stockholders The following table sets forth the computation of basic and diluted net loss per share of common stock (in thousands, except share and per share data): Three Months Ended September 30, Nine Months Ended September 30, 2023 2024 2023 2024 Net loss $ ( 15,634 ) $ ( 35,105 ) $ ( 40,998 ) $ ( 66,303 ) Weighted-average shares used in computing net loss per share 38,760,895 46,558,474 38,421,676 41,516,917 Net loss per share, basic and diluted $ ( 0.41 ) $ ( 0.75 ) $ ( 1.07 ) $ ( 1.60 ) Basic and diluted weighted average shares of common stock outstanding for the three and nine months ended September 30, 2024 include the weighted average effect of outstanding pre-funded warrants for the purchase of shares of common stock for which the remaining unfunded exercise price is $ 0.001 per share. The Company’s potentially dilutive securities, which include unexercised stock options outstanding, unexercised warrants and unvested restricted stock units, have been excluded from the computation of diluted net loss per share as the effect would be to reduce the net loss per share. Therefore, 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 Company excluded the following potential common shares, presented based on amounts outstanding at each period end, from the computation of diluted net loss per share attributable to common stockholders for the periods indicated because including them would have had an anti-dilutive effect. Three Months Ended September 30, Nine Months Ended September 30, 2023 2024 2023 2024 Stock options to purchase common stock 4,722,050 5,445,475 4,722,050 5,445,475 Warrants to purchase common stock 516,345 1,016,345 516,345 1,016,345 Unvested restricted stock units 339,556 721,766 339,556 721,766 Total 5,577,951 7,183,586 5,577,951 7,183,586

Investments

Investments	9 Months Ended
	Sep. 30, 2024
Investments, Debt and Equity Securities [Abstract]
Investments	4. Investments Cash in excess of the Company’s immediate requirements is invested in accordance with the Company’s investment policy that primarily seeks to maintain adequate liquidity and preserve capital. A summary of the Company’s available-for-sale classified investments as of December 31, 2023 consisted of the following (in thousands): At December 31, 2023 Investments - Current: Cost Basis Accumulated Unrealized Gains Accumulated Unrealized Losses Fair Value United States Treasury securities $ 13,967 $ 2 $ - $ 13,969 Commercial paper $ 9,427 $ - $ ( 2 ) 9,425 Corporate bonds 3,815 - - 3,815 United States Government Agency securities 1,991 - ( 1 ) 1,990 Total $ 29,200 $ 2 $ ( 3 ) $ 29,199 The Company did not have any investments as of September 30, 2024.

Inventory

Inventory	9 Months Ended
	Sep. 30, 2024
Inventory Disclosure [Abstract]
Inventory	5. Inventory The Company's inventory balance consists of the following (in thousands): December 31, September 30, Raw materials $ 4,256 $ 6,874 Work-in-process 4,188 10,363 Finished goods 396 870 $ 8,840 $ 18,107 Inventory is stated at the lower of cost and net realizable value and consists of raw materials, work-in-process and At December 31, 2023 and September 30, 2024, the Company has an allowance for excess, damaged and obsolete inventory in the amount of $ 0 and $ 75,000 , respectively. The Company currently uses a limited number of third-party contract manufacturing organizations ("CMOs") to produce its inventory.

Property and Equipment

Property and Equipment	9 Months Ended
	Sep. 30, 2024
Property, Plant and Equipment [Abstract]
Property and Equipment	6. Property and Equipment Purchased property and equipment consist of the following (dollars in thousands): ESTIMATED December 31, September 30, Office equipment 5 years $ 31 $ 31 Office furniture 7 years 64 73 Computer equipment 3 years 15 15 Leasehold improvements Life of lease 9 9 119 128 Less: Accumulated depreciation ( 61 ) ( 77 ) Property and equipment, net $ 58 $ 51 Depreciation expense for the three months ended September 30, 2023 and 2024 was $ 6,000 and $ 5,000 , respectively. Depreciation expense for the nine months ended September 30, 2023 and 2024 was $ 18,000 and $ 16,000 , respectively.

Accrued Expenses

Accrued Expenses	9 Months Ended
	Sep. 30, 2024
Accrued Liabilities, Current [Abstract]
Accrued Expenses	7. Accrued Expenses Accrued expenses consist of the following (in thousands): December 31, September 30, Employee compensation and related costs $ 4,375 $ 3,891 Manufacturing costs 434 2,260 Sales returns and allowances and related costs 1,418 1,477 Contract research and development 1,202 1,240 Consulting and professional service fees 945 658 Royalty 249 259 Inventory in transit 150 — Other 128 83 Total accrued expenses $ 8,901 $ 9,868

Fair Value of Financial Instrum

Fair Value of Financial Instruments	9 Months Ended
	Sep. 30, 2024
Fair Value Disclosures [Abstract]
Fair Value of Financial Instruments	8. Fair Value of Financial Instruments FASB ASC Topic 820, Fair Value Measurements and Disclosures (“ASC 820”), provides a fair value hierarchy, which classifies fair value measurements based on the inputs used in measuring fair value. Observable inputs are inputs that market participants would use in pricing the asset or liability based on market data obtained from sources independent of the Company. Unobservable inputs are inputs that reflect the Company’s assumptions about the inputs that market participants would use in pricing the asset or liability, and are developed based on the best information available in the circumstances. The fair value hierarchy applies only to the valuation inputs used in determining the reported fair value of the investments and is not a measure of the investment credit quality. The three levels of the fair value hierarchy are described below: Level 1—Valuations based on unadjusted quoted prices in active markets for identical assets or liabilities that the Company has the ability to access at the measurement date. Level 2—Valuations based on quoted prices for similar assets or liabilities in markets that are not active or for which all significant inputs are observable, either directly or indirectly. Level 3—Valuations that require inputs that reflect the Company’s own assumptions that are both significant to the fair value measurement and observable. To the extent that valuation is based on models or inputs that are less observable or unobservable in the market, the determination of fair value requires more judgment. Accordingly, the degree of judgment exercised by the Company in determining fair value is greatest for instruments categorized in Level 3. A financial instrument’s level within the fair value hierarchy is based on the lowest level of any input that is significant to the fair value measurement. The carrying values of the Company’s cash, prepaid expenses and deposits approximate their fair values due to their short-term nature. The following tables summarize the Company’s assets that are measured at fair value on a recurring basis and indicates the level of the fair value hierarchy utilized to determine such fair values (in thousands): As of December 31, 2023 TOTAL Quoted Prices Significant Significant Assets: Cash equivalents $ 44,202 $ 44,202 $ — $ — Total cash equivalents 44,202 44,202 — — United States Treasury securities 13,969 13,969 - — Commercial paper 9,425 — 9,425 — Corporate bonds 3,815 — 3,815 — United States Government Agency securities 1,990 — 1,990 — Investments 29,199 13,969 15,230 — Total $ 73,401 $ 58,171 $ 15,230 $ — Liabilities: Derivative liability $ 3,857 $ — $ — $ 3,857 Total $ 3,857 $ — $ — $ 3,857 As of September 30, 2024 TOTAL Quoted Prices Significant Significant Assets: Cash equivalents $ 90,346 $ 90,346 $ — $ — Total $ 90,346 $ 90,346 $ — $ — Liabilities: Term loan $ 51,099 $ — $ — $ 51,099 Revenue purchase and sale liability 26,830 — — 26,830 Total $ 77,929 $ — $ — $ 77,929 The Company measures the term loan and the revenue purchase and sale liability from the Perceptive Financing at fair value based on significant inputs not observable in the market, which causes them to be classified as Level 3 measurements within the fair value hierarchy. These valuations use assumptions and estimates the Company believes would be made by a market participant in making the same valuation. The Company assesses these assumptions and estimates on an on-going basis as additional data impacting the assumptions and estimates are obtained. Changes in the fair value of the Perceptive Financing related to updated assumptions and estimates are recognized within the Consolidated Statements of Operations and Comprehensive Loss. The fair value of the term loan was measured as of September 30, 2024, using a binomial lattice model to account for the dynamic nature of interest rate fluctuations and the strategic exercise of the certain optional prepayment features. Three variations of such binomial lattice models were utilized: the Black-Derman-Toy ("BDT"), Hull-White, and Ho-Lee models, each incorporating assumptions of future interest rate curves. The fair value of the revenue purchase and sale liability was measured as of September 30, 2024, using a hybrid methodology between the discounted cash flow ("DCF") and Monte Carlo simulation method (“MCS”), utilizing future cash flow projections and assumptions of the timing and probability of certain contingent events, such as the occurrence of a change of control and the exercise of call and put options. A discount rate of 20.5 % was used. The fair values of the term loan and the revenue purchase and sale liability may change significantly as additional data is obtained, impacting the Company’s assumptions regarding probabilities of outcomes used to estimate the fair value of the liabilities. The estimates of fair value may not be indicative of the amounts that could be realized in a current market exchange. Accordingly, the use of different market assumptions and/or different valuation techniques may have a material effect on the estimated fair value amounts, and such changes could materially impact the Company’s results of operations in future periods. Changes in the fair value of the Company's Level 3 liabilities for the nine months ended September 30, 2024 are as follows (in thousands): Derivative Liability Term Loan Revenue purchase and sale liability At December 31, 2023 $ 3,857 $ — $ — Initial fair value — 48,145 25,000 Change in fair value ( 3,857 ) 2,954 1,830 At September 30, 2024 $ — $ 51,099 $ 26,830

Financial Liabilities

Financial Liabilities	9 Months Ended
	Sep. 30, 2024
Debt Disclosure [Abstract]
Financial Liabilities	9. Financial Liabilities Perceptive Financing The following table presents the fair value of the Company's debt balance as of September 30, 2024 (in thousands): September 30, Par value of the term loan $ 50,000 Initial fair value adjustment ( 1,855 ) Fair value of the term loan at issuance 48,145 Change in fair value of the term loan 2,954 Total fair value of the term loan $ 51,099 On the Closing Date, the Company entered into the Credit Agreement. The Credit Agreement establishes a $ 75.0 million term loan facility, consisting of (i) $ 50.0 million funded on the Closing Date ("Tranche A Loan") and (ii) subject to satisfaction of certain conditions, $ 25.0 million (together with the Tranche A Loan, collectively, the "Term Loan") that the Company may borrow in a single borrowing on or prior to March 31, 2026. Borrowings under the Term Loan bear interest at a rate per annum equal to the one-month term SOFR (subject to a 3.25 % floor), plus an applicable margin of 6.75 %, payable monthly in arrears. There will be no scheduled repayments of outstanding principal on the Term Loan prior to August 9, 2029 (the “Maturity Date”). The Company may voluntarily prepay the outstanding Term Loan, subject to a yield protection premium equal to (i) 5.0 % of the principal amount of the Term Loan prepaid, if prepaid on or prior to the first anniversary of the Closing Date, (ii) 3.0 % of the principal amount of the Term Loan if prepaid after the first anniversary of the Closing Date through and including the second anniversary of the Closing Date, (iii) 1.0 % of the principal amount of the Term Loan if prepaid after the second anniversary of the Closing Date through and including the third anniversary of the Closing Date, with no prepayment premium due after the third anniversary of the Closing date through the Maturity Date. On the Closing Date, the Company was required to issue to the Lenders of such Term Loan warrants to purchase 300,000 of shares of the Company’s common stock, in the aggregate (the “ Warrant”), at an exercise price of $ 4.5902 . Upon the completion of the sale of common stock on August 13, 2024 (Note 10), the exercise price of the warrants was adjusted to $ 4.00 according to the terms of the agreement. Upon inception, the Company evaluated the warrants and determined that they met all the requirements for equity classification under ASC Topic 815 Derivatives and Hedging ("ASC 815"). This transaction was accounted for as a detachable warrant at its fair value, using the residual method, and is recorded as an increase to additional paid-in-capital on the consolidated statement of stockholder’s equity in the amount of $ 1.6 million. The Company used the Black-Scholes option pricing model to determine the fair value of the warrants. Assumptions included the fair market value per share of common stock on the valuation date of $ 4.33 , the exercise price per warrant equal to $ 4.00 , the expected volatility of 87.5 %, the risk-free interest rate of 3.83 %, the contractual term of 6 years and the absence of a dividend. The Warrant is immediately exercisable, and the exercise period will expire 6 years from the date of issuance. In addition to the Warrant, the Company will be required to issue to the Lenders warrants to purchase 200,000 of shares of the Company's common stock (the "Tranche B Warrant") upon the draw down of the second tranche of the Term Loan on or prior to March 31, 2026. These warrants were accounted for using the residual method and were recorded on a relative fair value basis, resulting in an increase to additional paid-in capital on the consolidated statement of stockholder's equity in the amount of $ 0.2 million. The Company used the Black-Scholes option pricing model to determine the fair value of the warrants. Assumptions included the fair market value per share of common stock on the valuation date of $ 4.33 , the exercise price per warrant equal to $ 4.00 , the expected volatility of 82.5 %, the risk-free interest rate of 3.87 %, the contractual term of 7.64 years and the absence of a dividend. The Tranche B Warrant will expire 6 years from the date of issuance. The Company's obligations under the Credit Agreement and the other Loan Documents (as defined in the Credit Agreement) will be guaranteed by any domestic subsidiaries of ours that become Guarantors (as defined in the Credit Agreement), subject to certain exceptions. The Borrowers’ and the Guarantors’ (collectively, the “Loan Parties” ) respective obligations under the Credit Agreement and the other Loan Documents are secured by first priority security interests in substantially all assets of the Loan Parties, subject to certain customary thresholds and exceptions. The Credit Agreement contains customary representations, warranties and affirmative and negative covenants, including financial covenants requiring the Company to (i) maintain certain levels of cash and cash equivalents in accounts subject to a control agreement in favor of the Agent of at least $ 5.0 million at all times after the Closing Date and (ii) meet minimum quarterly net sales targets described in the Credit Agreement. In addition, the Credit Agreement contains customary events of default that entitle the Agent to cause the Company's indebtedness under the Credit Agreement to become immediately due and payable, and to exercise remedies against the Loan Parties and the collateral securing the Term Loan, including cash. Under the Credit Agreement, an event of default will occur if, among other things, the Company fails to make payments under the Credit Agreement (subject to specified periods), the Company or its subsidiaries breach any of the covenants under the Credit Agreement (subject to specified cure periods with respect to certain breaches), a material adverse change occurs, the Company, its subsidiaries or its respective assets become subject to certain legal proceedings, such as bankruptcy proceedings, the Company and/or its subsidiaries are unable to pay its debts as they become due or default on contracts with third parties which would permit the holder of indebtedness in excess of a certain threshold to accelerate the maturity of such indebtedness or that could cause a material adverse change. Upon the occurrence and for the duration of an event of default, an additional default interest rate equal to 3.0 % per annum may apply to all obligations owed under the Credit Agreement. On the Closing Date, the Company also entered into the Revenue Purchase and Sale Agreement with the Purchaser. Under the Revenue Purchase and Sale Agreement, in exchange for the Purchaser's payment to the Company of a purchase price of up to $ 50.0 million, in the aggregate, the Company has agreed to sell to the Purchaser its right to receive payment in full of a tiered single digit percentage of net sales of FUROSCIX. The initial sale of the Revenue Payment under the Revenue Purchase and Sale Agreement in the amount of $ 25.0 million took place on the Closing Date. The Purchaser’s right to receive the Revenue Payment terminates and the Company no longer has the obligation to pay Purchaser Revenue Payments once the Purchaser receives 200.0 % (subject to reductions on September 30, 2027 and September 30, 2029 depending on the amount of Revenue Payments received by such dates) of the Purchase Price. The Company may also buy-out the Purchaser’s rights to receive the Revenue Payments by paying Purchaser a tiered multiple on the Purchaser Price. The Revenue Purchase and Sale Agreement contains various representations and warranties, including with respect to organization, authorization, and certain other matters, certain covenants with respect to payment, reporting, intellectual property, in-licenses, out-licenses, and certain other actions, indemnification obligations and other provisions customary for transactions of this nature. Certain conversion and redemption features of the Perceptive Financing would typically be considered derivatives that would require bifurcation. In lieu of bifurcating various features in the agreements, the Company has elected the fair value option for the Perceptive Financing and will record the changes in the fair value within the accompanying condensed consolidated statements of operations at the end of each reporting period. The initial fair value of the Term Loan and the Revenue Purchase and Sale Agreement were $ 48.1 million and $ 25.0 million, respectively. As of September 30, 2024 , the fair value of the Term Loan and the Revenue Purchase and Sale Agreement were $ 51.1 million and $ 26.8 million, respectively. Refer to Note 8 , “Fair Value of Financial Instruments” for additional details regarding the fair value measurement. In conjunction with the closing of the Perceptive Financing, the Company used a portion of the proceeds to prepay all outstanding loans under the Oaktree Agreement, including the exit fee, on the Closing Date. Oaktree Agreement The following table presents the carrying value of the Company's debt balance as of December 31, 2023 (in thousands): December 31, Face value $ 50,000 Discount ( 11,189 ) Total 38,811 Less: current portion — Long-term portion $ 38,811 On October 13, 2022 (“Oaktree Closing Date”), the Company entered into a Credit Agreement and Guaranty (the “Oaktree Agreement”) with Oaktree Fund Administration, LLC as administrative agent, and the lenders party thereto (collectively “Oaktree”) to borrow up to $ 100.0 million in three tranches with a maturity date of October 13, 2027 . The first tranche of $ 50.0 million was drawn immediately. In connection with entering into the Oaktree Agreement, the Company granted warrants to Oaktree to purchase up to an aggregate of 516,345 shares of the Company’s common stock at an exercise price of $ 5.40 per share. Upon inception, the Company evaluated the warrants and determined that they met all the requirements for equity classification under ASC Topic 815 Derivatives and Hedging ("ASC 815"). This transaction was accounted for as a detachable warrant at its fair value, using the relative fair value method, which is based on a number of unobservable inputs and is recorded as an increase to additional paid-in-capital on the consolidated statement of stockholder’s equity. The relative fair value of the warrants, $ 2.0 million, was reflected as a discount to the term loan and was amortized using the effective interest method. The Company used the Black-Scholes option pricing model to determine the fair value of the warrants. Assumptions included the fair market value per share of common stock on the valuation date of $ 5.50 , the exercise price per warrant equal to $ 5.40 , the expected volatility of 77 %, the risk-free interest rate of 4.11 %, the contractual term of 7 years and the absence of a dividend. The warrants are immediately exercisable and the exercise period expires on October 13, 2029. The Company identified a number of embedded derivatives that required bifurcation from the term loan and that were separately accounted for in the consolidated financial statements as one compound derivative liability. Certain of these embedded features include contingent interest rate reset upon event of default, contingent put options, including change in control and going concern provisions, and additional costs as a result of changes in law. These embedded features met the criteria requiring these to be bifurcated because they were not clearly and closely related to the host instrument in accordance with ASC 815-15. The fair value of the embedded derivative liabilities associated with the term loan was estimated using a hybrid between the discounted cash flow and Monte Carlo simulation methods. This involved significant Level 3 inputs and assumptions including an estimated probability and timing of a change in control. The initial recognition of the embedded derivative liability upon issuance of the Term Loan was $ 8.9 million. Prepayments of the term loan, in whole or in part, were subject to a prepayment fee. The Company was also required to pay an exit fee upon any payment or prepayment equal to 2.0 % of the aggregate principal amount of the loans funded under the Oaktree Agreement. In connection with the Credit Agreement, the Company paid off all unpaid borrowings under the Oaktree Agreement on August 9, 2024, including the $ 1.0 million exit fee and a prepayment premium of $ 2.6 million. For the three months ended September 30, 2023 and 2024, the Company recorded $ 521,000 and $ 276,000 related to the amortization of the debt discount associated with the Oaktree Agreement, respectively. For the nine months ended September 30, 2023 and 2024, the Company recorded $ 1.5 million and $ 1.5 million related to the amortization of the debt discount associated with the Oaktree Agreement, respectively. For the three months ended September 30, 2023 and 2024, the Company recorded $ 38,000 and $ 20,000 related to the amortization of the exit fee associated with the Oaktree Agreement, respectively. For the nine months ended September 30, 2023 and 2024, the Company recorded $ 108,000 and $ 107,000 related to the amortization of the exit fee associated with the Oaktree Agreement, respectively.

Stockholders' Equity

Stockholders' Equity	9 Months Ended
	Sep. 30, 2024
Equity [Abstract]
Stockholders' Equity	10. Stockholders’ Equity 2021 At-the-Market Issuance Sales Agreement On March 23, 2021, the Company entered into an Open Market Sale Agreement (the “2021 ATM Agreement”) with Cowen and Company, LLC (“Cowen”) with respect to an at-the-market offering program under which the Company could offer and sell shares of its common stock (the “2021 ATM Shares”), having an aggregate offering price of up to $ 50.0 million through Cowen as its sales agent. The Company agreed to pay Cowen a commission up to 3.0 % of the gross sales proceeds of such 2021 ATM Shares. On March 13, 2024, the Company amended and restated the 2021 ATM Agreement and entered into a new $ 50.0 million Open Market Sales Agreement with Cowen (the "2024 ATM Agreement"). As of March 13, 2024, the Company had sold a total of 1,726,043 2021 ATM Shares under the 2021 ATM Program at a weighted average gross selling price of $ 9.01 per share for net proceeds of $ 15.2 million . 2024 At-the-Market Issuance Sales Agreement Pursuant to the 2024 ATM Agreement, the Company could offer and sell shares of its common stock (the “2024 ATM Shares”), having an aggregate offering price of up to $ 50.0 million through Cowen as its sales agent (the "2024 ATM Program"). The offering and sale of the 2024 ATM Shares will be made pursuant to the Company's shelf registration statement on Form S-3, which was declared effective by the SEC on March 22, 2024 (the "2024 Registration Statement"). There were no shares issued under the 2024 ATM Program as of September 30, 2024. Sale of Common Stock On August 13 2024, the Company completed an underwritten public offering of 13,875,000 shares of its common stock, $ 0.0001 par value per share (the "2024 Offering Shares"), and, in lieu of shares of common stock to certain select investors, pre-funded warrants to purchase up to an aggregate of 500,000 shares of common stock at an exercise price equal to $ 0.001 per share, pursuant to the 2024 Registration Statement. The 2024 Offering Shares were sold at an offering price of $ 4.00 per share. The pre-funded warrants were sold at an offering price of $ 3.999 per underlying share, which was equal to the price per share of common stock being sold in this offering, minus $ 0.001 , which is the exercise price per share of the pre-funded warrants. The pre-funded warrants were accounted for as equity instruments. Net proceeds of the offering were $ 53.5 million, after deducting underwriting discounts, commissions and offering expenses.

Stock-Based Compensation

Stock-Based Compensation	9 Months Ended
	Sep. 30, 2024
Share-Based Payment Arrangement [Abstract]
Stock-Based Compensation	11. Stock-Based Compensation Stock Options The Company’s 2017 Stock Option and Incentive Plan (the “2017 Stock Plan”) became effective in November 2017 , upon the closing of the Company’s initial public offering and will expire in October 2027 . Under the 2017 Stock Plan, the Company may grant incentive stock options, non-statutory stock options, restricted stock awards, restricted stock units (“RSUs”) and other stock-based awards. The Company’s 2014 Stock Incentive Plan (the “2014 Stock Plan”) was terminated in November 2017 effective upon the completion of the Company’s initial public offering and no further options will be granted under the 2014 Stock Plan. At September 30, 2024, there were 555,427 opt ions outstanding under the 2014 Stock Plan. As of September 30, 2024, there we re 8,769,977 shares of the Company’s common stock authorized for issuance under the 2017 Stock Plan, including 366,823 options that have been forfeited from the 2014 Stock Plan. At September 30, 2024 , there were 3,206,310 options available for issuance under the 2017 Stock Plan, 4,775,676 options outstanding and 721,766 RSUs outstanding. On February 1, 2023, the Board of Directors of the Company adopted the 2023 Employment Inducement Award Plan (the "Inducement Plan") and, subject to the adjustment provisions of the Inducement Plan, reserved 500,000 shares of the Company’s common stock for issuance pursuant to equity awards granted under the Inducement Plan. At September 30, 2024 , there were 385,628 options available for issuance under the Inducement Plan, and 114,372 options outstanding. Awards granted under the 2017 Stock Plan and the Inducement Plan have a term of ten years . Vesting of awards under the 2017 Stock Plan and Inducement Plan is determined by the board of directors, but is generally over one to four-year terms. The fair value of options at date of grant was estimated using the Black-Scholes option-pricing model with the following assumptions: Nine Months Ended 2023 2024 Risk-free interest rate 3.40 % - 4.23 % 3.66 % - 4.59 % Expected dividend yield 0 % 0 % Expected life 5.5 - 6.98 years 5.5 - 6.7 years Expected volatility 77 %- 85 % 76 %- 79 % Weighted-average grant date fair value $ 5.36 $ 3.81 The following table summarizes information about stock option activity during the nine months ended September 30, 2024 (in thousands, except share and per share data): NUMBER OF WEIGHTED- WEIGHTED- AGGREGATE Outstanding, December 31, 2023 4,681,326 $ 6.09 Granted 1,119,772 5.43 Exercised ( 30,203 ) 2.85 Forfeited ( 325,420 ) 6.46 Outstanding, September 30, 2024 5,445,475 $ 5.95 6.81 $ 725 Vested and exercisable, September 30, 2024 3,517,499 $ 6.15 5.76 $ 606 Vested and expected to vest, September 30, 2024 5,081,614 $ 5.98 6.66 $ 709 24,343 options were exercised on December 29, 2023 and the shares settled on January 2, 2024. The share issuance has been recognized on the Company's Condensed Consolidated Statements of Stockholders' Equity for the quarter ending March 31, 2024. The following table summarizes information about RSU activity during the nine months ended September 30, 2024: RSUs AVERAGE GRANT RSUs outstanding, December 31, 2023 368,411 $ 6.33 Granted 471,790 5.70 Released ( 82,818 ) 6.33 Forfeited ( 35,617 ) 6.24 RSUs outstanding at September 30, 2024 721,766 $ 5.93 Unrecognized compensation expense related to unvested options as of September 30, 2024 was $ 5.2 million and will be recognized over the remaining vesting periods of the underlying awards. The weighted-average period over which such compensation is expected to be recognized is 2.3 years. Unrecognized compensation expense related to unvested RSUs as of September 30, 2024 was $ 2.4 million and will be recognized over the remaining vesting periods of the underlying awards. The weighted-average period over which such compensation is expected to be recognized is 3.0 years. Employee Stock Purchase Plan In October 2017, the board of directors approved the 2017 Employee Stock Purchase Plan (the "ESPP") which became effective in November 2017, upon the closing of the Company's IPO. As part of the ESPP, eligible employees may acquire an ownership interest in the Company by purchasing common stock, at a discount, through payroll deductions. Eligible employees who elected to participate were able to participate in the ESPP beginning September 1, 2021. During the nine months ended September 30, 2024, 85,393 shares were issued under the ESPP. As of September 30, 2024, there were 1,377,173 shares of common stock available for issuance under the ESPP. The Company recorded stock-based compensation expense in the following expense categories of its accompanying condensed consolidated statements of operations and comprehensive loss for the three and nine months ended September 30, 2023 and 2024 (in thousands): Three Months Ended Nine Months Ended 2023 2024 2023 2024 Research and development $ 370 $ 385 $ 1,075 $ 1,160 General and administrative 911 842 2,365 2,997 Total $ 1,281 $ 1,227 $ 3,440 $ 4,157

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2024
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	12. Commitments and Contingencies Operating Leases The Company leases office facilities and equipment under long-term, non-cancelable operating lease agreements. The leases expire at various dates through 2029 and do not include renewal options. Certain leases provide for increases in future minimum annual rental payments as defined in the lease agreements. The leases generally also include real estate taxes and common area maintenance charges in the annual rental payments. Short-term leases are leases having a term of twelve months or less. The Company recognizes short-term leases on a straight-line basis and does no t record a related lease asset or liability for such leases. The following is a maturity analysis of the annual undiscounted cash flows of the operating lease liabilities as of September 30, 2024 (in thousands): Year ended: December 31, 2024 $ 96 December 31, 2025 381 December 31, 2026 376 December 31, 2027 358 December 31, 2028 367 Thereafter 249 Total minimum lease payments 1,827 Less imputed interest ( 429 ) Total $ 1,398 Nine Months Ended 2023 2024 Lease cost: Operating lease cost $ 497 $ 261 Short-term lease cost 28 35 Total lease cost $ 525 $ 296 Other information Cash paid for amounts included in the measurement of lease liabilities $ 489 $ 258 Operating cash flows from operating leases $ 8 $ 10 Weighted-average remaining lease term - operating leases 5.5 years 4.8 years Weighted-average discount rate - operating leases 11.6 % 12.1 % Research and Development Agreements As part of the Company’s research and development efforts, the Company enters into research and development agreements with certain companies. These agreements contain varying terms and provisions which include fees and milestones to be paid by the Company. Some of these agreements also contain provisions which require the Company to make payments for exclusivity in the development of products in the area of loop diuretics.

Significant Accounting Polici_2

Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2024
Accounting Policies [Abstract]
Use of Estimates	Use of Estimates The preparation of financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and the disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of expenses during the reported periods. Actual results could differ from those estimates.
Cash and Cash Equivalents	Cash and Cash Equivalents Cash and cash equivalents consists of bank deposits and money market accounts with financial institutions. Cash equivalents are carried at cost which approximates fair value due to their short-term nature and which the Company believes do not have a material exposure to credit risk. The Company considers all highly liquid investments with maturities of three months or less from the date of purchase to be cash equivalents. The Company’s cash and cash equivalent accounts, at times, may exceed federally insured limits. The Company has not experienced any losses in such accounts.
Accounts Receivable	Accounts Receivable Accounts receivable are recorded net of any estimated expected credit losses. The Company's measurement of expected credit losses is based on relevant information about past events, current conditions, and reasonable and supportable forecasts that affect the collectability of the reported amount. The Company does not currently have a material credit loss allowance for uncollectible trade receivables.
Concentration of Credit Risk	Concentration of Credit Risk Financial instruments that subject the Company to credit risk primarily consist of cash and cash equivalents. The Company maintains its cash and cash equivalent balances with high-quality financial institutions and, consequently, the Company believes that such funds are subject to minimal credit risk. The Company has adopted an investment policy that limits the amounts the Company may invest in any one type of investment and requires all investments held by the Company to hold a minimum rating, thereby reducing credit risk exposure The Company has a limited number of specialty pharmacy customers and distributo rs. As of December 31, 2023 and September 30, 2024 , three customers represented 99 % and two customers represented 98 % of accounts receivable, respectively. For the three and nine months ended September 30, 2024 , two customers represented 98 % and three customers represented 99 % of revenue, respectively. For the three and nine months ended September 30, 2023, two customers represented 92 % and one customer represented 88 % of revenue, respectively. The Company has a limited number of suppliers and contract manufacturers utilized in the production of its product. As of December 31, 2023 and September 30, 2024 , one supplier represented 47 % and three suppliers represented 49 % of accounts payable, respectively. For the three and nine months ended September 30, 2024 , two suppliers represented 45 % and 49 % of purchases, respectively. For the three and nine months ended September 30, 2023, one supplier represented 29 % and two suppliers represented 40 % of purchases, respectively. The Company depends on suppliers for raw materials, active pharmaceutical ingredients, and other components that are subject to stringent FDA requirements. Some of these materials may only be available from one or a limited number of sources. Establishing additional or replacement suppliers may take a substantial period of time, as suppliers must be approved by the FDA. If the Company is unable to secure, on a timely basis, sufficient quantities of the materials it depends on to manufacture its products, it could have a materially adverse effect on the Company's business, financial condition and results of operations.
Investments	Investments The Company invests excess cash balances in available-for-sale debt securities. The Company determines the appropriate classification of these securities at the time they are acquired and evaluates the appropriateness of such classifications at each balance sheet date. The Company reports available-for-sale investments at fair value at each balance sheet date and includes any unrealized gains and losses in accumulated other comprehensive income (loss), a component of stockholders’ equity. Realized gains and losses are determined using the specific identification method and are included in other income. If any adjustment to fair value reflects a decline in the value of the investment, the Company considers all available evidence to evaluate the extent to which the decline is “other than temporary,” including the intention to sell and, if so, marks the investment to market through a charge to the Company’s consolidated statements of operations and comprehensive loss
Inventory	Inventory Inventory is stated at the lower of cost and net realizable value and consists of raw materials, work-in-process and finished goods. The Company began capitalizing inventory costs following U.S. Food and Drug Administration ("FDA") approval of FUROSCIX on October 7, 2022. Inventory is sold on a first in, first out ("FIFO") basis. The Company periodically reviews inventory for expiry and obsolescence and writes it down accordingly, if necessary. Prior to FDA approval of FUROSCIX, the Company expensed all inventory-related costs, including that used for clinical development, to research and development ("R&D") costs in the period incurred.
Leases	Leases The Company determines if an arrangement is a lease at inception. Operating leases are included in right-of-use (“ROU”) lease assets, current portion of lease obligations, and long-term lease obligations on the Company’s balance sheets. ROU lease assets represent the Company’s right to use an underlying asset for the lease term and lease obligations represent the Company’s obligation to make lease payments arising from the lease. Operating ROU lease assets and obligations are recognized at the commencement date based on the present value of lease payments over the lease term. As most of the Company’s leases do not provide an implicit rate, the Company uses its incremental borrowing rate based on the information available at the commencement date in determining the present value of lease payments. The ROU lease asset excludes lease incentives. The Company’s lease terms may include options to extend or terminate the lease when it is reasonably certain that the Company will exercise that option. Lease expense for lease payments is recognized on a straight-line basis over the lease term
Debt Issuance Costs	Debt Issuance Costs Debt issuance costs have been amortized to interest expense using the effective interest rate method over the term of the debt. Debt issuance costs paid to the lender and third parties are reflected as a discount to the debt in the consolidated balance sheet as of December 31, 2023.
Fair Value Option	Fair Value Option As permitted under Financial Accounting Standards Board's ("FASB") Accounting Standards Codification ("ASC") Topic 825, Financial Instruments (“ASC 825”), the Company elected the fair value option to account for the Credit Agreement and the Revenue Purchase and Sale Agreement (collectively, the "Perceptive Financing"). In accordance with ASC 825, the Company records these instruments at fair value with changes in fair value recorded in the Condensed Consolidated Statement of Operations and Comprehensive Loss. As a result of applying the fair value option, direct costs and fees related to the Perceptive Financing were expensed as incurred and were not deferred. The Company elected to account for the Perceptive Financing using the fair value option, which allows for valuing the Credit Agreement and the Revenue Purchase and Sale Agreement in their entirety versus bifurcation of the embedded derivatives.
Revenue Recognition	Revenue Recognition The Company recognizes revenue when its customer obtains control of promised goods or services, in an amount that reflects the consideration which the entity expects to receive in exchange for those goods or services. To determine revenue recognition for arrangements that the Company determines are within the scope of ASC Topic 606, Revenue from Contracts with Customer (“Topic 606”), the Company performs the following five steps: (i) identify the contract(s) with a customer; (ii) identify the performance obligations in the contract; (iii) determine the transaction price; (iv) allocate the transaction price to the performance obligations in the contract; and (v) recognize revenue when the Company satisfies a performance obligation. The Company only applies the five-step model to contracts when it is probable that it will collect the consideration it is entitled to in exchange for the goods or services it transfers to the customer. At contract inception, once the contract is determined to be within the scope of Topic 606, the Company assesses the goods or services promised within each contract and determines those that are performance obligations and assesses whether each promised good or service is distinct. The Company then recognizes as revenue the amount of the transaction price that is allocated to the respective performance obligation when the performance obligation is satisfied. The Company has identified one performance obligation, the delivery of FUROSCIX to its customers. The Company has not incurred any incremental costs associated with obtaining contracts with customers. The Company’s revenues consist solely of the sale of FUROSCIX to customers in the United States. Product Net Sales FUROSCIX was approved by the FDA on October 7, 2022. The Company launched sales of FUROSCIX in the first quarter of 2023 and its customers consist of specialty pharmacies (“SPs”) and specialty distributors ("SDs"). The Company recognizes revenue from product sales at a point in time, typically upon receipt of product at the SPs and SDs, the date at which the rights, title, interest and risk of loss are transferred. Revenues from product sales are recorded at the net sales price, which includes estimates of variable consideration that result from (a) sales discounts, (b) rebates (c) co-pay assistance, and (d) product returns. Reserves are established for the estimates of variable consideration based on the amounts earned or to be claimed on the related sales. The reserves for variable consideration are reflected as either as a reduction to the related account receivable or as an accrued liability, depending on how the consideration is settled. The amount of variable consideration that is included in the transaction price may be constrained and is included in net product revenues only to the extent that it is probable that a significant reversal in the amount of the cumulative revenue recognized will not occur in a future period. Actual amounts of consideration ultimately received may differ from the Company's estimates. If actual results vary from its estimates, the Company adjusts these estimates, which would affect net product revenue and earnings in the period such variances become known. Sales Discounts : Sales discounts are agreed-upon discounts, from negotiated contracts, taken directly off the Company’s sales invoices. Sales discounts are recorded as an offset to revenue based on contractual terms at the time revenue from the sale is recognized. Rebates : Allowance for rebates include mandated discounts under the Medicaid Drug Rebate Program and the Medicare Part D prescription drug benefit, TRICARE program and contractual rebates with commercial payers. Rebates are amounts owed after the final dispensing of the product to a benefit plan participant and are based upon contractual agreements or statutory requirements. The allowance for rebates is based on contracted or statutory discount rates and expected utilization by benefit plan participants. The Company’s estimates for expected utilization of rebates are based on utilization data received from the SPs since product launch. Rebates are generally invoiced and paid in arrears so that the accrual balance consists of an estimate of the amount expected to be incurred for the current quarter’s activity, plus an accrual balance for prior quarters’ unpaid rebates. If actual future rebates vary from estimates, the Company may need to adjust prior period accruals, which would affect revenue in the period of adjustment. Co-Payment Assistance: The Company offers co-payment assistance to commercially insured patients meeting certain eligibility requirements. Co-payment assistance is accrued at the time of product sale to SPs based on estimated patient participation and average co-pay benefit to be paid per a claim. The Company’s estimated amounts are compared to actual program participation and co-pay amounts paid using data provided by third-party administrators. If actual amounts differ from the original estimates the assumptions being applied are updated and adjustment for prior period accruals will be adjusted in the current period. Product Returns: Consistent with industry practice, the Company offers SPs and SDs limited product return rights for damages, shipment errors, and expiring product, provided that the return is within a specified period around the product expiration date as set forth in the applicable individual distribution agreement. The Company does not allow product returns for product that has been dispensed to a patient. As the Company receives inventory reports from the SPs and has the ability to control the amount of product that is sold to the SPs, it is able to make a reasonable estimate of future potential product returns based on this on-hand channel inventory data and sell-through data obtained from the SPs. Currently, sales to SDs are limited and there is no access to on-hand channel inventory or sell through data. As these arrangements mature, the Company will utilize any data that they can provide as part of this analysis. In arriving at its estimate, the Company also considers historical product returns, the underlying product demand, and industry data specific to the specialty pharmaceutical distribution industry.
Research and Development Costs	Research and Development Costs Research and development costs are expensed as incurred. Nonrefundable advance payments, if any, for goods or services used in research and development are initially recorded as an asset and then recognized as an expense as the related goods are delivered or services are performed. Research and development expenses include contract services, consulting, salaries, materials and supplies and overhead
Income Taxes	Income Taxes The Company accounts for income taxes in accordance with the FASB ASC 740, Income Taxes. Deferred tax assets and liabilities are recorded to reflect the impact of temporary differences between amounts of assets and liabilities for financial reporting purposes and such amounts as measured under enacted tax laws. A valuation allowance is required to offset any net deferred tax assets if, based upon the available evidence, it is more likely than not that some or all of the deferred tax asset will not be realized. The Company provides reserves for potential payments of tax to various tax authorities related to uncertain tax positions. The tax benefits recorded are based on a determination of whether and how much of a tax benefit taken by the Company in its tax filings or positions is “more likely than not” to be realized following resolution of any uncertainty related to the tax benefit, assuming that the matter in question will be raised by the tax authorities. Potential interest and penalties associated with such uncertain tax positions are recorded as a component of income tax expense. At September 30, 2024 , the Company had no such accruals. As part of the Tax Cuts and Jobs Act of 2017 ("TCJA"), beginning with the Company’s fiscal year ended December 31, 2022, the Company is required to capitalize research and development expenses, as defined under section 174 of the Internal Revenue Code of 1986, as amended. For expenses that are incurred for research and development in the United States, the amounts will be amortized over 5 years, and expenses that are incurred for research and experimentation outside the United States will be amortized over 15 years.

Net Loss per Share (Tables)

Net Loss per Share (Tables)	9 Months Ended
	Sep. 30, 2024
Earnings Per Share [Abstract]
Computation of Basic and Diluted Net Loss Per Share of Common Stock	The following table sets forth the computation of basic and diluted net loss per share of common stock (in thousands, except share and per share data): Three Months Ended September 30, Nine Months Ended September 30, 2023 2024 2023 2024 Net loss $ ( 15,634 ) $ ( 35,105 ) $ ( 40,998 ) $ ( 66,303 ) Weighted-average shares used in computing net loss per share 38,760,895 46,558,474 38,421,676 41,516,917 Net loss per share, basic and diluted $ ( 0.41 ) $ ( 0.75 ) $ ( 1.07 ) $ ( 1.60 )
Schedule of Antidilutive Securities Excluded from Computation of Net Loss Per Share	The Company’s potentially dilutive securities, which include unexercised stock options outstanding, unexercised warrants and unvested restricted stock units, have been excluded from the computation of diluted net loss per share as the effect would be to reduce the net loss per share. Therefore, 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 Company excluded the following potential common shares, presented based on amounts outstanding at each period end, from the computation of diluted net loss per share attributable to common stockholders for the periods indicated because including them would have had an anti-dilutive effect. Three Months Ended September 30, Nine Months Ended September 30, 2023 2024 2023 2024 Stock options to purchase common stock 4,722,050 5,445,475 4,722,050 5,445,475 Warrants to purchase common stock 516,345 1,016,345 516,345 1,016,345 Unvested restricted stock units 339,556 721,766 339,556 721,766 Total 5,577,951 7,183,586 5,577,951 7,183,586

Investments (Tables)

Investments (Tables)	9 Months Ended
	Sep. 30, 2024
Investments, Debt and Equity Securities [Abstract]
Summary of Available-for-Sale Classified Investments	A summary of the Company’s available-for-sale classified investments as of December 31, 2023 consisted of the following (in thousands): At December 31, 2023 Investments - Current: Cost Basis Accumulated Unrealized Gains Accumulated Unrealized Losses Fair Value United States Treasury securities $ 13,967 $ 2 $ - $ 13,969 Commercial paper $ 9,427 $ - $ ( 2 ) 9,425 Corporate bonds 3,815 - - 3,815 United States Government Agency securities 1,991 - ( 1 ) 1,990 Total $ 29,200 $ 2 $ ( 3 ) $ 29,199 The Company did not have any investments as of September 30, 2024.

Inventory (Tables)

Inventory (Tables)	9 Months Ended
	Sep. 30, 2024
Inventory Disclosure [Abstract]
Schedule of Inventory	The Company's inventory balance consists of the following (in thousands): December 31, September 30, Raw materials $ 4,256 $ 6,874 Work-in-process 4,188 10,363 Finished goods 396 870 $ 8,840 $ 18,107

Property and Equipment (Tables)

Property and Equipment (Tables)	9 Months Ended
	Sep. 30, 2024
Property, Plant and Equipment [Abstract]
Schedule of Purchased Property and Equipment	Purchased property and equipment consist of the following (dollars in thousands): ESTIMATED December 31, September 30, Office equipment 5 years $ 31 $ 31 Office furniture 7 years 64 73 Computer equipment 3 years 15 15 Leasehold improvements Life of lease 9 9 119 128 Less: Accumulated depreciation ( 61 ) ( 77 ) Property and equipment, net $ 58 $ 51

Accrued Expenses (Tables)

Accrued Expenses (Tables)	9 Months Ended
	Sep. 30, 2024
Accrued Liabilities, Current [Abstract]
Schedule of Accrued Expenses	Accrued expenses consist of the following (in thousands): December 31, September 30, Employee compensation and related costs $ 4,375 $ 3,891 Manufacturing costs 434 2,260 Sales returns and allowances and related costs 1,418 1,477 Contract research and development 1,202 1,240 Consulting and professional service fees 945 658 Royalty 249 259 Inventory in transit 150 — Other 128 83 Total accrued expenses $ 8,901 $ 9,868

Fair Value of Financial Instr_2

Fair Value of Financial Instruments (Tables)	9 Months Ended
	Sep. 30, 2024
Fair Value Disclosures [Abstract]
Summary of Assets Measured at Fair Value on Recurring Basis	The following tables summarize the Company’s assets that are measured at fair value on a recurring basis and indicates the level of the fair value hierarchy utilized to determine such fair values (in thousands): As of December 31, 2023 TOTAL Quoted Prices Significant Significant Assets: Cash equivalents $ 44,202 $ 44,202 $ — $ — Total cash equivalents 44,202 44,202 — — United States Treasury securities 13,969 13,969 - — Commercial paper 9,425 — 9,425 — Corporate bonds 3,815 — 3,815 — United States Government Agency securities 1,990 — 1,990 — Investments 29,199 13,969 15,230 — Total $ 73,401 $ 58,171 $ 15,230 $ — Liabilities: Derivative liability $ 3,857 $ — $ — $ 3,857 Total $ 3,857 $ — $ — $ 3,857 As of September 30, 2024 TOTAL Quoted Prices Significant Significant Assets: Cash equivalents $ 90,346 $ 90,346 $ — $ — Total $ 90,346 $ 90,346 $ — $ — Liabilities: Term loan $ 51,099 $ — $ — $ 51,099 Revenue purchase and sale liability 26,830 — — 26,830 Total $ 77,929 $ — $ — $ 77,929
Schedule of Changes in Fair Value of Level 3 Derivative Liabilities	Changes in the fair value of the Company's Level 3 liabilities for the nine months ended September 30, 2024 are as follows (in thousands): Derivative Liability Term Loan Revenue purchase and sale liability At December 31, 2023 $ 3,857 $ — $ — Initial fair value — 48,145 25,000 Change in fair value ( 3,857 ) 2,954 1,830 At September 30, 2024 $ — $ 51,099 $ 26,830

Financial Liabilities (Tables)

Financial Liabilities (Tables)	9 Months Ended
	Sep. 30, 2024
Debt Disclosure [Abstract]
Schedule of Fair Value of Debt Balance	The following table presents the fair value of the Company's debt balance as of September 30, 2024 (in thousands): September 30, Par value of the term loan $ 50,000 Initial fair value adjustment ( 1,855 ) Fair value of the term loan at issuance 48,145 Change in fair value of the term loan 2,954 Total fair value of the term loan $ 51,099
Schedule of Carrying Value of Debt Balnce	The following table presents the carrying value of the Company's debt balance as of December 31, 2023 (in thousands): December 31, Face value $ 50,000 Discount ( 11,189 ) Total 38,811 Less: current portion — Long-term portion $ 38,811

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	9 Months Ended
	Sep. 30, 2024
Share-Based Payment Arrangement [Abstract]
Schedule of Estimated Fair Value of Options Valuation Assumptions	The fair value of options at date of grant was estimated using the Black-Scholes option-pricing model with the following assumptions: Nine Months Ended 2023 2024 Risk-free interest rate 3.40 % - 4.23 % 3.66 % - 4.59 % Expected dividend yield 0 % 0 % Expected life 5.5 - 6.98 years 5.5 - 6.7 years Expected volatility 77 %- 85 % 76 %- 79 % Weighted-average grant date fair value $ 5.36 $ 3.81
Summary of Information about Stock Option Activity	The following table summarizes information about stock option activity during the nine months ended September 30, 2024 (in thousands, except share and per share data): NUMBER OF WEIGHTED- WEIGHTED- AGGREGATE Outstanding, December 31, 2023 4,681,326 $ 6.09 Granted 1,119,772 5.43 Exercised ( 30,203 ) 2.85 Forfeited ( 325,420 ) 6.46 Outstanding, September 30, 2024 5,445,475 $ 5.95 6.81 $ 725 Vested and exercisable, September 30, 2024 3,517,499 $ 6.15 5.76 $ 606 Vested and expected to vest, September 30, 2024 5,081,614 $ 5.98 6.66 $ 709
Schedule of RSU Activity	The following table summarizes information about RSU activity during the nine months ended September 30, 2024: RSUs AVERAGE GRANT RSUs outstanding, December 31, 2023 368,411 $ 6.33 Granted 471,790 5.70 Released ( 82,818 ) 6.33 Forfeited ( 35,617 ) 6.24 RSUs outstanding at September 30, 2024 721,766 $ 5.93
Summary of Stock-Based Compensation Expense	The Company recorded stock-based compensation expense in the following expense categories of its accompanying condensed consolidated statements of operations and comprehensive loss for the three and nine months ended September 30, 2023 and 2024 (in thousands): Three Months Ended Nine Months Ended 2023 2024 2023 2024 Research and development $ 370 $ 385 $ 1,075 $ 1,160 General and administrative 911 842 2,365 2,997 Total $ 1,281 $ 1,227 $ 3,440 $ 4,157

Commitments and Contingencies (

Commitments and Contingencies (Tables)	9 Months Ended
	Sep. 30, 2024
Commitments and Contingencies Disclosure [Abstract]
Schedule of Maturity Analysis of Annual Undiscounted Cash Flows of Operating Lease Liabilities	The following is a maturity analysis of the annual undiscounted cash flows of the operating lease liabilities as of September 30, 2024 (in thousands): Year ended: December 31, 2024 $ 96 December 31, 2025 381 December 31, 2026 376 December 31, 2027 358 December 31, 2028 367 Thereafter 249 Total minimum lease payments 1,827 Less imputed interest ( 429 ) Total $ 1,398
Schedule of Lease Cost and Other Information of Operating Lease Liabilities	Nine Months Ended 2023 2024 Lease cost: Operating lease cost $ 497 $ 261 Short-term lease cost 28 35 Total lease cost $ 525 $ 296 Other information Cash paid for amounts included in the measurement of lease liabilities $ 489 $ 258 Operating cash flows from operating leases $ 8 $ 10 Weighted-average remaining lease term - operating leases 5.5 years 4.8 years Weighted-average discount rate - operating leases 11.6 % 12.1 %

Description of Business and B_2

Description of Business and Basis of Presentation - Additional Information (Details) - USD ($) $ / shares in Units, $ in Thousands		3 Months Ended
	Aug. 09, 2024	Jun. 30, 2023	Mar. 31, 2023	Sep. 30, 2024	Aug. 13, 2024	Dec. 31, 2023
Description Of Business And Basis Of Presentation [Line Items]
Accumulated deficit				$ (347,649)		$ (281,346)
Cash and cash equivalents				$ 91,484		$ 46,814
Aggregate offering price					$ 53,500
Common stock, par value				$ 0.0001		$ 0.0001
Common Stock
Description Of Business And Basis Of Presentation [Line Items]
Number of shares sold		33,333	1,511,157
Credit Agreement
Description Of Business And Basis Of Presentation [Line Items]
Cash and cash equivalents	$ 5,000
Revenue Purchase and Sale Agreement
Description Of Business And Basis Of Presentation [Line Items]
Purchase price	$ 50,000

Significant Accounting Polici_3

Significant Accounting Policies - Additional Information (Details)	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2024 USD ($) Supplier Customer	Sep. 30, 2023 Supplier Customer	Sep. 30, 2024 USD ($) Supplier Customer	Sep. 30, 2023 Supplier Customer	Dec. 31, 2023 Customer Supplier
Schedule Of Accounting Policies [Line Items]
Potential interest and penalties associated with uncertain tax positions, accruals | $	$ 0		$ 0
Amortized period for expenses incurred for research and development in united states			5 years
Amortized period for expenses incurred for research and development outside united states			15 years
Accounts Receivable
Schedule Of Accounting Policies [Line Items]
Number of Customer | Customer			2		3
Revenue
Schedule Of Accounting Policies [Line Items]
Number of Customer | Customer	2	2	3	1
Accounts Payable
Schedule Of Accounting Policies [Line Items]
Number of Suppliers | Supplier			3		1
Purchases
Schedule Of Accounting Policies [Line Items]
Number of Suppliers | Supplier	2	1	2	2
Customer Concentration Risk | Accounts Receivable | Customer Three
Schedule Of Accounting Policies [Line Items]
Percentage of concentration risk					99%
Customer Concentration Risk | Accounts Receivable | Customer Two
Schedule Of Accounting Policies [Line Items]
Percentage of concentration risk			98%
Customer Concentration Risk | Revenue | Customer Two
Schedule Of Accounting Policies [Line Items]
Percentage of concentration risk	98%	92%	99%
Customer Concentration Risk | Revenue | Customer One
Schedule Of Accounting Policies [Line Items]
Percentage of concentration risk				88%
Supplier Concentration Risk | Accounts Payable | Supplier One
Schedule Of Accounting Policies [Line Items]
Percentage of concentration risk					47%
Supplier Concentration Risk | Accounts Payable | Supplier Three
Schedule Of Accounting Policies [Line Items]
Percentage of concentration risk			49%
Supplier Concentration Risk | Purchases | Supplier One
Schedule Of Accounting Policies [Line Items]
Percentage of concentration risk		29%
Supplier Concentration Risk | Purchases | Supplier Two
Schedule Of Accounting Policies [Line Items]
Percentage of concentration risk	45%		49%	40%

Net Loss per Share - Computatio

Net Loss per Share - Computation of Basic and Diluted Net Loss Per Share of Common Stock (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Earnings Per Share [Abstract]
Net loss	$ (35,105)	$ (15,634)	$ (66,303)	$ (40,998)
Weighted-average shares used in computing net loss per share, basic	46,558,474	38,760,895	41,516,917	38,421,676
Weighted-average shares used in computing net loss per share, diluted	46,558,474	38,760,895	41,516,917	38,421,676
Net loss per share, basic	$ (0.75)	$ (0.41)	$ (1.6)	$ (1.07)
Net loss per share, diluted	$ (0.75)	$ (0.41)	$ (1.6)	$ (1.07)

Net Loss per Share - Additional

Net Loss per Share - Additional Information (Details)	Sep. 30, 2024 $ / shares
Earnings Per Share [Abstract]
Exercise price per share	$ 0.001

Net Loss per Share - Schedule o

Net Loss per Share - Schedule of Antidilutive Securities Excluded from Computation of Net Loss Per Share (Details) - shares	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Anti-dilutive securities excluded from calculation of diluted net loss per share	7,183,586	5,577,951	7,183,586	5,577,951
Stock Options to Purchase Common Stock
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Anti-dilutive securities excluded from calculation of diluted net loss per share	5,445,475	4,722,050	5,445,475	4,722,050
Warrants to Purchase Common Stock
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Anti-dilutive securities excluded from calculation of diluted net loss per share	1,016,345	516,345	1,016,345	516,345
Unvested Restricted Stock Units
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Anti-dilutive securities excluded from calculation of diluted net loss per share	721,766	339,556	721,766	339,556

Investments - Summary of Availa

Investments - Summary of Available-for-Sale Classified Investments (Details) $ in Thousands	Dec. 31, 2023 USD ($)
Marketable Securities [Line Items]
Cost Basis	$ 29,200
Accumulated Unrealized Gains	2
Accumulated Unrealized Losses	(3)
Fair Value	29,199
United States Treasury Securities
Marketable Securities [Line Items]
Cost Basis	13,967
Accumulated Unrealized Gains	2
Fair Value	13,969
Commercial Paper
Marketable Securities [Line Items]
Cost Basis	9,427
Accumulated Unrealized Losses	(2)
Fair Value	9,425
Corporate Bonds
Marketable Securities [Line Items]
Cost Basis	3,815
Fair Value	3,815
United States Government Agency Securities
Marketable Securities [Line Items]
Cost Basis	1,991
Accumulated Unrealized Losses	(1)
Fair Value	$ 1,990

Inventory - Schedule of Invento

Inventory - Schedule of Inventory (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Inventory Disclosure [Abstract]
Inventory, Net, Total	$ 18,107	$ 8,840
Raw materials	6,874	4,256
Work-in-process	10,363	4,188
Finished goods	$ 870	$ 396

Inventory - Additional Informat

Inventory - Additional Information (Details) - USD ($)	9 Months Ended	12 Months Ended
	Sep. 30, 2024	Dec. 31, 2023
Inventory Disclosure [Abstract]
Allowance for excess, damaged and obsolete inventory	$ 75,000	$ 0

Property and Equipment - Schedu

Property and Equipment - Schedule of Purchased Property and Equipment (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Property Plant And Equipment [Line Items]
Property and equipment, gross	$ 128	$ 119
Less: Accumulated depreciation	(77)	(61)
Property and equipment, net	$ 51	58
Office Equipment
Property Plant And Equipment [Line Items]
ESTIMATED USEFUL LIFE	5 years
Property and equipment, gross	$ 31	31
Office Furniture
Property Plant And Equipment [Line Items]
ESTIMATED USEFUL LIFE	7 years
Property and equipment, gross	$ 73	64
Computer Equipment
Property Plant And Equipment [Line Items]
ESTIMATED USEFUL LIFE	3 years
Property and equipment, gross	$ 15	15
Leasehold Improvements
Property Plant And Equipment [Line Items]
Property, Plant, and Equipment, Useful Life, Term, Description [Extensible Enumeration]	us-gaap:UsefulLifeTermOfLeaseMember
Property and equipment, gross	$ 9	$ 9

Property and Equipment - Additi

Property and Equipment - Additional Information (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Property, Plant and Equipment [Abstract]
Depreciation expense	$ 5,000	$ 6,000	$ 16,000	$ 18,000

Accrued Expenses - Schedule of

Accrued Expenses - Schedule of Accrued Expenses (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Accrued Liabilities, Current [Abstract]
Employee compensation and related costs	$ 3,891	$ 4,375
Manufacturing costs	2,260	434
Sales returns and allowances and related costs	1,477	1,418
Contract research and development	1,240	1,202
Consulting and professional service fees	658	945
Royalty	259	249
Inventory in transit		150
Other	83	128
Total accrued expenses	$ 9,868	$ 8,901

Fair Value of Financial Instr_3

Fair Value of Financial Instruments - Summary of Assets Measured at Fair Value on Recurring Basis (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Liabilities:
Derivative liability	$ 0	$ 3,857
Term loan	51,099	38,811
Revenue purchase and sale liability	26,830	0
Fair Value, Measurements, Recurring
Assets:
Cash equivalents	90,346	44,202
Investments		29,199
Total		73,401
Liabilities:
Derivative liability		3,857
Term loan	51,099
Revenue purchase and sale liability	26,830
Total	77,929	3,857
Fair Value, Measurements, Recurring | Commercial Paper
Assets:
Investments		9,425
Fair Value, Measurements, Recurring | United States Treasury securities
Assets:
Investments		13,969
Fair Value, Measurements, Recurring | United States Government Agency securitites
Assets:
Investments		1,990
Fair Value, Measurements, Recurring | Corporate Bonds
Assets:
Investments		3,815
Fair Value, Measurements, Recurring | Quoted Prices in Active Markets (Level 1) [Member]
Assets:
Cash equivalents	90,346	44,202
Investments		13,969
Total		58,171
Fair Value, Measurements, Recurring | Quoted Prices in Active Markets (Level 1) [Member] | United States Treasury securities
Assets:
Investments		13,969
Fair Value, Measurements, Recurring | Significant Other Observable Inputs (Level 2) [Member]
Assets:
Investments		15,230
Total		15,230
Fair Value, Measurements, Recurring | Significant Other Observable Inputs (Level 2) [Member] | Commercial Paper
Assets:
Investments		9,425
Fair Value, Measurements, Recurring | Significant Other Observable Inputs (Level 2) [Member] | United States Government Agency securitites
Assets:
Investments		1,990
Fair Value, Measurements, Recurring | Significant Other Observable Inputs (Level 2) [Member] | Corporate Bonds
Assets:
Investments		3,815
Fair Value, Measurements, Recurring | Significant Unobservable Inputs (Level 3) [Member]
Liabilities:
Derivative liability		3,857
Term loan	51,099
Revenue purchase and sale liability	26,830
Total	$ 77,929	$ 3,857

Fair Value of Financial Instr_4

Fair Value of Financial Instruments - Schedule of Changes in Fair Value of Level 3 Derivative Liabilities (Details) - Significant Unobservable Inputs (Level 3) [Member] $ in Thousands	9 Months Ended
	Sep. 30, 2024 USD ($)
Term Loan
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Initial fair value	$ 48,145
Change in fair value	$ 2,954
Fair Value, Liability, Recurring Basis, Unobservable Input Reconciliation, Gain (Loss), Statement of Income or Comprehensive Income [Extensible Enumeration]	Other Nonoperating Income (Expense)
Ending balance	$ 51,099
Revenue Purchase and Sale Liability
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Initial fair value	25,000
Change in fair value	$ 1,830
Fair Value, Liability, Recurring Basis, Unobservable Input Reconciliation, Gain (Loss), Statement of Income or Comprehensive Income [Extensible Enumeration]	Other Nonoperating Income (Expense)
Ending balance	$ 26,830
Derivative Liability
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Beginning balance	3,857
Change in fair value	$ (3,857)
Fair Value, Liability, Recurring Basis, Unobservable Input Reconciliation, Gain (Loss), Statement of Income or Comprehensive Income [Extensible Enumeration]	Other Nonoperating Income (Expense)

Fair Value of Financial Instr_5

Fair Value of Financial Instruments - Additional Information (Details)	Sep. 30, 2024
Discounted Cash Flow | Discount Rate
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.205

Financial Liabilities - Schedul

Financial Liabilities - Schedule of Fair Value of Debt Balance (Details) - Term Loan $ in Thousands	9 Months Ended
	Sep. 30, 2024 USD ($)
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Par value of the term loan	$ 50,000
Initial fair value adjustment	(1,855)
Fair value of the term loan at issuance	48,145
Change in fair value of the term loan	2,954
Total fair value of the term loan	$ 51,099

Financial Liabilities - Additio

Financial Liabilities - Additional Information (Details) - USD ($)			3 Months Ended				9 Months Ended
	Aug. 09, 2024	Oct. 13, 2022	Sep. 30, 2024	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2023
Debt Instrument [Line Items]
Fair value of warrants as an increase to additional paid-in capital			$ 1,744,000
Cash and cash equivalents			$ 91,484,000				$ 91,484,000		$ 46,814,000
Proceeds from term loan							$ 46,772,000
Exercise price per share			$ 0.001				$ 0.001
Fair market value per share of common stock							$ 3.81	$ 5.36
Minimum
Debt Instrument [Line Items]
Contractual life							5 years 6 months	5 years 6 months
Maximum
Debt Instrument [Line Items]
Contractual life							6 years 8 months 12 days	6 years 11 months 23 days
Common Stock
Debt Instrument [Line Items]
Purchase shares of common stock					33,333	1,511,157
Term Loan
Debt Instrument [Line Items]
Fair value of debt	$ 48,100,000		$ 51,100,000				$ 51,100,000
Credit Agreement
Debt Instrument [Line Items]
Loan and security agreement, amount	$ 75,000,000
Loan agreement, maturity date	Aug. 09, 2029
Scheduled repayments outstanding	$ 0
Yield protection premium percentage year one	5%
Yield protection premium percentage year two	3%
Yield protection premium percentage year three	1%
Yield protection premium percentage after year three	0%
Cash and cash equivalents	$ 5,000,000
Exercise price per share	$ 4.5902
Increase in interest rate on default	3%
Credit Agreement | Common Stock
Debt Instrument [Line Items]
Warrants to purchase of shares	300,000
Fair market value per share of common stock	$ 4.33
Credit Agreement | Warrants
Debt Instrument [Line Items]
Warrants exercise period	6 years
Fair value of warrants as an increase to additional paid-in capital							1,600,000
Risk-free rate	3.83%
Contractual life	6 years
Exercise price per warrant	$ 4
Expected volatility	87.50%
Credit Agreement | Tranche B Warrant
Debt Instrument [Line Items]
Warrants to purchase of shares	200,000
Warrants exercise period	6 years
Fair value of warrants as an increase to additional paid-in capital	$ 200,000
Risk-free rate	3.87%
Contractual life	7 years 7 months 20 days
Fair market value per share of common stock	$ 4.33
Exercise price per warrant	$ 4
Expected volatility	82.50%
Credit Agreement | SOFR
Debt Instrument [Line Items]
Basis spread on variable base rate	6.75%
Frequency of periodic payment	monthly
Credit Agreement | SOFR | Interest Rate Floor [Member]
Debt Instrument [Line Items]
Basis spread on variable base rate	3.25%
Credit Agreement | Borrowings One [Member]
Debt Instrument [Line Items]
Loan and security agreement, amount	$ 50,000,000
Credit Agreement | Borrowings Two [Member]
Debt Instrument [Line Items]
Loan and security agreement, amount	25,000,000
Revenue Purchase and Sale Agreement
Debt Instrument [Line Items]
Purchase price	50,000,000
Initial draw amount	$ 25,000,000
Percentage of purchase price with related to purchaser revenue payment	200%
Fair value of debt	$ 25,000,000		26,800,000				26,800,000
Oaktree Agreement [Member]
Debt Instrument [Line Items]
Loan and security agreement, amount									$ 50,000,000
Loan agreement, maturity date		Oct. 13, 2027
Exit fee	1,000,000
Embedded derivative liability upon issuance of Term Loan		$ 8,900,000
Amortization of debt discount			276,000	$ 521,000			1,500,000	$ 1,500,000
Exit fee			$ 20,000	$ 38,000			$ 107,000	$ 108,000
Prepayment premium percentage one		0.02
Long term debt prepayment premium amount	$ 2,600,000
Oaktree Agreement [Member] | Maximum
Debt Instrument [Line Items]
Loan and security agreement, amount		$ 100,000,000
Oaktree Agreement [Member] | Warrants
Debt Instrument [Line Items]
Exercise price per share		$ 5.4
Relative fair value of detachable warrants		$ 2,000,000
Risk-free rate		4.11%
Contractual life		7 years
Fair market value per share of common stock		$ 5.5
Exercise price per warrant		$ 5.4
Expected volatility		77%
Oaktree Agreement [Member] | Warrants | Maximum
Debt Instrument [Line Items]
Purchase shares of common stock		516,345
Oaktree Agreement [Member] | Borrowings One [Member]
Debt Instrument [Line Items]
Loan and security agreement, amount		$ 50,000,000

Financial Liabilities - Sched_2

Financial Liabilities - Schedule of Carrying Value of Debt Balance (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Debt Instrument [Line Items]
Long-term portion	$ 51,099	$ 38,811
Oaktree Agreement [Member]
Debt Instrument [Line Items]
Face value		50,000
(Discount) premium		(11,189)
Total		38,811
Long-term portion		$ 38,811

Stockholders' Equity - Addition

Stockholders' Equity - Additional Information (Details) - USD ($)			3 Months Ended		9 Months Ended
	Aug. 13, 2024	Mar. 23, 2021	Jun. 30, 2023	Mar. 31, 2023	Sep. 30, 2024	Mar. 13, 2024	Dec. 31, 2023
Stockholders Equity Note [Line Items]
Aggregate offering price	$ 53,500,000
Common stock, par value					$ 0.0001		$ 0.0001
Exercise price per share					$ 0.001
Common Stock
Stockholders Equity Note [Line Items]
Number of shares sold			33,333	1,511,157
2021 ATM Agreement | Cowen | Common Stock
Stockholders Equity Note [Line Items]
Number of shares sold					1,726,043
Proceeds from sale of shares, Net					$ 15,200,000
2021 ATM Agreement | Cowen | Common Stock | Maximum
Stockholders Equity Note [Line Items]
Aggregate offering price		$ 50,000,000
Percentage of commission on gross sales proceeds		3%
2021 ATM Agreement | Cowen | Common Stock | Weighted Average
Stockholders Equity Note [Line Items]
Selling price per share					$ 9.01
2024 ATM Agreement | Cowen | Common Stock
Stockholders Equity Note [Line Items]
Number of shares sold					0
2024 ATM Agreement | Cowen | Common Stock | Maximum
Stockholders Equity Note [Line Items]
Aggregate offering price						$ 50,000,000
2024 Public Offering | Underwriting Agreement
Stockholders Equity Note [Line Items]
Selling price per share	$ 4
Proceeds from sale of shares, Net	$ 53,500,000
2024 Public Offering | Common Stock | Underwriting Agreement
Stockholders Equity Note [Line Items]
Number of shares sold	13,875,000
Common stock, par value	$ 0.0001
Common stock additional shares exercisable	500,000
Exercise price per share	$ 0.001
Common stock additional shares price per share	$ 3.999

Stock-Based Compensation - Addi

Stock-Based Compensation - Additional Information (Details) - USD ($) $ in Millions			9 Months Ended
	Dec. 29, 2023	Feb. 01, 2023	Sep. 30, 2024	Dec. 31, 2023
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Additional options granted			1,119,772
Stock option, number of shares outstanding			5,445,475	4,681,326
Number of options exercised	24,343		30,203
Unrecognized compensation expense			$ 5.2
Recognition period (in years)			2 years 3 months 18 days
Restricted Stock Units (RSUs)
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Unrecognized compensation expense			$ 2.4
Recognition period (in years)			3 years
2017 Stock Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock option and incentive plan effective date			Nov. 30, 2017
Stock option and incentive plan expiration date			Oct. 31, 2027
Stock option, number of shares outstanding			4,775,676
Number of common shares authorized for issuance			8,769,977
Stock options, available for issuance			3,206,310
Term of option granted			10 years
2017 Stock Plan | Minimum
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock option vesting term			1 year
2017 Stock Plan | Maximum
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock option vesting term			4 years
2017 Stock Plan | Restricted Stock Units (RSUs)
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of restricted stock units outstanding			721,766
2014 Stock Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Additional options granted			0
Stock option and incentive plan expiration date			Nov. 30, 2017
Stock option, number of shares outstanding			555,427
Number of options forfeited			366,823
2017 Employee Stock Purchase Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of common stock shares issued			85,393
Number of common stock shares available for issuance			1,377,173
2023 Employment Inducement Award Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock option, number of shares outstanding			114,372
Stock options, available for issuance			385,628
Equity awards granted under the inducement , Granted		500,000
Term of option granted			10 years

Stock-Based Compensation - Sche

Stock-Based Compensation - Schedule of Estimated Fair Value of Options Valuation Assumptions (Details) - $ / shares	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Risk-free interest rate, minimum	3.66%	3.40%
Risk-free interest rate, maximum	4.59%	4.23%
Expected dividend yield	0%	0%
Expected volatility, minimum	76%	77%
Expected volatility, maximum	79%	85%
Weighted-average grant date fair value	$ 3.81	$ 5.36
Minimum
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Expected life	5 years 6 months	5 years 6 months
Maximum
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Expected life	6 years 8 months 12 days	6 years 11 months 23 days

Stock-Based Compensation - Summ

Stock-Based Compensation - Summary of Information about Stock Option Activity (Details) $ / shares in Units, $ in Thousands		9 Months Ended
	Dec. 29, 2023 shares	Sep. 30, 2024 USD ($) $ / shares shares
NUMBER OF SHARES
Number of shares outstanding, beginning balance | shares		4,681,326
Number of shares granted | shares		1,119,772
Number of shares exercised | shares	(24,343)	(30,203)
Number of shares forfeited | shares		(325,420)
Number of shares outstanding, ending balance | shares		5,445,475
Vested and exercisable, ending balance | shares		3,517,499
Vested and expected to vest, ending balance | shares		5,081,614
WEIGHTED-AVERAGE EXERCISE PRICE
Weighted average exercise prices, outstanding beginning balance | $ / shares		$ 6.09
Weighted average exercise prices, granted | $ / shares		5.43
Weighted average exercise prices, exercised | $ / shares		2.85
Weighted average exercise prices, forfeited | $ / shares		6.46
Weighted average exercise prices, outstanding ending balance | $ / shares		5.95
Weighted average exercise prices, vested and exercisable ending balance | $ / shares		6.15
Weighted average exercise prices, vested and expected to vest ending balance | $ / shares		$ 5.98
WEIGHTED-AVERAGE REMAINING CONTRACTUAL TERM
Weighted average remaining contractual term, outstanding		6 years 9 months 21 days
Weighted average remaining contractual term, vested and exercisable		5 years 9 months 3 days
Weighted average remaining contractual term, vested and expected to vest		6 years 7 months 28 days
AGGREGATE INTRINSIC VALUE
Aggregate intrinsic value, outstanding ending balance | $		$ 725
Aggregate intrinsic value, vested and exercisable ending balance | $		606
Aggregate intrinsic value, vested and expected to vest ending balance | $		$ 709

Stock-Based Compensation - Sc_2

Stock-Based Compensation - Schedule of RSU Activity (Details) - Restricted Stock Units (RSUs)	9 Months Ended
	Sep. 30, 2024 $ / shares shares
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
RSUs outstanding | shares	368,411
RSUs Granted | shares	471,790
RSUs Released | shares	(82,818)
RSUs Forfeited | shares	(35,617)
RSUs outstanding | shares	721,766
AVERAGE GRANT DATE FAIR VALUE, RSUs outstanding | $ / shares	$ 6.33
AVERAGE GRANT DATE FAIR VALUE, Granted | $ / shares	5.7
AVERAGE GRANT DATE FAIR VALUE, Released | $ / shares	6.33
AVERAGE GRANT DATE FAIR VALUE, Forfeited | $ / shares	6.24
AVERAGE GRANT DATE FAIR VALUE, RSUs outstanding | $ / shares	$ 5.93

Stock-Based Compensation - Su_2

Stock-Based Compensation - Summary of Stock Based Compensation Expense (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total stock-based compensation expense	$ 1,227	$ 1,281	$ 4,157	$ 3,440
Research and Development
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total stock-based compensation expense	385	370	1,160	1,075
General and Administrative
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total stock-based compensation expense	$ 842	$ 911	$ 2,997	$ 2,365

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Details) - USD ($)	9 Months Ended
	Sep. 30, 2024	Dec. 31, 2023
Commitments And Contingencies [Line Items]
Operating leases expire	2029
Short-term lease asset	$ 1,330,000	$ 1,401,000
Short-term lease liability	231,000	$ 176,000
Short-term Leases Recognized on Straight-line Basis
Commitments And Contingencies [Line Items]
Short-term lease asset	0
Short-term lease liability	$ 0

Commitments and Contingencies_2

Commitments and Contingencies - Schedule of Maturity Analysis of Annual Undiscounted Cash Flows of Operating Lease Liabilities (Details) $ in Thousands	Sep. 30, 2024 USD ($)
Year ended:
December 31, 2024	$ 96
December 31, 2025	381
December 31, 2026	376
December 31, 2027	358
December 31, 2028	367
Thereafter	249
Total minimum lease payments	1,827
Less imputed interest	(429)
Total	$ 1,398

Commitments and Contingencies_3

Commitments and Contingencies - Schedule of Lease Cost and Other Information of Operating Lease Liabilities (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023
Lease cost:
Operating lease cost	$ 261	$ 497
Short-term lease cost	35	28
Total lease cost	296	525
Other information
Cash paid for amounts included in the measurement of lease liabilities	258	489
Operating cash flows from operating leases	$ 10	$ 8
Weighted-average remaining lease term - operating leases	4 years 9 months 18 days	5 years 6 months
Weighted-average discount rate - operating leases	12.10%	11.60%