Karuna Therapeutics (KRTX) 10-Q 2 Nov 23 2023 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
	Sep. 30, 2023	Oct. 31, 2023
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2023
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	Q3
Trading Symbol	KRTX
Entity Registrant Name	Karuna Therapeutics, Inc.
Entity Central Index Key	0001771917
Current Fiscal Year End Date	--12-31
Entity File Number	001-38958
Entity Tax Identification Number	27-0605902
Entity Address, Address Line One	99 High Street
Entity Address, Address Line Two	26th Floor
Entity Address, City or Town	Boston
Entity Address, State or Province	MA
Entity Address, Postal Zip Code	02110
City Area Code	857
Local Phone Number	449-2244
Entity Current Reporting Status	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Common Stock, Shares Outstanding		37,727,117
Entity Shell Company	false
Document Quarterly Report	true
Document Transition Report	false
Entity Interactive Data Current	Yes
Title of 12(b) Security	Common Stock, $0.0001 par value per share
Security Exchange Name	NASDAQ
Entity Incorporation, State or Country Code	DE

CONSOLIDATED BALANCE SHEETS (Un

CONSOLIDATED BALANCE SHEETS (Unaudited) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Current assets:
Cash and cash equivalents	$ 184,471	$ 248,329
Restricted cash	104	0
Investment securities, available-for-sale	1,155,006	875,715
Short-term investments, other	2,033	0
Accounts receivable	0	57
Prepaid expenses	12,876	29,106
Deferred offering costs	829	568
Other current assets	10,078	994
Total current assets	1,365,397	1,154,769
Restricted cash, net of current portion	0	261
Right-of-use lease assets - operating, net	14,603	4,674
Property and equipment, net	4,715	3,201
Other non-current assets	382	429
Total assets	1,385,097	1,163,334
Current liabilities:
Accounts payable	2,939	2,379
Accrued expenses	44,129	29,285
Current portion of operating lease liability	1,796	2,282
Other current liabilities	104	0
Total current liabilities	48,968	33,946
Operating lease liability, net of current portion	13,813	3,046
Other non-current liabilities	0	104
Total liabilities	62,781	37,096
Commitments and Contingencies (Note 10)
Stockholders’ equity:
Preferred stock, value	0	0
Common Stock, value	4	3
Additional paid-in capital	2,209,304	1,693,732
Accumulated deficit	(884,063)	(564,207)
Accumulated other comprehensive loss	(2,929)	(3,290)
Total stockholders’ equity	1,322,316	1,126,238
Total liabilities and stockholders’ equity	$ 1,385,097	$ 1,163,334

CONSOLIDATED BALANCE SHEETS (_2

CONSOLIDATED BALANCE SHEETS (Unaudited) (Parenthetical) - $ / shares	Sep. 30, 2023	Dec. 31, 2022
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 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	37,719,367	34,473,905
Common stock, shares outstanding	37,719,367	34,473,905

CONSOLIDATED STATEMENTS OF OPER

CONSOLIDATED STATEMENTS OF OPERATIONS (Unaudited) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Income Statement [Abstract]
License and other revenue	$ 0	$ 81	$ 654	$ 5,359
Operating expenses:
Research and development	103,952	61,950	281,909	158,243
General and administrative	32,266	19,125	83,936	51,756
Total operating expenses	136,218	81,075	365,845	209,999
Loss from operations	(136,218)	(80,994)	(365,191)	(204,640)
Other income, net:
Interest income	16,952	3,884	44,894	4,611
Sublease income	147	147	441	433
Total other income, net	17,099	4,031	45,335	5,044
Net loss before income taxes	(119,119)	(76,963)	(319,856)	(199,596)
Income tax provision				(528)
Net loss attributable to common stockholders	$ (119,119)	$ (76,963)	$ (319,856)	$ (200,124)
Net loss per share, basic	$ (3.16)	$ (2.38)	$ (8.72)	$ (6.52)
Net loss per share, diluted	$ (3.16)	$ (2.38)	$ (8.72)	$ (6.52)
Weighted Average Number of Shares Outstanding, Basic	37,689,144	32,349,111	36,682,056	30,693,117
Weighted Average Number of Shares Outstanding, Diluted	37,689,144	32,349,111	36,682,056	30,693,117

CONSOLIDATED STATEMENTS OF COMP

CONSOLIDATED STATEMENTS OF COMPREHENSIVE LOSS (Unaudited) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Statement of Comprehensive Income [Abstract]
Net Income (Loss)	$ (119,119)	$ (76,963)	$ (319,856)	$ (200,124)
Other comprehensive loss:
Unrealized gains (losses) on available-for-sale investments	713	(703)	361	(3,201)
Comprehensive loss	$ (118,406)	$ (77,666)	$ (319,495)	$ (203,325)

CONSOLIDATED STATEMENTS OF STOC

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY (Unaudited) - USD ($) $ in Thousands	Total	Common Stock	Additional Paid In Capital	Accumulated Deficit	Accumulated Other Comprehensive Loss
Beginning balance at Dec. 31, 2021	$ 502,026	$ 3	$ 790,391	$ (287,871)	$ (497)
Beginning balance, shares at Dec. 31, 2021		29,770,558
Stock-based compensation expense	22,768		22,768
Exercise of common options	6,274		6,274
Exercise of common options, shares		162,545
Other comprehensive income (loss)	(2,498)				(2,498)
Net Income (Loss)	(123,161)			(123,161)
Ending balance at Jun. 30, 2022	405,409	$ 3	819,433	(411,032)	(2,995)
Ending balance, shares at Jun. 30, 2022		29,933,103
Beginning balance at Dec. 31, 2021	502,026	$ 3	790,391	(287,871)	(497)
Beginning balance, shares at Dec. 31, 2021		29,770,558
Net Income (Loss)	(200,124)
Ending balance at Sep. 30, 2022	1,183,955	$ 3	1,675,645	(487,995)	(3,698)
Ending balance, shares at Sep. 30, 2022		34,345,991
Beginning balance at Jun. 30, 2022	405,409	$ 3	819,433	(411,032)	(2,995)
Beginning balance, shares at Jun. 30, 2022		29,933,103
Issuance of common stock	819,047		819,047
Issuance of common stock, shares		4,011,628
Stock-based compensation expense	12,021		12,021
Exercise of common options	25,144		25,144
Exercise of common options, shares		401,260
Other comprehensive income (loss)	(703)				(703)
Net Income (Loss)	(76,963)			(76,963)
Ending balance at Sep. 30, 2022	1,183,955	$ 3	1,675,645	(487,995)	(3,698)
Ending balance, shares at Sep. 30, 2022		34,345,991
Beginning balance at Dec. 31, 2022	1,126,238	$ 3	1,693,732	(564,207)	(3,290)
Beginning balance, shares at Dec. 31, 2022		34,473,905
Issuance of common stock	436,720	$ 1	436,719
Issuance of common stock, shares		2,851,299
Stock-based compensation expense	33,510		33,510
Exercise of common options	24,184		24,184
Exercise of common options, shares		319,090
Other comprehensive income (loss)	(352)				(352)
Net Income (Loss)	(200,737)			(200,737)
Ending balance at Jun. 30, 2023	1,419,563	$ 4	2,188,145	(764,944)	(3,642)
Ending balance, shares at Jun. 30, 2023		37,644,294
Beginning balance at Dec. 31, 2022	$ 1,126,238	$ 3	1,693,732	(564,207)	(3,290)
Beginning balance, shares at Dec. 31, 2022		34,473,905
Exercise of common options, shares	394,163
Net Income (Loss)	$ (319,856)
Ending balance at Sep. 30, 2023	1,322,316	$ 4	2,209,304	(884,063)	(2,929)
Ending balance, shares at Sep. 30, 2023		37,719,367
Beginning balance at Jun. 30, 2023	1,419,563	$ 4	2,188,145	(764,944)	(3,642)
Beginning balance, shares at Jun. 30, 2023		37,644,294
Exercise of common options	2,863		2,863
Exercise of common options, shares		75,073
Other comprehensive income (loss)	713				713
Net Income (Loss)	(119,119)			(119,119)
Ending balance at Sep. 30, 2023	$ 1,322,316	$ 4	$ 2,209,304	$ (884,063)	$ (2,929)
Ending balance, shares at Sep. 30, 2023		37,719,367

CONSOLIDATED STATEMENTS OF ST_2

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY (Unaudited) (Parenthetical) - Public Offering - USD ($) $ in Thousands	3 Months Ended	6 Months Ended
	Sep. 30, 2022	Jun. 30, 2023
Underwriting discounts and commissions	$ 43,125	$ 23,000
Offering cost	$ 328	$ 281

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022
Cash flows from operating activities
Net loss	$ (319,856)	$ (200,124)
Adjustments to reconcile net loss to net cash used in operating activities:
Stock-based compensation expense	51,806	34,789
Amortization of premiums and accretion of discounts on investment securities	(27,567)	(327)
Depreciation and amortization expense	1,254	807
Changes in operating assets and liabilities:
Accrued interest on investment securities	(2,753)	(399)
Accounts receivable	57	1,669
Prepaid expenses	16,230	(4,454)
Other current assets	(9,084)	(1,443)
Right-of-use assets	1,891	1,322
Other non-current assets	47	108
Accounts payable	413	13,777
Accrued expenses	14,341	6,643
Other current liabilities	104	0
Operating lease liability	(1,539)	(1,617)
Other non-current liabilities	(104)	0
Net cash used in operating activities	(274,760)	(149,249)
Cash flows from investing activities
Purchases of investment securities	(1,292,308)	(459,353)
Purchase of short-term investments (certificates of deposit)	(2,033)	0
Maturities of investment securities	1,043,698	180,199
Acquisition of property and equipment	(2,118)	(625)
Net cash (used in) provided by investing activities	(252,761)	(279,779)
Cash flows from financing activities
Proceeds from public offering, net of underwriting discounts and commissions	436,720	819,375
Payment of offering costs	(261)	(401)
Proceeds from exercise of stock options	27,047	31,418
Net cash provided by financing activities	463,506	850,392
Net (decrease) increase in cash, cash equivalents and restricted cash	(64,015)	421,364
Cash, cash equivalents and restricted cash at beginning of period	248,590	207,214
Cash, cash equivalents and restricted cash at end of period	184,575	628,578
Supplemental disclosures of cash flows information
Lease liabilities arising from obtaining right-of-use assets	11,820	0
Purchases of property and equipment included in accounts payable and accrued expenses	$ 650	$ 9

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended		6 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Jun. 30, 2023	Jun. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Pay vs Performance Disclosure
Net Income (Loss)	$ (119,119)	$ (76,963)	$ (200,737)	$ (123,161)	$ (319,856)	$ (200,124)

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended	9 Months Ended
	Sep. 30, 2023	Sep. 30, 2023
Trading Arrangements, by Individual
Material Terms of Trading Arrangement		Trading Arrangements During the three months ended September 30, 2023, none of our directors or officers (as defined in Rule 16a-1(f) under the Exchange Act) adopted or terminated (1) a contract, instruction or written plan for the purchase or sale of Company securities intended to satisfy the affirmative defense conditions of Rule 10b5-1 (c) or (2) a " non-Rule 10b5-1 trading arrangement" (as defined in Item 408(c) of Regulation S-K).
Rule 10b5-1 Arrangement Adopted	true
Non-Rule 10b5-1 Arrangement Adopted	true

Nature of the Business and Basi

Nature of the Business and Basis of Presentation	9 Months Ended
	Sep. 30, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Nature of the Business and Basis of Presentation	Note 1. Nature of the Business and Basis of Presentation Description of the Business Karuna Therapeutics, Inc. (the “Company”) was incorporated under the laws of the State of Delaware in July 2009 as Karuna Pharmaceuticals, Inc. and is headquartered in Boston, Massachusetts. In March 2019, the Company changed its name to Karuna Therapeutics, Inc. The Company is a clinical-stage biopharmaceutical company driven to discover, develop, and deliver transformative medicines for people living with psychiatric and neurological conditions. Since the Company’s inception, it has focused substantially all of its efforts and financial resources on organizing and staffing the Company, acquiring and developing its technology, raising capital, building its intellectual property portfolio, undertaking preclinical studies and clinical trials, preparing for the potential commercialization of KarXT, and providing general and administrative support for these activities. The Company has not generated any product revenue related to its primary business purpose to date and is subject to a number of risks similar to those of other early stage companies, including dependence on key individuals, regulatory approval of products, uncertainty of market acceptance of products, competition from substitute products and larger companies, compliance with government regulations, protection of proprietary technology, dependence on third parties, product liability, the impact of the effects of the COVID-19 coronavirus pandemic, and the need to obtain adequate additional financing to fund the development of its product candidates. In March 2023, the Company completed a follow-on public offering under an effective registration statement on Form S-3 (File No. 333-239657) and a related prospectus supplement in which it issued and sold 2,851,299 shares of common stock, which included the full exercise of the underwriters’ option to purchase an additional 371,908 shares of common stock, at a public offering price of $ 161.33 per share. The aggregate net proceeds to the Company from the offering, inclusive of proceeds from the option exercise, were $ 436.7 million after deducting underwriting discounts and commissions of $ 23.0 million and offering expenses of $ 0.3 million. On June 21, 2023, the Company filed an automatically effective registration statement on Form S-3 (File No. 333- 272813) with the Securities and Exchange Commission (the “SEC"), which registers the offering, issuance and sale of an unspecified amount of common stock, preferred stock, debt securities, warrants and/or units of any combination thereof. The Company’s consolidated financial statements have been prepared on the basis of continuity of operations, realization of assets and the satisfaction of liabilities in the ordinary course of business. The Company experienced negative operating cash flows of $ 274.8 million for the nine months ended September 30, 2023 and had an accumulated deficit of $ 884.1 million as of September 30, 2023. The Company expects to continue to generate operating losses for the foreseeable future. The Company expects that its cash, cash equivalents and available-for-sale investments of $ 1,339.5 million as of September 30, 2023 will be sufficient to fund its operating expenses and capital expenditure requirements through at least 12 months from the date of issuance of these consolidated financial statements. Basis of Presentation The accompanying consolidated financial statements have been prepared in conformity with accounting principles generally accepted in the United States of America (“U.S. GAAP”). Any reference in these notes to applicable guidance is meant to refer to the authoritative U.S. GAAP as found in the Accounting Standards Codification (“ASC”) and Accounting Standards Updates (“ASUs”) of the Financial Accounting Standards Board (“FASB”). The consolidated financial statements include the accounts of Karuna Therapeutics, Inc. and its wholly owned subsidiary, Karuna Securities Corporation, a Massachusetts corporation. All inter-company transactions and balances have been eliminated in consolidation. The accompanying consolidated balance sheet as of September 30, 2023 and the consolidated statements of operations, comprehensive loss, and stockholders’ equity for the three and nine months ended September 30, 2023 and 2022, and the statements of cash flow for the nine months ended September 30, 2023 and 2022, are unaudited. The unaudited interim consolidated financial statements have been prepared on the same basis as the audited annual consolidated financial statements and, in the opinion of management, reflect all adjustments, which include only normal recurring adjustments, necessary for the fair statement of the Company’s financial position as of September 30, 2023 and the results of its operations for the three and nine months ended September 30, 2023 and 2022 and cash flows for the nine months ended September 30, 2023 and 2022. Certain information and footnote disclosures typically included in annual financial statements prepared in accordance with U.S. GAAP have been condensed or omitted. Accordingly, these unaudited consolidated interim financial statements should be read in conjunction with the Company’s consolidated financial statements as of and for the year ended December 31, 2022. The results for the three and nine months ended September 30, 2023 are not necessarily indicative of results to be expected for the year ending December 31, 2023 , any other interim periods, or any future year or period.

Summary of Significant Accounti

Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2023
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	Note 2. Summary of Significant Accounting Policies The significant accounting policies and estimates used in preparation of the consolidated financial statements are described in the Company’s audited consolidated financial statements as of and for the year ended December 31, 2022, and the notes thereto, which are included in the Company’s Annual Report on Form 10-K. During the three and nine months ended September 30, 2023, there were no material changes to the Company’s significant accounting policies, except for the addition of the following policy: Policy Regarding Acquired In-Process Research and Development (IPR&D) and Development Milestones Acquired IPR&D and development milestones include the initial costs of externally developed IPR&D projects, acquired directly in a transaction other than a business combination, that do not have an alternative future use. Prior to regulatory approval of the compound, initial costs are expensed when incurred, and milestone payment obligations related to these transactions are expensed when the event triggering an obligation to pay the milestone occurs. Milestone payments made upon or after regulatory approval are capitalized and amortized over the remaining useful life of the related asset. Recently Issued Accounting Pronouncements New pronouncements issued but not effective until after September 30, 2023 are not expected to have a material impact on the Company’s consolidated financial statements.

Prepaid Expenses and Other Curr

Prepaid Expenses and Other Current Assets and Accrued Expenses	9 Months Ended
	Sep. 30, 2023
Prepaid Expenses And Other Assets And Accrued Expenses [Abstract]
Prepaid Expenses and Other Assets and Accrued Expenses	Note 3. Prepaid Expenses, Other Current Assets, and Accrued Expenses Prepaid expenses consisted of the following (in thousands): September 30, December 31, Research and development expenses $ 8,881 $ 25,285 Insurance 2,581 2,472 Other 1,414 1,349 Total prepaid expenses $ 12,876 $ 29,106 The Company also had other current assets totaling $ 10.1 million as of September 30, 2023 and $ 1.0 million as of December 31, 2022, respectively. As of September 30, 2023 , other current assets included a refundable regulatory fee of $ 3.2 million paid in connection with the Company's New Drug Application ("NDA") submission and a receivable of $ 4.9 million in connection with the acquisition of rights to a general unsecured claim against Goldfinch Bio, Inc. ("Goldfinch Bio"). As of December 31, 2022, other current assets included interest receivable on our investment securities of $ 0.7 million . Accrued expenses consisted of the following (in thousands): September 30, December 31, Research and development expenses $ 22,821 $ 11,962 Payroll and related expenses 14,717 11,950 Professional fees 4,593 2,943 Other 1,998 2,430 Total accrued expenses $ 44,129 $ 29,285

Stockholders' Equity

Stockholders' Equity	9 Months Ended
	Sep. 30, 2023
Equity [Abstract]
Stockholders' Equity	Note 4. Stockholders’ Equity Preferred Stock On July 2, 2019, in connection with the closing of the Company’s initial public offering of its common stock ("IPO"), the Company filed its amended and restated Certificate of Incorporation, which authorizes the Company to issue up to 10,000,000 shares of preferred stock, $ 0.0001 par value per share. Through September 30, 2023 , no preferred stock has been issued. Common Stock As of September 30, 2023 , the Company’s amended and restated Certificate of Incorporation authorized the Company to issue 150,000,000 shares of common stock, $ 0.0001 par value per share. Holders of the common stock are entitled to one vote for each share of common stock held at all meetings of stockholders and written actions in lieu of meetings. The holders of common stock are entitled to receive dividends out of funds legally available, as declared by the board of directors. These dividends are subject to the preferential dividend rights of the holders of the Company’s preferred stock. Through September 30, 2023 , no cash dividends have been declared or paid. As of September 30, 2023 , there were 37,719,367 shares of common stock outstanding.

Zai License Agreement

Zai License Agreement	9 Months Ended
	Sep. 30, 2023
Research and Development [Abstract]
Zai License Agreement	Note 5. Zai License Agreement Terms of Agreement On November 8, 2021, the Company and Zai Lab (Shanghai) Co., Ltd. ("Zai") entered into a license agreement (the "Zai License Agreement"), pursuant to which Karuna granted to Zai the right to exclusively develop, manufacture and commercialize KarXT in Greater China, including mainland China, Hong Kong, Macau, and Taiwan (the “Licensed Territory”). Zai will fund substantially all development, regulatory, and commercialization activities in the Licensed Territory. Under the terms of the Zai License Agreement, the Company received a non-refundable $ 35.0 million upfront payment and payment of certain taxes on its behalf. The Zai License Agreement also provides that the Company is eligible to receive total development and regulatory milestone payments of up to $ 80.0 million, total sales milestone payments of up to $ 72.0 million and low double-digit to high-teens tiered royalties based on annual net sales of KarXT in the Licensed Territory, subject to reduction under specified circumstances. Receipt of sales milestone payments and royalties are not contingent on any further participation by the Company in the development of KarXT in the Licensed Territory. The Zai License Agreement will expire upon the latest of the following dates with respect to the last licensed product in any region in the Licensed Territory: (i) the date of expiration of the last valid claim covering such licensed product in such region, (ii) the date that is a specific period after the date of the first commercial sale of such licensed product in such region and (iii) the expiration date of any regulatory exclusivity for such licensed product in such region. Zai may terminate the Zai License Agreement for convenience, subject to the terms thereto, by providing written notice to the Company, which termination will be effective following a prescribed notice period. In addition, the Company may terminate the Zai License Agreement under specified circumstances if Zai or certain other parties challenge the Company’s patent rights or if Zai or its affiliates fail to complete certain development activities with respect to the licensed product for a specified period of time, subject to specified exceptions. Either party may terminate the Zai License Agreement for the other party’s uncured material breach, with a customary notice and cure period, or insolvency. After termination or expiration, the Company is entitled to retain a worldwide, exclusive, and perpetual license from Zai to exploit the licensed product, which license would be non-exclusive after expiration (but not termination), subject to a reasonable royalty to be agreed by the parties if terminated for the Company’s uncured material breach. Revenue Recognition The Company concluded that the distinct units of account within the agreement are reflective of a vendor-customer relationship and therefore within the scope of ASC 606, Revenue From Contracts with Customers. Under the provisions of ASC 606, the Company identified one performance obligation. The Company provided an exclusive license to intellectual property, bundled with the associated know-how and certain professional services that are not substantive. Under the terms of the Zai License Agreement, Zai has the sole right to manufacture, or have manufactured, KarXT for use in development and commercialization in the Licensed Territory. At the election of Zai, the Company may supply KarXT to Zai at the fully burdened manufacturing cost plus a specified margin, as defined within the Zai License Agreement. This provision was determined to be an option to acquire additional goods or services at a price that approximates the stand-alone selling price for that good or service, and therefore does not represent a material right, or separate performance obligation, within the context of the Zai License Agreement. For the nine months ended September 30, 2023 , the Company recognized $ 0.7 million in revenue associated with sales of clinical drug supply to Zai. No revenue associated with sales of clinical drug supply was recognized during the three months ended September 30, 2023. For the three and nine months ended September 30, 2022 , less than $ 0.1 million revenue was recognized for sales of clinical drug supply to Zai. The Company determined the transaction price of the Zai License Agreement was equal to $ 37.0 million, which includes the upfront fee of $ 35.0 million and payments to taxing authorities on the Company’s behalf. In estimating the stand-alone selling price, the Company determined that there were no significant financing components, noncash consideration or amounts that may be refunded to the customer, and as such the total unconstrained consideration of $ 37.0 million was included in the total transaction price. License of Intellectual Property. The license to the Company's intellectual property represents a distinct performance obligation. The license and associated know-how was transferred to Zai in the fourth quarter of 2021 to satisfy this performance obligation. The Company allocated the full transaction price to the license of the Company's intellectual property and accordingly recognized revenue of $ 37.0 million as license revenue in its Consolidated Statement of Operations for the year ended December 31, 2021. Milestone Payments. The potential development and regulatory milestone payments, as well as sales milestone payments, are paid upon achievement of certain milestones as defined in the Zai License Agreement. For the three and nine months ended September 30, 2023 , there was no revenue related to milestone payments recognized pursuant to the Zai License Agreement. For the nine months ended September 30, 2022 , the Company recognized $ 5.3 million in license revenue for certain development milestones and related payments to taxing authorities on the Company's behalf, and recorded $ 0.5 million in foreign tax expense to income tax provision. For the three months ended September 30, 2022 , there was no revenue related to milestone payments recognized pursuant to the Zai License Agreement. For all remaining development and regulatory milestones, which, as of September 30, 2023 , can total up to $ 70.0 million, it was determined that their achievement is highly dependent on factors outside of the Company's control. These payments have been fully constrained until the Company concludes that achievement of the milestone is probable, and that recognition of revenue related to the milestone will not result in a significant reversal in amounts recognized in future periods, and as such have been excluded from the transaction price. At the end of each subsequent reporting period, the Company will re-evaluate the probability of achievement of each milestone and any related constraint and, if necessary, adjust its estimate of the overall transaction price. As of September 30, 2023, the Company has not recognized any revenue associated with sales milestones. Royalties. Any consideration related to royalties will be recognized if and when the related sales occur, as they were determined to relate predominantly to the license granted to Zai and, therefore, have also been excluded from the transaction price. As of September 30, 2023, the Company has not recognized any revenue associated with royalties. There was no deferred revenue as of September 30, 2023 or December 31, 2022 related to the Zai License Agreement.

Net Loss per Share

Net Loss per Share	9 Months Ended
	Sep. 30, 2023
Earnings Per Share [Abstract]
Net Loss per Share	Note 6. Net Loss per Share The following table sets forth the computation of basic and diluted net loss per share of common stock for the three and nine months ended September 30, 2023 and 2022 (in thousands, except share and per share data): Three Months Ended Nine Months Ended 2023 2022 2023 2022 Net Loss $ ( 119,119 ) $ ( 76,963 ) $ ( 319,856 ) $ ( 200,124 ) Weighted-average shares used in computing net loss per share 37,689,144 32,349,111 36,682,056 30,693,117 Net loss per share, basic and diluted $ ( 3.16 ) $ ( 2.38 ) $ ( 8.72 ) $ ( 6.52 ) The Company’s potentially dilutive securities, which consist of stock options and restricted stock units ("RSUs"), have been excluded from the computation of diluted net loss per share because including them would have had an anti-dilutive impact. 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 following common stock equivalents, presented based on amounts outstanding at each period end, have been excluded from the calculation of diluted net loss per share: September 30, 2023 2022 Stock options to purchase common stock 5,541,686 5,561,493 Restricted stock units 314,854 — 5,856,540 5,561,493

License Agreements

License Agreements	9 Months Ended
	Sep. 30, 2023
Asset Acquisition [Abstract]
License Agreements	Note 7. License Agreements Acquisition of KAR-2618 and other TRPC4/5 candidates In January 2023, the Company entered into an exclusive license agreement (the "GFB Agreement"), with GFB (ABC), LLC ("GFB"), assignee of the assignment estate of Goldfinch Bio, pursuant to which GFB granted to the Company the exclusive right and license to develop, manufacture, and commercialize GFB’s TRPC4/5 candidates (the "GFB Compounds"), including the lead clinical-stage candidate known as KAR-2618 (formerly GFB-887). The Company agreed to use commercially reasonable efforts to develop, obtain regulatory approval for, and commercialize at least one licensed product that contains or comprises a GFB Compound in at least two indications in the United States. Under the terms of the GFB Agreement, the Company paid to GFB a $ 15.0 million upfront payment, and agreed to pay a total of up to $ 520.0 million for each GFB Compound upon the achievement of certain development, regulatory and commercial milestones with respect to such GFB Compound, of which $ 110.0 million, $ 150.0 million, and $ 260.0 million are related to development, regulatory, and commercial sales milestones, respectively. The Company also agreed to pay GFB a flat low-single digit royalty on aggregate net sales of each licensed product on a country-by-country basis until the expiration of the applicable royalty term, which ends on the later of (i) the expiration date of the last valid claim covering the licensed product in such country, (ii) the expiration date of regulatory exclusivity with respect to such licensed product in such country, and (iii) the date that is a specific period after the first commercial sale of such licensed product in such country. The royalty rate is subject to reduction on a licensed product-by-licensed product and country-by-country basis under certain circumstances. In the event that the Company sublicenses to a third party any of the rights to the licensed intellectual property granted under the GFB Agreement, the Company will be obligated to pay GFB royalties within the range of 25 % to 35 % on any consideration the Company receives from the sublicensee, excluding royalties and certain other payments. Unless earlier terminated, the GFB Agreement will expire on the expiration of the last to expire royalty term. Unless the GFB Agreement is earlier terminated, on expiration of each applicable royalty term, the Company will have a fully paid-up, irrevocable and perpetual license to develop, manufacture and commercialize each applicable licensed product in the applicable country. Either party may terminate the GFB Agreement for the other party’s material breach, following a customary notice and cure period, or insolvency. The Company may terminate the GFB Agreement for any reason upon 90 days written notice to GFB. The upfront payment of $ 15.0 million was accounted for as an asset acquisition and recorded within research and development expense in the consolidated statement of operations for the nine months ended September 30, 2023, as KAR-2618 is prior to regulatory approval and has no alternative future use. The Company did not incur or recognize any milestone payments under the GFB Agreement during the three and nine months ended September 30, 2023. Intellectual Property License with Eli Lilly and Company In May 2012, the Company entered into an exclusive license agreement (the “Lilly License Agreement”), with Eli Lilly and Company (“Eli Lilly”), pursuant to which Eli Lilly assigned to the Company all of its rights to certain patents (now expired), regulatory documentation, data records and materials related to xanomeline. The Company is also entitled to sublicense or otherwise transfer the rights granted in connection with the Lilly License Agreement. Under the Lilly License Agreement, the Company is obligated to use commercially reasonable efforts to develop, manufacture, commercialize and seek and maintain regulatory approval for xanomeline, in any formulation, for use in humans. The Company paid Eli Lilly an upfront payment of $ 0.1 million and has agreed to make milestone payments to Eli Lilly of up to an aggregate of $ 16.0 million upon the achievement of specified regulatory milestones and up to an aggregate of $ 54.0 million in commercial milestones. In addition, the Company is obligated to pay Eli Lilly tiered royalties, at rates in the low to mid single-digit percentages, on the worldwide net sales of any commercialized product on a country-by-country basis until the expiration of the applicable royalty term, which is the longer of six years from the date of first commercial sale of each licensed product within a country or data package exclusivity in such country. During the royalty term, Eli Lilly is prohibited from granting any third party rights to the patents, regulatory documentation, data records and materials that have been licensed to the Company under the Lilly License Agreement. The Lilly License Agreement will expire on the later of (i) the expiration of the last-to-expire royalty term on a licensed product-by-licensed product basis or (ii) the date on which the Company has made all milestone payments pursuant to the terms of the Lilly License Agreement, unless terminated earlier by the parties. In no event will the term of the Lilly License Agreement exceed 15 years past the anniversary of the first commercial sale of a xanomeline product. The Company may terminate the Lilly License Agreement for any reason with proper prior notice to Eli Lilly. Either party may terminate the Lilly License Agreement upon an uncured material breach by the other party. The initial upfront payment of $ 0.1 million was expensed when incurred in May 2012. As of September 30, 2023 , no regulatory or commercial milestones have been reached and, accordingly, no milestone payments have been made. Intellectual Property License with PureTech Health In March 2011, the Company entered into an exclusive license agreement (the “Patent License Agreement”) with PureTech Health, pursuant to which PureTech Health granted the Company an exclusive license to patent rights relating to combinations of a muscarinic activator with a muscarinic inhibitor for the treatment of central nervous system disorders. In connection with the Patent License Agreement, the Company has agreed to make milestone payments to PureTech Health of up to an aggregate of $ 10.0 million upon the achievement of specified development and regulatory milestones. In addition, the Company is obligated to pay PureTech Health low single-digit royalties on the worldwide net sales of any commercialized product covered by the licenses granted under the Patent License Agreement. In the event that the Company sublicenses any of the patent rights granted under the Patent License Agreement, the Company will be obligated to pay PureTech Health royalties within the range of 15 % to 25 % on any income the Company receives from the sublicensee, excluding royalties. The Company may terminate the Patent License Agreement for any reason with proper prior notice to PureTech Health. Either party may terminate the Patent License Agreement upon an uncured material breach by the other party. The Company incurred no expenses related to the Patent License Agreement during the three and nine months ended September 30, 2023 and 2022. As of September 30, 2023 , the remaining development and regulatory milestone payments under the Patent License Agreement total up to $ 8.0 million. The Company had no outstanding liabilities to PureTech Health related to the Patent License Agreement as of September 30, 2023 and December 31, 2022 .

Stock-based Compensation

Stock-based Compensation	9 Months Ended
	Sep. 30, 2023
Share-Based Payment Arrangement [Abstract]
Stock-based Compensation	Note 8. Stock-based Compensation In September 2009, the Company’s board of directors approved the 2009 Stock Incentive Plan (the “2009 Plan”) which provided for the grant of incentive stock options to employees and non-statutory stock options to directors, consultants, and non-employees of the Company. The 2009 Plan terminated in July 2019 effective upon the completion of the Company’s IPO. No additional options will be granted under the 2009 Plan. As of September 30, 2023 , there were 1,981,828 options outstanding under the 2009 Plan. In May 2019, the Company’s board of directors approved the 2019 Stock Option and Incentive Plan (the “2019 Plan”) which became effective on June 26, 2019, the date immediately prior to the date on which the registration statement related to the IPO was declared effective by the SEC. The 2019 Plan will expire in May 2029 . Under the 2019 Plan, the Company may grant incentive stock options, non-statutory stock options, restricted stock awards, RSUs, and other stock-based awards. There were 1,709,832 shares of the Company’s common stock initially reserved for issuance under the 2019 Plan. The number of shares of common stock underlying awards that expire, or are terminated, surrendered, canceled or forfeited without having been fully exercised under the 2009 Plan will be added to the shares of common stock available for issuance under the 2019 Plan. In addition, the number of shares of common stock that may be issued under the 2019 Plan automatically increases on January 1 of each calendar year, commencing on January 1, 2020, by 4 % of the number of shares of common stock outstanding on the immediately preceding December 31 or such lesser amount determined by the Company’s board of directors or the compensation committee of the board of directors. As of September 30, 2023 , there were 2,661,308 common shares available for issuance, 3,559,858 options outstanding, and 314,854 RSUs outstanding under the 2019 Plan. Stock Options Option awards under the 2019 Plan generally vest based on the grantee’s continued service with the Company during a specified period following a grant and expire ten years from the grant date. Awards typically vest in four years , but vesting conditions can vary based on the discretion of the Company’s board of directors. A summary of the Company’s stock option activity and related information is as follows: Number of Weighted- Weighted- Aggregate Outstanding as of December 31, 2022 5,570,355 $ 63.82 7.2 $ 744,097 Granted 636,014 195.44 Exercised ( 394,163 ) 68.62 Forfeited ( 268,382 ) 142.72 Expired ( 2,138 ) 123.63 Outstanding as of September 30, 2023 5,541,686 $ 74.74 6.5 $ 546,440 Options vested and expected to vest as of 5,541,686 $ 74.74 6.5 $ 546,440 Options exercisable as of September 30, 2023 3,892,864 $ 41.37 5.6 $ 497,659 The aggregate intrinsic values of options outstanding, exercisable, vested and expected to vest were calculated as the difference between the exercise price of the options and the publicly traded stock price of the Company’s common stock as of September 30, 2023. As of September 30, 2023 , there was $ 132.2 million of unrecognized compensation cost, which is expected to be recognized over a weighted-average period of 2.8 years. The weighted-average fair values of options granted during the nine months ended September 30, 2023 and 2022 was $ 114.69 and $ 70.59 , respectively. The intrinsic value of options exercised during the nine months ended September 30, 2023 and 2022 was $ 54.5 million and $ 84.0 million, respectively. Restricted Stock Units RSUs are granted to certain employees and are payable in shares of the Company's common stock. RSU shares are accounted for at fair value based upon the closing stock price on the date of grant. The corresponding expense is amortized over the vesting period, which is typically four years. A summary of the Company’s restricted stock unit activity and related information is as follows: Number of Weighted- Unvested as of December 31, 2022 — $ — Granted 330,267 195.46 Vested — — Forfeited ( 15,413 ) 189.49 Unvested as of September 30, 2023 314,854 $ 195.75 As of September 30, 2023, the total remaining unrecognized compen sation cost related to nonvested RSUs was $ 53.6 million, which will be amortized over the weighted-average remaining requisite service period of 3.4 years. Stock-based Compensation Expense Stock-based compensation expense is classified in the statements of operations for the three and nine months ended September 30, 2023 and 2022 as follows (in thousands): Three Months Ended Nine Months Ended 2023 2022 2023 2022 Research and development $ 10,880 $ 5,431 $ 29,955 $ 15,140 General and administrative 7,416 6,590 21,851 19,649 Total stock-based compensation expense $ 18,296 $ 12,021 $ 51,806 $ 34,789

Fair Value of Financial Assets

Fair Value of Financial Assets and Liabilities	9 Months Ended
	Sep. 30, 2023
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Abstract]
Fair Value of Financial Assets and Liabilities	Note 9. Fair Value of Financial Assets and Liabilities The following tables present information about the Company’s assets as of September 30, 2023 and December 31, 2022 that are measured at fair value on a recurring basis and indicate the level of the fair value hierarchy utilized to determine such fair values (in thousands): Fair Value Measurement at September 30, 2023 Using Level 1 Level 2 Level 3 Total Cash equivalents: Money market fund $ 135,160 $ — $ — $ 135,160 Commercial paper — 29,422 — 29,422 Short-term investments, other: Certificate of deposit — 2,033 — 2,033 Investment securities: US Treasuries 689,176 — — 689,176 US government agencies 202,646 — — 202,646 Corporate debt securities — 33,120 — 33,120 Commercial paper — 230,064 — 230,064 Total $ 1,026,982 $ 294,639 $ — $ 1,321,621 Fair Value Measurement at December 31, 2022 Using Level 1 Level 2 Level 3 Total Cash equivalents: Money market fund $ 160,158 $ — $ — $ 160,158 Commercial paper — 61,277 — 61,277 Investment securities: US Treasuries 423,688 — — 423,688 US government agencies 210,188 — — 210,188 Corporate debt securities — 63,728 — 63,728 Commercial paper — 178,111 — 178,111 Total $ 794,034 $ 303,116 $ — $ 1,097,150 The fair values of the Company’s commercial paper and corporate debt securities are based on prices obtained from independent pricing sources. Securities with validated quotes from pricing services are reflected within Level 2, as they are primarily based on observable pricing for similar assets or other market observable inputs. Typical inputs used by these pricing services include, but are not limited to, reported trades, benchmark yields, issuer spreads, bids, offers or estimates of cash flow, prepayment spreads and default rates. Certificates of deposit held for investment with an original maturity greater than three months and less than twelve months are carried at amortized cost and reported as short-term investments on the Company's consolidated balance sheet, which approximates their fair value based on Level 2 inputs. The Company does not hold any securities classified as Level 3, which are securities valued using unobservable inputs. The Company has not transferred any investment securities between the classification levels. The estimated fair value and amortized cost of the Company’s available-for-sale investments, by contractual maturity and security type, are summarized as follows (in thousands): September 30, 2023 Amortized Unrealized Unrealized Fair Value US Treasuries (due within one year) $ 559,852 $ 7 $ ( 1,193 ) $ 558,666 US Treasuries (due after one year and 131,249 2 ( 741 ) 130,510 US government agencies (due within one year) 147,612 10 ( 296 ) 147,326 US government agencies (due after one year and 55,752 — ( 432 ) 55,320 Corporate debt securities (due within one year) 30,361 — ( 138 ) 30,223 Corporate debt securities (due after one year and 2,948 — ( 51 ) 2,897 Commercial paper (due within one year) 230,161 6 ( 103 ) 230,064 Total $ 1,157,935 $ 25 $ ( 2,954 ) $ 1,155,006 December 31, 2022 Amortized Unrealized Unrealized Fair Value US Treasuries (due within one year) $ 329,533 $ 17 $ ( 2,044 ) $ 327,506 US Treasuries (due after one year and 96,802 — ( 620 ) 96,182 US government agencies (due within one year) 178,319 54 ( 108 ) 178,265 US government agencies (due after one year and 32,104 — ( 181 ) 31,923 Corporate debt securities (due within one year) 51,952 1 ( 170 ) 51,783 Corporate debt securities (due after one year and 11,983 — ( 38 ) 11,945 Commercial paper (due within one year) 178,312 16 ( 217 ) 178,111 Total $ 879,005 $ 88 $ ( 3,378 ) $ 875,715 The Company has classified all of its available-for-sale investment securities, including those with maturities beyond one year, as current assets on its consolidated balance sheets based on the highly liquid nature of the investment securities and because these investment securities are considered available for use in current operations. The Company is required to determine whether a decline in the fair value below the amortized cost basis of available-for-sale securities is due to credit-related factors. At each reporting date, the Company performs an evaluation of impairment to determine if any unrealized losses are the result of credit losses. Impairment is assessed at the individual security level. Factors considered in determining whether a loss resulted from a credit loss or other factors include the Company’s intent and ability to hold the investment until the recovery of its amortized cost basis, the extent to which the fair value is less than the amortized cost basis, the length of time and extent to which fair value has been less than the cost basis, the financial condition of the issuer, any historical failure of the issuer to make scheduled interest or principal payments, any changes to the rating of the security by a rating agency, any adverse legal or regulatory events affecting the issuer or issuer’s industry, and any significant deterioration in economic conditions. Unrealized losses on available-for-sale securities presented in the previous table have not been recognized in the consolidated statements of operations because the securities are high credit quality, investment grade securities that the Company does not intend to sell and will not be required to sell prior to their anticipated recovery, and the decline in fair value is attributable to factors other than credit losses. Based on its evaluation, the Company determined its year-to-date credit losses related to its available-for-sale securities were immaterial at September 30, 2023 and December 31, 2022 .

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2023
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Note 10. Commitments and Contingencies Leases The Company has 25,445 square feet of office space on High Street in Boston, Massachusetts (“High Street Sublease”). The term of the High Street Sublease extends from April 1, 2021 through December 31, 2025 and provides for escalating annualized base rent payments starting at approximately $ 1.5 million and increasing to $ 1.6 million in the final year of the sublease. In April 2023, the Company entered into an agreement ("High Street Lease") to lease approximately 50,890 square feet of additional office space located at 99 High Street in Boston, Massachusetts. The Company took possession of the premises in June 2023. The initial term of the lease is ten years from the date alterations are substantially complete, estimated to occur no later than April 2024, with the option to renew for an additional five-year term. Annual base rent under the lease is approximately $ 3.5 million and is subject to annual increases in accordance with the terms of the lease agreement. Lease payments begin on the earlier of January 1, 2025 or nine months from the date alterations are substantially complete. The Company recognized a right-of-use ("ROU") asset and corresponding lease liability of approximately $ 11.7 million and $ 11.4 million, respectively, on its consolidated balance sheet as of June 8, 2023 upon commencement of the High Street Lease. The lease provides for a tenant improvement allowance of $ 9.2 million, which was recognized as a reduction in the ROU asset and lease liability recognized at commencement, as the Company is reasonably certain to incur reimbursable costs related to alterations equal to or exceeding this amount. The option to renew the lease for an additional five-year term was excluded from the determination of lease liabilities arising from obtaining the ROU assets, as it was not considered reasonably certain of being exercised at commencement. Upon signing of the High Street Lease, the Company was also required to pay the first full monthly installment of base rent of $ 0.3 million, which was included as an adjustment to the ROU asset recognized upon commencement of the lease. The agreement requires a security deposit of $ 2.0 million, which is in the form of a line of credit collateralized by a certificate of deposit with a six month maturity which will be continually reinvested for the duration of the lease term. This certificate of deposit has been recorded within "short-term investments, other" on the consolidated balance sheet as of September 30, 2023. The Company also has office space at 33 Arch Street in Boston, Massachusetts ("Arch Street Lease"), which expires in December 2023, as amended. The associated space is entirely subleased to third parties through the remainder of the current lease term ("Arch Street Subleases"). We additionally have office space in Carmel, Indiana. For each of the lease agreements entered into or modified, the Company identified certain non-lease components. Lease and non-lease components were combined into a single lease component. In addition, all identified leases were assessed as operating leases. As the Company’s leases do not provide an implicit rate, the Company used its incremental borrowing rate, which is the rate incurred to borrow on a collateralized basis over a term equal to the lease payments in a similar economic environment, in determining the present value of lease payments for each identified lease at the lease commencement date. The components of lease cost were as follows (dollar amounts in thousands): Nine Months Ended 2023 2022 Lease Cost Operating lease cost $ 2,506 $ 1,613 Short-term lease cost — — Sublease income ( 441 ) ( 433 ) Total lease cost $ 2,065 $ 1,180 Other Information Cash paid for amounts included in the measurement of lease liabilities $ 2,154 $ 1,908 Operating lease liabilities arising from obtaining right-of-use assets 11,820 — Weighted-average remaining lease term 9.05 years 2.85 years Weighted-average discount rate 10.44 % 5.88 % The following is a maturity analysis of the remaining annual undiscounted cash flows of the operating lease liabilities and a reconciliation to present value of lease liabilities as of September 30, 2023 (in thousands): Year ended: December 31, 2023 $ 649 December 31, 2024 1,704 December 31, 2025 4,818 December 31, 2026 3,591 December 31, 2027 3,698 Thereafter 29,188 Total future minimum lease payments 43,648 Less lease incentive ( 9,184 ) Less imputed interest ( 18,855 ) Present value of lease liabilities $ 15,609 Cash inflows related to the $ 9.2 million lease incentive under the High Street Lease are expected to be received in the years ended December 31, 2023 and 2024 and are expected to exceed cash outflows relating to our operating leases during those years. The annual undiscounted cash flows to be received from subleases is $ 0.2 million as of September 30, 2023. The Arch Street Lease and the Arch Street Subleases mature in December 2023 and will not be extended. Indemnification In the normal course of business, the Company enters into contracts and agreements that contain a variety of representations and warranties and provide for general indemnifications. The Company’s exposure under these agreements is unknown because it involves claims that may be made against the Company in the future but have not yet been made. To date, the Company has not paid any claims or been required to defend any action related to its indemnification obligations. However, the Company may incur charges in the future as a result of these indemnification obligations. Contingencies From time to time, the Company may have certain contingent liabilities that arise in the ordinary course of its business activities. The Company accrues a liability for such matters when it is probable that future expenditures will be made, and such expenditures can be reasonably estimated. Litigation The Company is no t a party to any litigation and does not have contingency reserves established for any litigation liabilities as of September 30, 2023 .

401(k) Savings Plan

401(k) Savings Plan	9 Months Ended
	Sep. 30, 2023
Retirement Benefits [Abstract]
401(k) Savings Plan	Note 11. 401(k) Savings Plan The Company has a 401(k) retirement plan in which substantially all U.S. employees are eligible to participate. Eligible employees may elect to contribute up to the maximum limits, as set by the Internal Revenue Service, of their eligible compensation. The total contribution expense for the Company was $ 1.5 million and $ 0.7 m illion for the nine months ended September 30, 2023 and 2022 , respectively.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2023
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The accompanying consolidated financial statements have been prepared in conformity with accounting principles generally accepted in the United States of America (“U.S. GAAP”). Any reference in these notes to applicable guidance is meant to refer to the authoritative U.S. GAAP as found in the Accounting Standards Codification (“ASC”) and Accounting Standards Updates (“ASUs”) of the Financial Accounting Standards Board (“FASB”). The consolidated financial statements include the accounts of Karuna Therapeutics, Inc. and its wholly owned subsidiary, Karuna Securities Corporation, a Massachusetts corporation. All inter-company transactions and balances have been eliminated in consolidation. The accompanying consolidated balance sheet as of September 30, 2023 and the consolidated statements of operations, comprehensive loss, and stockholders’ equity for the three and nine months ended September 30, 2023 and 2022, and the statements of cash flow for the nine months ended September 30, 2023 and 2022, are unaudited. The unaudited interim consolidated financial statements have been prepared on the same basis as the audited annual consolidated financial statements and, in the opinion of management, reflect all adjustments, which include only normal recurring adjustments, necessary for the fair statement of the Company’s financial position as of September 30, 2023 and the results of its operations for the three and nine months ended September 30, 2023 and 2022 and cash flows for the nine months ended September 30, 2023 and 2022. Certain information and footnote disclosures typically included in annual financial statements prepared in accordance with U.S. GAAP have been condensed or omitted. Accordingly, these unaudited consolidated interim financial statements should be read in conjunction with the Company’s consolidated financial statements as of and for the year ended December 31, 2022. The results for the three and nine months ended September 30, 2023 are not necessarily indicative of results to be expected for the year ending December 31, 2023 , any other interim periods, or any future year or period.
Policy Regarding Acquired In-Process Research and Development (IPR&D) and Development Milestones	Policy Regarding Acquired In-Process Research and Development (IPR&D) and Development Milestones Acquired IPR&D and development milestones include the initial costs of externally developed IPR&D projects, acquired directly in a transaction other than a business combination, that do not have an alternative future use. Prior to regulatory approval of the compound, initial costs are expensed when incurred, and milestone payment obligations related to these transactions are expensed when the event triggering an obligation to pay the milestone occurs. Milestone payments made upon or after regulatory approval are capitalized and amortized over the remaining useful life of the related asset.
Recently Issued Accounting Pronouncements	Recently Issued Accounting Pronouncements New pronouncements issued but not effective until after September 30, 2023 are not expected to have a material impact on the Company’s consolidated financial statements.

Prepaid Expenses and Other Cu_2

Prepaid Expenses and Other Current Assets and Accrued Expenses (Tables)	9 Months Ended
	Sep. 30, 2023
Prepaid Expenses And Other Assets And Accrued Expenses [Abstract]
Schedule of Prepaid Expenses and Other Current Assets	Prepaid expenses consisted of the following (in thousands): September 30, December 31, Research and development expenses $ 8,881 $ 25,285 Insurance 2,581 2,472 Other 1,414 1,349 Total prepaid expenses $ 12,876 $ 29,106
Schedule of Accrued Expenses	Accrued expenses consisted of the following (in thousands): September 30, December 31, Research and development expenses $ 22,821 $ 11,962 Payroll and related expenses 14,717 11,950 Professional fees 4,593 2,943 Other 1,998 2,430 Total accrued expenses $ 44,129 $ 29,285

Net Loss per Share (Tables)

Net Loss per Share (Tables)	9 Months Ended
	Sep. 30, 2023
Earnings Per Share [Abstract]
Schedule of 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 for the three and nine months ended September 30, 2023 and 2022 (in thousands, except share and per share data): Three Months Ended Nine Months Ended 2023 2022 2023 2022 Net Loss $ ( 119,119 ) $ ( 76,963 ) $ ( 319,856 ) $ ( 200,124 ) Weighted-average shares used in computing net loss per share 37,689,144 32,349,111 36,682,056 30,693,117 Net loss per share, basic and diluted $ ( 3.16 ) $ ( 2.38 ) $ ( 8.72 ) $ ( 6.52 )
Schedule of Anti-Dilutive Securities Excluded from Calculation of Diluted Net Loss Per Share	The following common stock equivalents, presented based on amounts outstanding at each period end, have been excluded from the calculation of diluted net loss per share: September 30, 2023 2022 Stock options to purchase common stock 5,541,686 5,561,493 Restricted stock units 314,854 — 5,856,540 5,561,493

Stock-based Compensation (Tabl

Stock-based Compensation (Tables)	9 Months Ended
	Sep. 30, 2023
Share-Based Payment Arrangement [Abstract]
Summary of Stock Option Activity	A summary of the Company’s stock option activity and related information is as follows: Number of Weighted- Weighted- Aggregate Outstanding as of December 31, 2022 5,570,355 $ 63.82 7.2 $ 744,097 Granted 636,014 195.44 Exercised ( 394,163 ) 68.62 Forfeited ( 268,382 ) 142.72 Expired ( 2,138 ) 123.63 Outstanding as of September 30, 2023 5,541,686 $ 74.74 6.5 $ 546,440 Options vested and expected to vest as of 5,541,686 $ 74.74 6.5 $ 546,440 Options exercisable as of September 30, 2023 3,892,864 $ 41.37 5.6 $ 497,659
Share-Based Payment Arrangement, Restricted Stock and Restricted Stock Unit, Activity	A summary of the Company’s restricted stock unit activity and related information is as follows: Number of Weighted- Unvested as of December 31, 2022 — $ — Granted 330,267 195.46 Vested — — Forfeited ( 15,413 ) 189.49 Unvested as of September 30, 2023 314,854 $ 195.75
Summary of Stock-based Compensation Expense	Stock-based compensation expense is classified in the statements of operations for the three and nine months ended September 30, 2023 and 2022 as follows (in thousands): Three Months Ended Nine Months Ended 2023 2022 2023 2022 Research and development $ 10,880 $ 5,431 $ 29,955 $ 15,140 General and administrative 7,416 6,590 21,851 19,649 Total stock-based compensation expense $ 18,296 $ 12,021 $ 51,806 $ 34,789

Fair Value of Financial Asset_2

Fair Value of Financial Assets and Liabilities (Tables)	9 Months Ended
	Sep. 30, 2023
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Abstract]
Schedule of Fair Value Measurement on Recurring Basis and Indicates the level of Fair Value Hierarchy Utilized	The following tables present information about the Company’s assets as of September 30, 2023 and December 31, 2022 that are measured at fair value on a recurring basis and indicate the level of the fair value hierarchy utilized to determine such fair values (in thousands): Fair Value Measurement at September 30, 2023 Using Level 1 Level 2 Level 3 Total Cash equivalents: Money market fund $ 135,160 $ — $ — $ 135,160 Commercial paper — 29,422 — 29,422 Short-term investments, other: Certificate of deposit — 2,033 — 2,033 Investment securities: US Treasuries 689,176 — — 689,176 US government agencies 202,646 — — 202,646 Corporate debt securities — 33,120 — 33,120 Commercial paper — 230,064 — 230,064 Total $ 1,026,982 $ 294,639 $ — $ 1,321,621 Fair Value Measurement at December 31, 2022 Using Level 1 Level 2 Level 3 Total Cash equivalents: Money market fund $ 160,158 $ — $ — $ 160,158 Commercial paper — 61,277 — 61,277 Investment securities: US Treasuries 423,688 — — 423,688 US government agencies 210,188 — — 210,188 Corporate debt securities — 63,728 — 63,728 Commercial paper — 178,111 — 178,111 Total $ 794,034 $ 303,116 $ — $ 1,097,150
Summary of Estimated Fair Value and Amortized Cost of Available-for-Sale Investments by Contractual Maturity	The estimated fair value and amortized cost of the Company’s available-for-sale investments, by contractual maturity and security type, are summarized as follows (in thousands): September 30, 2023 Amortized Unrealized Unrealized Fair Value US Treasuries (due within one year) $ 559,852 $ 7 $ ( 1,193 ) $ 558,666 US Treasuries (due after one year and 131,249 2 ( 741 ) 130,510 US government agencies (due within one year) 147,612 10 ( 296 ) 147,326 US government agencies (due after one year and 55,752 — ( 432 ) 55,320 Corporate debt securities (due within one year) 30,361 — ( 138 ) 30,223 Corporate debt securities (due after one year and 2,948 — ( 51 ) 2,897 Commercial paper (due within one year) 230,161 6 ( 103 ) 230,064 Total $ 1,157,935 $ 25 $ ( 2,954 ) $ 1,155,006 December 31, 2022 Amortized Unrealized Unrealized Fair Value US Treasuries (due within one year) $ 329,533 $ 17 $ ( 2,044 ) $ 327,506 US Treasuries (due after one year and 96,802 — ( 620 ) 96,182 US government agencies (due within one year) 178,319 54 ( 108 ) 178,265 US government agencies (due after one year and 32,104 — ( 181 ) 31,923 Corporate debt securities (due within one year) 51,952 1 ( 170 ) 51,783 Corporate debt securities (due after one year and 11,983 — ( 38 ) 11,945 Commercial paper (due within one year) 178,312 16 ( 217 ) 178,111 Total $ 879,005 $ 88 $ ( 3,378 ) $ 875,715

Commitments and Contingencies (

Commitments and Contingencies (Tables)	9 Months Ended
	Sep. 30, 2023
Commitments and Contingencies Disclosure [Abstract]
Schedule of Components of Lease Cost	The components of lease cost were as follows (dollar amounts in thousands): Nine Months Ended 2023 2022 Lease Cost Operating lease cost $ 2,506 $ 1,613 Short-term lease cost — — Sublease income ( 441 ) ( 433 ) Total lease cost $ 2,065 $ 1,180 Other Information Cash paid for amounts included in the measurement of lease liabilities $ 2,154 $ 1,908 Operating lease liabilities arising from obtaining right-of-use assets 11,820 — Weighted-average remaining lease term 9.05 years 2.85 years Weighted-average discount rate 10.44 % 5.88 %
Schedule of Maturity Analysis of Annual Undiscounted Cash Flows of Operating Lease Liabilities and Reconciliation to Present Value of Lease Liabilities	The following is a maturity analysis of the remaining annual undiscounted cash flows of the operating lease liabilities and a reconciliation to present value of lease liabilities as of September 30, 2023 (in thousands): Year ended: December 31, 2023 $ 649 December 31, 2024 1,704 December 31, 2025 4,818 December 31, 2026 3,591 December 31, 2027 3,698 Thereafter 29,188 Total future minimum lease payments 43,648 Less lease incentive ( 9,184 ) Less imputed interest ( 18,855 ) Present value of lease liabilities $ 15,609

Nature of the Business and Ba_2

Nature of the Business and Basis of Presentation - Additional Information (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		6 Months Ended	9 Months Ended
	Mar. 31, 2023	Sep. 30, 2022	Jun. 30, 2023	Sep. 30, 2023	Sep. 30, 2022	Dec. 31, 2022
Subsidiary Sale Of Stock [Line Items]
Shares issued and sold	2,851,299
Purchase of additional shares	371,908
Proceeds from issuance of public offering	$ 436,700
Underwriting discounts and commissions	23,000
Stock issuance costs incurred	$ 300
Cash flows from operating activities				$ 274,760	$ 149,249
Accumulated deficit				884,063		$ 564,207
Cash and cash equivalents and available-for-sale investments				$ 1,339,500
Common Stock
Subsidiary Sale Of Stock [Line Items]
Shares issued and sold		4,011,628	2,851,299
Initial Public Offering
Subsidiary Sale Of Stock [Line Items]
Public offering price pre share	$ 161.33

Prepaid Expenses and Other Cu_3

Prepaid Expenses and Other Current Assets and Accrued Expenses - Schedule of Prepaid Expenses and Other Current Assets (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]
Research and development expenses	$ 8,881	$ 25,285
Insurance	2,581	2,472
Other	1,414	1,349
Total prepaid expenses and other current assets	$ 12,876	$ 29,106

Prepaid Expenses and Other Cu_4

Prepaid Expenses and Other Current Assets and Accrued Expenses - Additional Information (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2023	Dec. 31, 2022
Other current assets	$ 10,078	$ 994
Refundable fee	3,200
Securities Investment [Member]
Interest receivable		700
Goldfinch Bio [Member]
Other current assets	10,100	$ 1,000
Due from related party	$ 4,900

Prepaid Expenses and Other Cu_5

Prepaid Expenses and Other Current Assets and Accrued Expenses - Schedule of Accrued Expenses (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Payables and Accruals [Abstract]
Research and development expenses	$ 22,821	$ 11,962
Payroll and related expenses	14,717	11,950
Professional fees	4,593	2,943
Other	1,998	2,430
Total accrued expenses	$ 44,129	$ 29,285

Stockholders' Equity - Addition

Stockholders' Equity - Additional Information (Details) - USD ($) $ / shares in Units, $ in Thousands	9 Months Ended
	Sep. 30, 2023	Dec. 31, 2022	Jul. 02, 2019
Class Of Stock [Line Items]
Preferred stock, shares authorized	10,000,000	10,000,000
Preferred stock, par value	$ 0.0001	$ 0.0001
Preferred stock, shares outstanding	0	0
Common Stock, Shares, Outstanding	37,719,367	34,473,905
Common stock, shares authorized	150,000,000	150,000,000
Common stock, par value	$ 0.0001	$ 0.0001
Dividends declared	$ 0
Initial Public Offering
Class Of Stock [Line Items]
Preferred stock, shares authorized			10,000,000
Preferred stock, par value			$ 0.0001
Preferred Stock, Shares Issued	0

Zai License Agreement (Addition

Zai License Agreement (Additional Information) (Details) - USD ($)		3 Months Ended		9 Months Ended		12 Months Ended
	Nov. 08, 2021	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022	Dec. 31, 2021	Dec. 31, 2022
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
License and other revenue		$ 0	$ 81,000	$ 654,000	$ 5,359,000
Zai License Agreement [Member]
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Upfront Payment for License Agreement	$ 35,000,000
Development and Regulatory Milestone Payments Under License Agreement	80,000,000			70,000,000
Other Revenue		0	100,000	700,000	100,000
Sales Milestone Payments Under License Agreement	72,000,000
Transaction Price of License Agreement	37,000,000
Initial payment	$ 35,000,000
License and other revenue					5,300,000
Income tax provision Include Foreign Tax Expenses		0	$ 0	0	0
Deferred revenue		$ 0		$ 0			$ 0
Zai License Agreement [Member] | Intellectual Property License Agreement [Member]
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
License and other revenue						$ 37,000,000
Zai License Agreement [Member] | General and Administrative Expense [Member]
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Income tax provision Include Foreign Tax Expenses					$ 500,000

Net Loss Per Share - Schedule o

Net Loss Per Share - Schedule of Computation of Basic and Diluted Net Loss Per Share of Common Stock (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		6 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Jun. 30, 2023	Jun. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Earnings Per Share [Abstract]
Net Loss	$ (119,119)	$ (76,963)	$ (200,737)	$ (123,161)	$ (319,856)	$ (200,124)
Weighted-average shares used in computing net loss per share, Basic	37,689,144	32,349,111			36,682,056	30,693,117
Weighted-average shares used in computing net loss per share, Diluted	37,689,144	32,349,111			36,682,056	30,693,117
Net loss per share, basic	$ (3.16)	$ (2.38)			$ (8.72)	$ (6.52)
Net loss per share, diluted	$ (3.16)	$ (2.38)			$ (8.72)	$ (6.52)

Net Loss Per Share - Schedule_2

Net Loss Per Share - Schedule of Diluted net loss per share (Details) - shares	9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Anti-dilutive securities excluded from computation of earnings per share, amount	5,856,540	5,561,493
Employee Stock Option
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Anti-dilutive securities excluded from computation of earnings per share, amount	5,541,686	5,561,493
Restricted Stock Units (RSUs) [Member]
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Anti-dilutive securities excluded from computation of earnings per share, amount	314,854	0

License Agreements (Additional

License Agreements (Additional Information) (Details)	1 Months Ended			9 Months Ended
	Jan. 31, 2023 USD ($)	May 31, 2012 USD ($)	Mar. 31, 2011 USD ($)	Sep. 30, 2023 USD ($) Milestone	Dec. 31, 2022 USD ($)
GFB Agreement [Member]
Business Acquisition [Line Items]
Upfront Payment for License Agreement	$ 15,000,000			$ 15,000,000
Maximum future payments under license agreement	520,000,000
Development Milestone Payments	110,000,000
Regulatory Milestone Payments	150,000,000
Commercial sales milestones	$ 260,000,000
GFB Agreement [Member] | Minimum [Member]
Business Acquisition [Line Items]
Payments for royalties, percentage	25%
GFB Agreement [Member] | Maximum [Member]
Business Acquisition [Line Items]
Payments for royalties, percentage	35%
Intellectual Property License Agreement [Member] | Eli Lilly And Company [Member]
Business Acquisition [Line Items]
Upfront Payment for License Agreement		$ 100,000
Royalty Expiration Term		6 years
License Agreement Maximum Term				15 years
Number Of Milestones Reached | Milestone				0
Milestone Payment				$ 0
Intellectual Property License Agreement [Member] | Eli Lilly And Company [Member] | Maximum [Member]
Business Acquisition [Line Items]
Contingent Milestone Payments Payable		$ 16,000,000
Commercial Milestone Payments Payable		$ 54,000,000
Patent License Agreement [Member] | Pure Tech Health [Member]
Business Acquisition [Line Items]
Contingent Milestone Payments Payable			$ 10,000,000
Development and Regulatory Milestone Payments Under License Agreement				8,000,000
Related Party Deposit Liabilities				$ 0	$ 0
Patent License Agreement [Member] | Pure Tech Health [Member] | Minimum [Member]
Business Acquisition [Line Items]
Percentage Of Royalties Payable On Income From Sublicensee Excluding Royalties			15%
Patent License Agreement [Member] | Pure Tech Health [Member] | Maximum [Member]
Business Acquisition [Line Items]
Percentage Of Royalties Payable On Income From Sublicensee Excluding Royalties			25%

Stock-based Compensation - Addi

Stock-based Compensation - Additional Information (Details) - USD ($) $ / shares in Units, $ in Millions	1 Months Ended	9 Months Ended		12 Months Ended
	May 30, 2019	Sep. 30, 2023	Sep. 30, 2022	Dec. 31, 2020	Dec. 31, 2022
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of shares outstanding		5,541,686			5,570,355
Share-Based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Period for Recognition		2 years 9 months 18 days
Unrecognized compensation cost		$ 132.2
Unrecognized compensation costs, weighted average recognition period		2 years 9 months 18 days
Share-Based Compensation Arrangement by Share-Based Payment Award, Options, Grants in Period, Weighted Average Grant Date Fair Value		$ 114.69	$ 70.59
Share-Based Compensation Arrangement by Share-Based Payment Award, Options, Exercises in Period, Intrinsic Value		$ 54.5	$ 84
Restricted Stock [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of shares outstanding		314,854			0
Employee service share based compensation nonvested awards total compensation cost not yet recognized Restricted Stock Units Shares		$ 53.6
Share-Based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Period for Recognition		3 years 4 months 24 days
Unrecognized compensation costs, weighted average recognition period		3 years 4 months 24 days
2009 Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of shares outstanding		1,981,828
Share based compensation arrangement by share based payment award termination date		Jul. 02, 2019
2019 Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Aggregate common shares issuable		2,661,308
Number of shares outstanding		3,559,858
Common stock reserved for future issuance	1,709,832
Automatic increase in stock issuance as percentage on outstanding stock				4%
Stock option and incentive plan expiration month and year	2029-05
Expiration period		10 years
Vesting period		4 years

Stock-based Compensation - Summ

Stock-based Compensation - Summary of Stock Option Activity (Details) $ / shares in Units, $ in Thousands	9 Months Ended	12 Months Ended
	Sep. 30, 2023 USD ($) $ / shares shares	Dec. 31, 2022 USD ($) $ / shares shares
Schedule of Share-Based Compensation Arrangements by Share-Based Payment Award [Table]
Number of Shares, Outstanding, beginning of period | shares	5,570,355
Number of Shares, Granted | shares	636,014
Number of Shares, Exercised | shares	(394,163)
Number of Shares, Forfeited | shares	(268,382)
Number of Shares,Expired | shares	2,138
Number of Shares, Outstanding, end of period | shares	5,541,686	5,570,355
Number of Shares, Options vested and expected to vest | shares	5,541,686
Number of Shares, Options exercisable | shares	3,892,864
Weighted-Average Exercise Price Per Share, Outstanding, beginning of period | $ / shares	$ 63.82
Weighted-Average Exercise Price Per Share, Outstanding, Granted | $ / shares	195.44
Weighted-Average Exercise Price Per Share, Outstanding, Exercised | $ / shares	68.62
Weighted-Average Exercise Price Per Share, Outstanding, Forfeited | $ / shares	142.72
Weighted-Average Exercise Price Per Share, Outstanding,Expired | $ / shares	123.63
Weighted-Average Exercise Price Per Share, Outstanding, end of period | $ / shares	74.74	$ 63.82
Weighted-Average Exercise Price Per Share, Options vested and expected to vest | $ / shares	74.74
Weighted-Average Exercise Price Per Share, Options exercisable | $ / shares	$ 41.37
Weighted-Average Remaining Contractual Term, Outstanding (Years)	6 years 6 months	7 years 2 months 12 days
Weighted-Average Remaining Contractual Term, Options vested and expected to vest	6 years 6 months
Weighted-Average Remaining Contractual Term, Options exercisable	5 years 7 months 6 days
Aggregate Intrinsic Value, Outstanding | $	$ 546,440	$ 744,097
Aggregate Intrinsic Value, Options vested and expected to vest | $	546,440
Aggregate Intrinsic Value, Options exercisable | $	$ 497,659
Restricted Stock [Member]
Schedule of Share-Based Compensation Arrangements by Share-Based Payment Award [Table]
Number of Shares, Outstanding, beginning of period | shares	0
Number of Shares, Granted | shares	330,267
Number of Shares, Forfeited | shares	(15,413)
Number of Shares, Outstanding, end of period | shares	314,854	0
Weighted-Average Exercise Price Per Share, Outstanding, beginning of period | $ / shares	$ 0
Weighted-Average Exercise Price Per Share, Outstanding, Granted | $ / shares	195.46
Weighted-Average Exercise Price Per Share, Outstanding, Forfeited | $ / shares	189.49
Weighted-Average Exercise Price Per Share, Outstanding, end of period | $ / shares	$ 195.75	$ 0

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, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock based compensation expense	$ 18,296	$ 12,021	$ 51,806	$ 34,789
General and Administrative
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock based compensation expense	7,416	6,590	21,851	19,649
Research and Development
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock based compensation expense	$ 10,880	$ 5,431	$ 29,955	$ 15,140

Fair Value of Financial Asset_3

Fair Value of Financial Assets and Liabilities - Schedule of Fair Value Measurement on Recurring Basis and Indicates the level of Fair Value Hierarchy Utilized (Details) - Recurring - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total fair value assets	$ 1,321,621	$ 1,097,150
Corporate Debt Securities
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Investment securities	33,120	63,728
Money Market Funds
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Cash equivalents	135,160	160,158
US Treasury Securities
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Investment securities	689,176	423,688
Commercial Paper
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Cash equivalents	230,064	61,277
Investment securities	29,422	178,111
US Government Agencies
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Cash equivalents	202,646	210,188
Certificate of deposit
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Certificate of deposit	2,033
Fair Value, Inputs, Level 1
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total fair value assets	1,026,982	794,034
Fair Value, Inputs, Level 1 | Corporate Debt Securities
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Investment securities	0	0
Fair Value, Inputs, Level 1 | Money Market Funds
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Cash equivalents	135,160	160,158
Fair Value, Inputs, Level 1 | US Treasury Securities
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Investment securities	689,176	423,688
Fair Value, Inputs, Level 1 | Commercial Paper
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Cash equivalents	0	0
Investment securities	0	0
Fair Value, Inputs, Level 1 | US Government Agencies
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Cash equivalents	202,646	210,188
Fair Value, Inputs, Level 1 | Certificate of deposit
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Certificate of deposit	0
Fair Value, Inputs, Level 2
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total fair value assets	294,639	303,116
Fair Value, Inputs, Level 2 | Corporate Debt Securities
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Investment securities	33,120	63,728
Fair Value, Inputs, Level 2 | Money Market Funds
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Cash equivalents	0	0
Fair Value, Inputs, Level 2 | US Treasury Securities
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Investment securities	0	0
Fair Value, Inputs, Level 2 | Commercial Paper
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Cash equivalents	230,064	61,277
Investment securities	29,422	178,111
Fair Value, Inputs, Level 2 | US Government Agencies
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Cash equivalents	0	0
Fair Value, Inputs, Level 2 | Certificate of deposit
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Certificate of deposit	2,033
Fair Value, Inputs, Level 3
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total fair value assets	0	0
Fair Value, Inputs, Level 3 | Corporate Debt Securities
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Investment securities	0	0
Fair Value, Inputs, Level 3 | Money Market Funds
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Cash equivalents	0	0
Fair Value, Inputs, Level 3 | US Treasury Securities
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Investment securities	0	0
Fair Value, Inputs, Level 3 | Commercial Paper
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Cash equivalents	0	0
Investment securities	0	0
Fair Value, Inputs, Level 3 | US Government Agencies
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Cash equivalents	0	$ 0
Fair Value, Inputs, Level 3 | Certificate of deposit
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Certificate of deposit	$ 0

Fair Value of Financial Asset_4

Fair Value of Financial Assets and Liabilities - Summary of Estimated Fair Value and Amortized Cost of Available-for-Sale Investments by Contractual Maturity (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Amortized Cost	$ 1,157,935	$ 879,005
Available For Sale Securities Accumulated Gross Unrealized Gains Before Tax	25	88
Available For Sale Securities Accumulated Gross Unrealized Losses Before Tax	(2,954)	(3,378)
Fair Value	1,155,006	875,715
Corporate Debt Securities
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Due within in one year, Amortized cost	30,361	51,952
Due within one year, Amortized cost, Unrealized gains	0	1
Due within one year , Amortized cost, Unrealized losses	(138)	(170)
Due in one year or less, Fair value	30,223	51,783
Due after one year and less than two years, Amortized cost	2,948	11,983
Due after one year and less than two years, Amortized cost, Unrealized gains	0	0
Due after one year and less than two years, Amortized cost, Unrealized losses	(51)	(38)
Due after one year and less than two years, Fair value	2,897	11,945
US Treasury Securities
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Due after one year and less than two years, Amortized cost	131,249	96,802
Due after one year and less than two years, Amortized cost, Unrealized losses	(741)	(620)
Due after one year and less than two years, Fair value	130,510	96,182
Due within in one year, Amortized cost	559,852	329,533
Due within one year, Amortized cost, Unrealized gains	7	17
Due within one year, Amortized cost, Unrealized losses	(1,193)	(2,044)
Due in one year or less, Fair value	558,666	327,506
Due after one year and less than two years, Amortized cost, Unrealized gains	2	0
US Government Agencies
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Due within in one year, Amortized cost	147,612	178,319
Due within one year, Amortized cost, Unrealized gains	10	54
Due within one year, Amortized cost, Unrealized losses	(296)	(108)
Due in one year or less, Fair value	147,326	178,265
Due after one year and less than two years, Amortized cost	55,752	32,104
Due after one year and less than two years, Amortized cost, Unrealized gains	0	0
Due after one year and less than two years, Amortized cost, Unrealized losses	(432)	(181)
Due after one year and less than two years, Fair value	55,320	31,923
Commercial Paper
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Due within in one year, Amortized cost	230,161	178,312
Due within one year, Amortized cost, Unrealized gains	6	16
Due within one year , Amortized cost, Unrealized losses	(103)	(217)
Due in one year or less, Fair value	$ 230,064	$ 178,111

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Details)	1 Months Ended			9 Months Ended
	Apr. 30, 2023 USD ($) ft²	May 31, 2012 USD ($)	Mar. 31, 2011 USD ($)	Sep. 30, 2023 USD ($) ft² Milestone	Jun. 08, 2023 USD ($)	Dec. 31, 2022 USD ($)
Commitments And Contingencies [Line Items]
Restricted cash, net of current portion				$ 0		$ 261,000
Right-of-use lease assets - operating, net				14,603,000		$ 4,674,000
Lease liability				15,609,000
Contingency reserves for litigation				$ 0
Intellectual Property License Agreement | Eli Lilly and Company
Commitments And Contingencies [Line Items]
Royalty expiration term		6 years
Number of milestones reached | Milestone				0
Milestone payments				$ 0
License agreement term				15 years
Patent License | PureTech Health
Commitments And Contingencies [Line Items]
Contingent milestone payments payable			$ 10,000,000
Development and Regulatory Milestone Payments Under License Agreement				$ 8,000,000
Maximum | Intellectual Property License Agreement | Eli Lilly and Company
Commitments And Contingencies [Line Items]
Contingent milestone payments payable		$ 16,000,000
Commercial milestone payments payable		$ 54,000,000
Maximum | Patent License | PureTech Health
Commitments And Contingencies [Line Items]
Percentage of royalties payable on income from sublicensee, excluding royalties			25%
Minimum | Patent License | PureTech Health
Commitments And Contingencies [Line Items]
Percentage of royalties payable on income from sublicensee, excluding royalties			15%
Boston, Massachusetts | High Street Lease Agreement [Member]
Commitments And Contingencies [Line Items]
Lease base rent	$ 3,500,000
Base rent, first rent due date	Jan. 01, 2025
Right-of-use lease assets - operating, net					$ 11,700,000
Lease liability					$ 11,400,000
Tenant Improvement Allowance	$ 9,200,000
Monthly installment of base rental	$ 300,000
Area of land | ft²	50,890
Lease initial term	10 years
Boston, Massachusetts | High Street Lease Agreement [Member] | Years Ended December 31, 2023 [Member]
Commitments And Contingencies [Line Items]
Lease incentive receivables				9,200,000
Boston, Massachusetts | High Street Lease Agreement [Member] | Years Ended December 31, 2024 [Member]
Commitments And Contingencies [Line Items]
Lease incentive receivables				9,200,000
The Arch Street Lease Agreement Member
Commitments And Contingencies [Line Items]
Annual undiscounted cash flows from Sublease				200,000
Office Space | High Street Lease Agreement [Member]
Commitments And Contingencies [Line Items]
Security deposit				$ 2,000,000
Office Space | Boston, Massachusetts
Commitments And Contingencies [Line Items]
Sublease area of office space | ft²				25,445
Sublease commencement date				Apr. 01, 2021
Sublease expiring date				Dec. 31, 2025
Annualized Base Rent Payments				$ 1,500,000
Final year of the sublease.				$ 1,600,000

Commitments and Contingencies_2

Commitments and Contingencies - Components of Lease Cost (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Lease Cost
Operating lease cost			$ 2,506	$ 1,613
Short-term lease cost			0	0
Sublease income	$ (147)	$ (147)	(441)	(433)
Total lease cost			2,065	1,180
Cash paid for amounts included in the measurement of lease liabilities			2,154	1,908
Operating lease liabilities arising from obtaining right-of-use assets			$ 11,820	$ 0
Weighted-average remaining lease term	9 years 18 days	2 years 10 months 6 days	9 years 18 days	2 years 10 months 6 days
Weighted-average discount rate	10.44%	5.88%	10.44%	5.88%

Commitments and Contingencies_3

Commitments and Contingencies - Schedule of Maturity Analysis of Annual Undiscounted Cash Flows of Operating Lease Liabilities and Reconciliation to Present Value of Lease Liabilities (Details) $ in Thousands	Sep. 30, 2023 USD ($)
Commitments and Contingencies Disclosure [Abstract]
December 31, 2023	$ 649
December 31, 2024	1,704
December 31, 2025	4,818
December 31, 2026	3,591
December 31, 2027	3,698
Thereafter	29,188
Total future minimum lease payments	43,648
Less Lease Incentive	(9,184)
Less imputed interest	(18,855)
Present value of lease liabilities	$ 15,609

401(k) Savings Plan - Additiona

401(k) Savings Plan - Additional Information (Details) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022
Retirement Benefits [Abstract]
Defined contribution plan, plan name	401(k)
Total contribution expense	$ 1.5	$ 0.7