Karuna Therapeutics (KRTX) 10-Q 7 May 20 2020 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2020	Apr. 30, 2020
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2020
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	Q1
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	33 Arch Street
Entity Address, Address Line Two	Suite 3110
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	Non-accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	true
Entity Ex Transition Period	false
Entity Common Stock, Shares Outstanding		26,130,120
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	Mar. 31, 2020	Dec. 31, 2019
Current assets:
Cash and cash equivalents	$ 190,645	$ 208,929
Short-term investments	192,846	180,468
Prepaid expenses and other current assets	3,177	3,309
Total current assets	386,668	392,706
Restricted cash	157	123
Property and equipment, net	371	195
Right-of-use lease assets - operating, net	2,522
Total assets	389,718	393,024
Current liabilities:
Accounts payable (includes $0 and $51 at March 31, 2020 and December 31, 2019, respectively, due to related parties)	603	547
Accrued expenses	1,425	2,353
Current portion of deferred lease obligation		58
Current portion of operating lease liability	624
Total current liabilities	2,652	2,958
Deferred lease obligation, net of current portion		150
Operating lease liability, net of current portion	2,125
Total liabilities	4,777	3,108
Commitments and Contingencies (Note 10)
Stockholders’ equity:
Preferred stock, $0.0001 par value; 10,000,000 shares authorized and 0 shares outstanding as of March 31, 2020 and December 31, 2019
Common stock, $0.0001 par value; 150,000,000 shares authorized at March 31, 2020 and December 31, 2019; 26,094,892 and 26,012,754 shares issued and outstanding at March 31, 2020 and December 31, 2019, respectively	3	3
Additional paid-in capital	467,537	465,420
Accumulated deficit	(84,170)	(75,512)
Accumulated other comprehensive income	1,571	5
Total stockholders’ equity	384,941	389,916
Total liabilities, redeemable convertible preferred stock and stockholders’ equity	$ 389,718	$ 393,024

CONSOLIDATED BALANCE SHEETS (_2

CONSOLIDATED BALANCE SHEETS (Unaudited) (Parenthetical) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Statement Of Financial Position [Abstract]
Accounts payable to related party	$ 0	$ 51
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	26,094,892	26,012,754
Common stock, shares outstanding	26,094,892	26,012,754

CONSOLIDATED STATEMENTS OF OPER

CONSOLIDATED STATEMENTS OF OPERATIONS (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Operating expenses:
Research and development	$ 4,420	$ 6,967
General and administrative	5,635	4,606
Total operating expenses	10,055	11,573
Loss from operations	(10,055)	(11,573)
Other income (expense):
Interest income	1,397	115
Interest income, net (Note 4)		11
Accretion of debt discount (Note 4)		(423)
Change in fair value of derivative (Note 4)		(135)
Total other income (expense), net	1,397	(432)
Net loss before income taxes	(8,658)	(12,005)
Net loss attributable to common stockholders	$ (8,658)	$ (12,005)
Net loss per share, basic and diluted (Note 7)	$ (0.33)	$ (4,484)
Weighted average common shares outstanding used in computing net loss per share, basic and diluted	26,042,434	2,677

CONSOLIDATED STATEMENTS OF COMP

CONSOLIDATED STATEMENTS OF COMPREHENSIVE LOSS (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Statement Of Income And Comprehensive Income [Abstract]
Net loss	$ (8,658)	$ (12,005)
Other comprehensive income:
Unrealized gains on short-term investments	1,566
Comprehensive loss	$ (7,092)	$ (12,005)

CONSOLIDATED STATEMENTS OF REDE

CONSOLIDATED STATEMENTS OF REDEEMABLE CONVERTIBLE PREFERRED STOCK AND STOCKHOLDERS' EQUITY (DEFICIT) (Unaudited) - USD ($) $ in Thousands	Total	Common Stock	Additional Paid In Capital	Accumulated Deficit	Accumulated Other Comprehensive Income	Series Seed, A and B Redeemable Convertible Preferred Stock
Temporary Equity, beginning balance at Dec. 31, 2018						$ 41,965
Temporary Equity, beginning balance, shares at Dec. 31, 2018						7,539,200
Beginning balance at Dec. 31, 2018	$ (29,922)		$ 1,633	$ (31,555)
Beginning balance, shares at Dec. 31, 2018		12
Issuance of Series B redeemable convertible preferred stock, net of issuance costs of $175						$ 79,841
Temporary Equity, Issuance of Series B redeemable convertible preferred stock, net of issuance costs of $175, shares						5,285,102
Stock-based compensation expense	3,104		3,104
Exercise of common warrants	58		58
Exercise of common warrants, shares		19,986
Net loss	(12,005)			(12,005)
Temporary Equity, ending balance at Mar. 31, 2019						$ 121,806
Temporary Equity, ending balance, shares at Mar. 31, 2019						12,824,302
Ending balance at Mar. 31, 2019	(38,765)		4,795	(43,560)
Ending balance, shares at Mar. 31, 2019		19,998
Temporary Equity, beginning balance, shares at Dec. 31, 2019						0
Beginning balance at Dec. 31, 2019	389,916	$ 3	465,420	(75,512)	$ 5
Beginning balance, shares at Dec. 31, 2019		26,012,754
Follow-on offering costs	(34)		(34)
Stock-based compensation expense	1,634		1,634
Exercise of common options	$ 517		517
Exercise of common options, shares	82,138	82,138
Other comprehensive income	$ 1,566				1,566
Net loss	(8,658)			(8,658)
Temporary Equity, ending balance, shares at Mar. 31, 2020						0
Ending balance at Mar. 31, 2020	$ 384,941	$ 3	$ 467,537	$ (84,170)	$ 1,571
Ending balance, shares at Mar. 31, 2020		26,094,892

CONSOLIDATED STATEMENTS OF RE_2

CONSOLIDATED STATEMENTS OF REDEEMABLE CONVERTIBLE PREFERRED STOCK AND STOCKHOLDERS' EQUITY (DEFICIT) (Unaudited) (Parenthetical) $ in Thousands	3 Months Ended
	Mar. 31, 2019USD ($)
Series B Redeemable Convertible Preferred Stock
Issuance of redeemable convertible preferred stock, net of issuance costs	$ 175

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Cash flows from operating activities
Net loss	$ (8,658)	$ (12,005)
Adjustments to reconcile net loss to net cash used in operating activities:
Stock-based compensation expense	1,634	3,104
Non-cash interest income	(462)	(17)
Non-cash interest income, net (Note 4)		(11)
Accretion of debt discount (Note 4)		423
Change in fair value of derivative liability (Note 4)		135
Depreciation and amortization expense	21	10
Changes in operating assets and liabilities:
Prepaid expenses and other current assets	132	1,478
Right-of-use assets	121
Accounts payable	24	585
Accrued expenses	(1,051)	74
Deferred lease obligation		110
Operating lease liability	(102)
Net cash used in operating activities	(8,341)	(6,114)
Cash flows from investing activities
Purchases of short-term investments	(70,350)
Maturities of short-term investments	60,000	5,000
Acquisition of property and equipment	(76)	(17)
Net cash (used in) provided by investing activities	(10,426)	4,983
Cash flows from financing activities
Proceeds from issuance of convertible notes		1,564
Proceeds from exercise of stock options	517
Proceeds from exercise of warrant		58
Payment of deferred offering costs		(97)
Net cash provided by financing activities	517	76,502
Net increase in cash, cash equivalents and restricted cash	(18,250)	75,371
Cash, cash equivalents and restricted cash at beginning of period	209,052	9,027
Cash, cash equivalents and restricted cash at end of period	190,802	84,398
Supplemental disclosures of cash flows information
Lease liabilities arising from obtaining right-of-use assets	2,851
Purchases of property and equipment included in accounts payable and accrued expenses	121
Deferred offering costs included in accrued expenses	$ 34	529
Conversion of convertible notes, accrued interest and discount upon conversion to preferred stock		5,016
Series B Redeemable Convertible Preferred Stock
Cash flows from financing activities
Proceeds from issuance of Series B redeemable convertible preferred stock, net of issuance costs		$ 74,977

Nature of the Business

Nature of the Business	3 Months Ended
	Mar. 31, 2020
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Nature of the Business	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 focused on developing novel therapies with the potential to transform the lives of people with disabling and potentially fatal neuropsychiatric disorders and pain. 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 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 and the need to obtain adequate additional financing to fund the development of its product candidates. On June 14, 2019, the Company effected a one-for-1.2987 stock split of its issued and outstanding shares of common stock and a proportional adjustment to the existing conversion ratios for each series of the Company’s redeemable convertible preferred stock. Accordingly, all share and per share amounts for all periods presented in the accompanying consolidated financial statements and notes thereto have been adjusted retroactively, where applicable, to reflect this stock split and adjustment of the redeemable convertible preferred stock conversion ratios. On June 27, 2019, the Company’s registration statement on Form S-1 relating to its initial public offering of its common stock (“IPO”) was declared effective by the Securities and Exchange Commission (“SEC”). In the IPO, which closed on July 2, 2019, the Company issued and sold 6,414,842 On November 20, 2019, the Company’s registration statement on Form S-1 relating to its follow-on public offering of its common stock was declared effective by the SEC. In this offering, which closed on November 25, 2019, the Company issued and sold 2,600,000 shares of common stock at a public offering price of $96.00 per share. The aggregate net proceeds were approximately $234.2 million after deducting underwriting discounts and commissions of $15.0 million and offering expenses of $0.4 million. 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 $8.3 million for the three months ended March 31, 2020 The Company expects that its cash, cash equivalents and short-term investments of $383.5 million as of March 31, 2020 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. The future viability of the Company beyond that point is dependent on its ability to raise additional capital to fund its operations. If the Company is unable to obtain funding, the Company could be forced to delay, reduce or eliminate some or all of its research and development programs, product portfolio expansion or commercialization efforts, which could adversely affect its business prospects, or the Company may be unable to continue operations. Although management continues to pursue these plans, there is no assurance that the Company will be successful in obtaining sufficient funding on terms acceptable to the Company to fund continuing operations, if at all. 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 the Company 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 March 31, 2020, the consolidated statements of operations, comprehensive loss, and cash flows for the three months ended March 31, 2020 and 2019, and the consolidated statements of redeemable convertible preferred stock and stockholders’ equity (deficit) for the three months ended March 31, 2020 and 2019 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 March 31, 2020 and the results of its operations and its cash flows for the three months ended March 31, 2020 and 2019. Certain information and footnote disclosures typically included in annual financial statements prepared in accordance with 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, 2019.

Summary of Significant Accounti

Summary of Significant Accounting Policies	3 Months Ended
	Mar. 31, 2020
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, 2019, and the notes thereto, which are included in the Company’s Annual Report on Form 10-K. During the three months ended March 31, 2020, there were no material changes to the Company’s significant accounting policies, except for the adoption of ASU 2016-02, Leases (Topic 842) Recently Adopted Accounting Pronouncements In February 2016, the FASB issued ASU 2016-02, Leases Leases (Topic 842): Targeted Improvements Leases (Topic 842): Codification Improvements The Company determines if an arrangement contains a lease at inception. Operating leases are included in right-of-use (“ROU”) lease assets, current portion of operating lease liability, and operating lease liability, net of current portion, on the Company’s balance sheets. ROU lease assets represent the Company’s right to use an underlying asset for the lease term and lease liabilities represent the Company’s obligation to make lease payments arising from the lease. Operating ROU lease assets and liabilities are recognized at the commencement date based on the present value of lease payments over the lease term. As most of the Company’s leases do not provide an implicit rate, the Company uses its incremental borrowing rate based on the information available at the commencement date in determining the present value of lease payments. The ROU lease asset excludes lease incentives. The Company’s lease terms may include options to extend or terminate the lease when it is reasonably certain that the Company will exercise that option. Lease expense for lease payments is recognized on a straight-line basis over the lease term. Changes to terms and conditions of an arrangement that contains a lease are evaluated to determine if a modification had occurred and a lease continues to exist. Lease modifications are accounted for as a separate contract or are treated as a change in accounting for the existing lease. In August 2018, the FASB issued ASU 2018-13, Fair Value Measurement (Topic 820) consolidated In December 2019, the FASB issued ASU 2019-12, Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes Recently Issued Accounting Pronouncements In June 2016, the FASB issued ASU 2016-13, Financial Instruments – Credit Losses (Topic 326)

Prepaid Expenses and Other Curr

Prepaid Expenses and Other Current Assets and Accrued Expenses	3 Months Ended
	Mar. 31, 2020
Prepaid Expenses And Other Current Assets And Accrued Expenses [Abstract]
Prepaid Expenses and Other Current Assets and Accrued Expenses	Note 3. Prepaid Expenses and Other Current Assets and Accrued Expenses Prepaid expenses and other current assets consisted of the following (in thousands): March 31, 2020 December 31, 2019 Prepaid insurance $ 1,050 $ 2,130 Prepaid research and development expenses 1,810 694 Other 317 485 Total prepaid expenses and other current assets $ 3,177 $ 3,309 Accrued expenses consisted of the following (in thousands): March 31, 2020 December 31, 2019 Accrued payroll and related expenses $ 572 $ 1,823 Accrued research and development expenses 398 344 Professional fees 267 142 Other 188 44 Total accrued expenses $ 1,425 $ 2,353

Convertible Notes Payable

Convertible Notes Payable	3 Months Ended
	Mar. 31, 2020
Convertible Debt Disclosure [Abstract]
Convertible Notes Payable	Note 4. Convertible Notes Payable In June 2018, the Company entered into a Company Funding Agreement with The Wellcome Trust, Limited (“Wellcome Trust”) to receive up to $8.0 million in gross proceeds from the issuance of a convertible note (the “2018 Convertible Note”). The Company received $2.0 million of proceeds in July 2018, $2.7 million in November 2018, $1.6 million in March 2019, and $1.6 million in April 2019. The 2018 Convertible Note had a stated interest rate of 2% per annum above the three-month Dollar LIBOR rate, which was not payable until settlement of the principal. The note was subject to redemption upon written demand by Wellcome Trust any time after the fifth anniversary of the effective date. The principal due under the 2018 Convertible Note was convertible into the class of the Company’s stock issued in the Company’s next qualified financing or upon event of default at a discounted conversion price between 0% and 25% of the purchase price per share of such securities issued. The accrued interest in such a circumstance would be forgiven. At inception, the Company concluded that the 2018 Convertible Note contained a conversion option at a significant discount that was deemed to be an embedded derivative, which was required to be bifurcated and accounted for separately from the debt host. There were no debt issuance costs associated with the 2018 Convertible Note. The Company recognized the following changes in the debt related to the 2018 Convertible Note during Financial statement impacted Balance, December 31, 2018 $ 2,516 Issuance of 2018 Convertible Note 1,564 Balance sheet Allocation of proceeds to derivative liability (228 ) Balance sheet Accretion to settlement value 423 Statement of operations Accrued interest 29 Statement of operations Interest forgiven upon conversion (40 ) Statement of operations Conversion of Wellcome Trust Convertible Notes to redeemable convertible preferred stock (4,264 ) Balance sheet Balance, March 31, 2019 $ — In March and April 2019, all outstanding principal under the 2018 Convertible Note was converted into Series B redeemable convertible preferred stock in connection with the Company’s Series B preferred stock financing.

Redeemable Convertible Preferre

Redeemable Convertible Preferred Stock	3 Months Ended
	Mar. 31, 2020
Temporary Equity Disclosure [Abstract]
Redeemable Convertible Preferred Stock	Note 5. Redeemable Convertible Preferred Stock As of December 31, 2018, the Company had 7,539,200 shares of preferred stock issued and outstanding which were redeemable and convertible by the holders under specified conditions. The redeemable convertible preferred stock was classified outside of stockholders’ equity (deficit) because the shares contained redemption features that were not solely within the control of the Company. In March 2019, the Company authorized 5,422,845 shares of Series B Preferred Stock. The Company then issued 4,953,758 shares of Series B Preferred Stock at an issuance price of $15.14 per share resulting in gross proceeds of approximately $75.0 million. There were $0.2 million of issuance costs associated with the Series B Preferred Stock. In conjunction with the March 2019 issuance of Series B Preferred Stock, all outstanding principal under the Wellcome Trust Notes converted into 331,344 shares of Series B Preferred Stock. In April 2019, the Company received an additional $1.6 million pursuant to the 2018 Wellcome Trust Note, which was subsequently converted into 137,743 shares of Series B Preferred Stock. Upon closing of the Company’s IPO on July 2, 2019, the then-outstanding shares of the redeemable convertible preferred stock converted into common stock. There were no shares of redeemable convertible preferred stock authorized, issued or outstanding as of March 31, 2020 or December 31, 2019.

Stockholders' Equity (Deficit)

Stockholders' Equity (Deficit)	3 Months Ended
	Mar. 31, 2020
Equity [Abstract]
Stockholders' Equity (Deficit)	Note 6. Stockholders’ Equity (Deficit) Preferred Stock On July 2, 2019, in connection with the closing of the Company’s 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. There were no shares of preferred stock outstanding as of March 31, 2020 or December 31, 2019. Common Stock As of March 31, 2020, 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 March 31, 2020 , no cash dividends have been declared or paid. Upon completion of the Company’s IPO on July 2, 2019, all outstanding shares of redeemable convertible preferred stock converted to common stock. As of March 31, 2020, there were 26,094,892 shares of common stock outstanding.

Net Loss per Share

Net Loss per Share	3 Months Ended
	Mar. 31, 2020
Earnings Per Share [Abstract]
Net Loss per Share	Note 7. 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 months ended March 31, 2020 and 2019 Three Months Ended March 31, 2020 2019 Net Loss $ (8,658 ) $ (12,005 ) Weighted-average shares used in computing net loss per share 26,042,434 2,677 Net loss per share, basic and diluted $ (0.33 ) $ (4,484 ) The Company’s potentially dilutive securities, which include stock options and convertible preferred stock, have been excluded from the computation of diluted net loss per share as the effect would be to reduce the net loss per share. Therefore, the weighted average number of common shares outstanding used to calculate both basic and diluted net loss per share attributable to common stockholders is the same. Prior to the IPO, the Company’s outstanding shares of redeemable convertible preferred stock contractually entitled the holders of such shares to participate in distributions but contractually did not require the holders of such shares to participate in losses of the Company. Accordingly, these shares have not been included in the denominator used to calculate net loss per share. Common Stock Equivalents 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 because including them would have had an anti-dilutive impact: March 31, 2020 2019 Redeemable convertible preferred stock (as converted to common stock) — 16,654,904 Stock options to purchase common stock 4,974,356 3,755,633 4,974,356 20,410,537

Stock-based Compensation

Stock-based Compensation	3 Months Ended
	Mar. 31, 2020
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Stock-based Compensation	Note 8. Stock-based Compensation Stock Options 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 aggregate common shares issuable were 3,911,138 under the 2009 Plan, as amended. 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 In May 2019, the 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 Options under the 2019 Plan generally vest based on the grantee’s continued service with the Company during a specified period following a grant as determined by the board of directors and expire ten years from the grant date. In general, 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 Shares Underlying Options Weighted- Average Exercise Price Per Share Weighted- Average Remaining Contractual Term (Years) Aggregate Intrinsic Value (in thousands) Outstanding as of December 31, 2019 4,614,544 $ 8.94 8.3 $ 306,395 Granted 490,950 98.88 Exercised (82,138 ) 6.29 Forfeited (49,000 ) 16.00 Outstanding as of March 31, 2020 4,974,356 $ 17.79 8.1 $ 282,841 Options vested and expected to vest as of March 31, 2020 4,974,356 $ 17.79 8.1 $ 282,841 Options exercisable as of March 31, 2020 3,247,651 $ 8.43 7.6 $ 206,439 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 fair value of the Company’s common stock as of March 31, 2020. As of March 31, 2020, there was $31.9 million of unrecognized compensation cost, which is expected to be recognized over a weighted-average period of 3.6 years. Warrants In October 2016, PureTech Health LLC, a related party (“PureTech Health”), agreed to provide management services to the Company in exchange for a warrant to purchase up to 19,998 shares of the Company’s common stock. As of December 31, 2018, the warrant was fully vested and PureTech Health had partially exercised the warrant to purchase 12 shares of the Company’s common stock. In March 2019, PureTech Health exercised the remaining portion of the warrant to purchase 19,986 shares of the Company’s common stock resulting in proceeds to the Company of $0.1 million. There were no outstanding warrants as of March 31, 2020 or December 31, 2019. Stock-based Compensation Expense Stock-based compensation expense is classified in the statements of operations for the three months ended March 31, 2020 and 2019 as follows (in thousands): Three Months Ended March 31, 2020 2019 Research and development $ 1,285 $ 80 General and administrative 349 3,024 Total stock-based compensation expense $ 1,634 $ 3,104

Fair Value of Financial Assets

Fair Value of Financial Assets and Liabilities	3 Months Ended
	Mar. 31, 2020
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 and liabilities as of March 31, 2020 and December 31, 2019 that are measured at fair value on a recurring basis and indicates the level of the fair value hierarchy utilized to determine such fair values (in thousands): Fair Value Measurement at March 31, 2020 Using Level 1 Level 2 Level 3 Total Assets: Cash equivalents (Money Market Fund) $ 173,118 $ — $ — $ 173,118 Short-term investments (US Treasuries) 192,846 — — 192,846 Total $ 365,964 $ — $ — $ 365,964 Fair Value Measurement at December 31, 2019 Using Level 1 Level 2 Level 3 Total Assets: Cash equivalents (Money Market Fund) $ 197,303 $ — $ — $ 197,303 Short-term investments (US Treasuries) 180,468 — — 180,468 Total $ 377,771 $ — $ — $ 377,771 The estimated fair value and amortized cost of the Company’s short-term investments by contractual maturity are summarized as follows (in thousands): March 31, 2020 Amortized Cost Unrealized Gains Unrealized Losses Fair Value Due in one year or less $ 191,275 $ 1,571 $ — $ 192,846 Total $ 191,275 $ 1,571 $ — $ 192,846 December 31, 2019 Amortized Cost Unrealized Gains Unrealized Losses Fair Value Due in one year or less $ 180,463 $ 5 $ — $ 180,468 Total $ 180,463 $ 5 $ — $ 180,468 As of December 31, 2018, the Company had recorded a derivative liability of $0.4 million in connection with the 2018 Convertible Note. The derivative liability was considered a Level 3 liability because its fair value measurement was based, in part, on significant inputs not observed in the market. In March 2019, an additional derivative liability of $0.2 million was recognized in connection with the 2018 Convertible Note (see Note 4). For the three months ended March 31, 2019, the Company recognized a change in fair value of derivative of $0.1 million in the consolidated statement of operations. Upon the Company’s issuance of Series B redeemable convertible preferred stock in March and April 2019, all outstanding principal under the 2018 Convertible Note was converted into redeemable convertible preferred stock. There was no derivative liability recorded as of March 31, 2020 or December 31, 2019.

Commitments and Contingencies

Commitments and Contingencies	3 Months Ended
	Mar. 31, 2020
Commitments And Contingencies Disclosure [Abstract]
Commitments and Contingencies	Note 10. Commitments and Contingencies Leases The Company entered into an agreement to lease approximately 7,050 square feet of office space in Boston, Massachusetts (“Original Premises”) that began in December 2018 and had an original expiry in February 2023. In January 2020, the Company entered into an amended agreement (“Amended Lease Agreement”) to gain access to approximately 4,175 square feet of additional office space (“Expansion Premises”) beginning in March 2020, and to extend the maturity of the agreement for the Original Premises to December 2023. The Amended Lease Agreement provides for future minimum annual rental payments as defined within the agreement. Under the terms of the amended agreement, the Company is required to maintain a cash balance of approximately $0.2 million to secure a letter of credit associated with this lease. The amount was classified as restricted cash in the consolidated balance sheets as of March 31, 2020 and December 31, 2019. The amended agreement also provides for approximately $0.1 million in leasehold incentives which may be applied to base rent or improvements to the Expansion Premises, subject to limitations. The Company determined the Amended Lease Agreement represented a lease modification, and the Original Premises and Expansion Premises were identified as separate lease components. The extension of maturity with respect to the Original Premises was treated as a modification not accounted for as a separate contract, in which lease classification was reassessed and the lease liability was remeasured. The effect of the remeasurement, in the amount of million, was recorded as an adjustment to the right-of-use asset as of February 1, 2020, the effective date of the modification. The addition of the Expansion Premises was accounted for as a separate contract which granted the Company an additional right of use not included in the original lease, in which the lease payments increased commensurate with the standalone price for the additional right of use. As the leasehold incentives were not paid or payable at commencement, the Company will account for the incentives once the contingency is resolved. In February 2020, the Company entered into an agreement to lease approximately 5,050 square feet of office space, and furniture within the office space, in Carmel, Indiana (“Indiana Lease Agreement”), which begins in June 2020 and expires in July 2023, with the option to renew for an additional three-year term. In addition, the agreement provides an option to purchase the office furniture at the expiration of the agreement. The Company determined the Amended Lease Agreement represents a lease modification, and the Original Premises and Expansion Premises were identified as separate lease components. The extension of maturity with respect to the Original Premises was treated as a modification not accounted for as a separate contract, in which lease classification was reassessed and the lease liability was remeasured. The effect of the remeasurement, in the amount of $0.4 million, was recorded as an adjustment to the right-of-use asset. The addition of the Expansion Premises was accounted for as a separate contract which granted the Company an additional right of use not included in the original lease, in which the lease payments increased commensurate with the standalone price for the additional right of use. As the leasehold incentives were not paid or payable at commencement, the Company will account for the incentives once the contingency is resolved. The office space and office furniture within the Indiana Lease Agreement were each determined to represent separate lease components. Consideration for the contract was allocated to each lease component based on their relative stand-alone selling price. The options to renew the lease for an additional three-year term as well as purchase the office furniture at the expiration of the agreement were excluded from the determination of lease liabilities arising from obtaining the ROU assets, as they were not considered probable of being exercised at commencement. 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 of identified lease at lease commencement date. In addition to the lease liabilities arising from ROU assets recognized upon adoption of ASC 842, Leases The components of lease cost were as follows (dollar amounts in thousands): Three Months Ended March 31, 2020 Lease Cost Operating lease cost $ 155 Short-term lease cost — Total lease cost $ 155 Other Information Cash paid for amounts included in the measurement of lease liabilities $ 136 Operating lease liabilities arising from obtaining right-of-use assets $ 2,851 Weighted-average remaining lease term 3.69 years Weighted-average discount rate 6.16 % The following is a maturity analysis of the annual undiscounted cash flows of the operating lease liabilities as of March 31, 2020 (in thousands): Year ended: December 31, 2020 $ 563 December 31, 2021 845 December 31, 2022 860 December 31, 2023 804 Total future minimum lease payments 3,072 Less imputed interest (323 ) Present value of lease liabilities $ 2,749 Future minimum lease payments under non-cancelable operating lease agreements as of December 31, 2019 (under ASC 840, prior to the adoption of ASC 842 effective January 1, 2020), were as follows (in thousands): Year ended: December 31, 2020 $ 499 December 31, 2021 506 December 31, 2022 514 December 31, 2023 86 December 31, 2024 and thereafter — $ 1,605 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 million upon the achievement of specified regulatory milestones and up to an aggregate of $54 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 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 us 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 March 31, 2020, no 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 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 we receive 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 provided by PureTech Health during the three months ended March 31, 2020 or 2019. The Company had no outstanding liabilities to PureTech Health related to the Patent License as of March 31, 2020 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 not a party to any litigation and does not have contingency reserves established for any litigation liabilities as of March 31, 2020.

Related Party Transactions

Related Party Transactions	3 Months Ended
	Mar. 31, 2020
Related Party Transactions [Abstract]
Related Party Transactions	Note 11. Related Party Transactions PureTech Health Management Consulting Services and Overhead Agreement The Company engaged PureTech Health, a related party, to provide, among other things, management expertise, strategic advice, administrative support, computer and telecommunications services and office infrastructure. In exchange for providing such services, the Company paid PureTech Health a monthly fee. In addition, PureTech Health periodically invoiced the Company for out-of-pocket expenses reasonably incurred in connection with providing such business services. The Company incurred general and administrative costs for management services provided by PureTech Health totaling less than $0.1 million in the three months ended March 31, 2019. In addition, the Company had outstanding current liabilities to PureTech Health of less than $0.1 million as of December 31, 2019, which were recorded as accounts payable in the consolidated balance sheets. As of and for the three months ended March 31, 2020, the Company had no outstanding liabilities to PureTech Health and no general and administrative costs for management services were incurred.

401(k) Savings Plan

401(k) Savings Plan	3 Months Ended
	Mar. 31, 2020
Compensation And Retirement Disclosure [Abstract]
401(k) Savings Plan	Note 12. 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 matching expense for the Company was less than $0.1 million for each of the three months ended March 31, 2020 and 2019.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2020
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The accompanying 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 the Company 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 March 31, 2020, the consolidated statements of operations, comprehensive loss, and cash flows for the three months ended March 31, 2020 and 2019, and the consolidated statements of redeemable convertible preferred stock and stockholders’ equity (deficit) for the three months ended March 31, 2020 and 2019 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 March 31, 2020 and the results of its operations and its cash flows for the three months ended March 31, 2020 and 2019. Certain information and footnote disclosures typically included in annual financial statements prepared in accordance with 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, 2019.
Recently Adopted Accounting Pronouncements	Recently Adopted Accounting Pronouncements In February 2016, the FASB issued ASU 2016-02, Leases Leases (Topic 842): Targeted Improvements Leases (Topic 842): Codification Improvements The Company determines if an arrangement contains a lease at inception. Operating leases are included in right-of-use (“ROU”) lease assets, current portion of operating lease liability, and operating lease liability, net of current portion, on the Company’s balance sheets. ROU lease assets represent the Company’s right to use an underlying asset for the lease term and lease liabilities represent the Company’s obligation to make lease payments arising from the lease. Operating ROU lease assets and liabilities are recognized at the commencement date based on the present value of lease payments over the lease term. As most of the Company’s leases do not provide an implicit rate, the Company uses its incremental borrowing rate based on the information available at the commencement date in determining the present value of lease payments. The ROU lease asset excludes lease incentives. The Company’s lease terms may include options to extend or terminate the lease when it is reasonably certain that the Company will exercise that option. Lease expense for lease payments is recognized on a straight-line basis over the lease term. Changes to terms and conditions of an arrangement that contains a lease are evaluated to determine if a modification had occurred and a lease continues to exist. Lease modifications are accounted for as a separate contract or are treated as a change in accounting for the existing lease. In August 2018, the FASB issued ASU 2018-13, Fair Value Measurement (Topic 820) consolidated In December 2019, the FASB issued ASU 2019-12, Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes Recently Issued Accounting Pronouncements In June 2016, the FASB issued ASU 2016-13, Financial Instruments – Credit Losses (Topic 326)

Prepaid Expenses and Other Cu_2

Prepaid Expenses and Other Current Assets and Accrued Expenses (Tables)	3 Months Ended
	Mar. 31, 2020
Prepaid Expenses And Other Current Assets And Accrued Expenses [Abstract]
Schedule of Prepaid Expenses and Other Current Assets	Prepaid expenses and other current assets consisted of the following (in thousands): March 31, 2020 December 31, 2019 Prepaid insurance $ 1,050 $ 2,130 Prepaid research and development expenses 1,810 694 Other 317 485 Total prepaid expenses and other current assets $ 3,177 $ 3,309
Schedule of Accrued Expenses	Accrued expenses consisted of the following (in thousands): March 31, 2020 December 31, 2019 Accrued payroll and related expenses $ 572 $ 1,823 Accrued research and development expenses 398 344 Professional fees 267 142 Other 188 44 Total accrued expenses $ 1,425 $ 2,353

Convertible Notes Payable (Tabl

Convertible Notes Payable (Tables)	3 Months Ended
	Mar. 31, 2020
2018 Convertible Note
Convertible Notes Payable [Line Items]
Schedule of Changes in Convertible Debt	The Company recognized the following changes in the debt related to the 2018 Convertible Note during Financial statement impacted Balance, December 31, 2018 $ 2,516 Issuance of 2018 Convertible Note 1,564 Balance sheet Allocation of proceeds to derivative liability (228 ) Balance sheet Accretion to settlement value 423 Statement of operations Accrued interest 29 Statement of operations Interest forgiven upon conversion (40 ) Statement of operations Conversion of Wellcome Trust Convertible Notes to redeemable convertible preferred stock (4,264 ) Balance sheet Balance, March 31, 2019 $ —

Net Loss per Share (Tables)

Net Loss per Share (Tables)	3 Months Ended
	Mar. 31, 2020
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 months ended March 31, 2020 and 2019 Three Months Ended March 31, 2020 2019 Net Loss $ (8,658 ) $ (12,005 ) Weighted-average shares used in computing net loss per share 26,042,434 2,677 Net loss per share, basic and diluted $ (0.33 ) $ (4,484 )
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 because including them would have had an anti-dilutive impact: March 31, 2020 2019 Redeemable convertible preferred stock (as converted to common stock) — 16,654,904 Stock options to purchase common stock 4,974,356 3,755,633 4,974,356 20,410,537

Stock-based Compensation (Tabl

Stock-based Compensation (Tables)	3 Months Ended
	Mar. 31, 2020
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Summary of Stock Option Activity	A summary of the Company’s stock option activity and related information is as follows: Number of Shares Underlying Options Weighted- Average Exercise Price Per Share Weighted- Average Remaining Contractual Term (Years) Aggregate Intrinsic Value (in thousands) Outstanding as of December 31, 2019 4,614,544 $ 8.94 8.3 $ 306,395 Granted 490,950 98.88 Exercised (82,138 ) 6.29 Forfeited (49,000 ) 16.00 Outstanding as of March 31, 2020 4,974,356 $ 17.79 8.1 $ 282,841 Options vested and expected to vest as of March 31, 2020 4,974,356 $ 17.79 8.1 $ 282,841 Options exercisable as of March 31, 2020 3,247,651 $ 8.43 7.6 $ 206,439
Summary of Stock-based Compensation Expense	Stock-based compensation expense is classified in the statements of operations for the three months ended March 31, 2020 and 2019 as follows (in thousands): Three Months Ended March 31, 2020 2019 Research and development $ 1,285 $ 80 General and administrative 349 3,024 Total stock-based compensation expense $ 1,634 $ 3,104

Fair Value of Financial Asset_2

Fair Value of Financial Assets and Liabilities (Tables)	3 Months Ended
	Mar. 31, 2020
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 and liabilities as of March 31, 2020 and December 31, 2019 that are measured at fair value on a recurring basis and indicates the level of the fair value hierarchy utilized to determine such fair values (in thousands): Fair Value Measurement at March 31, 2020 Using Level 1 Level 2 Level 3 Total Assets: Cash equivalents (Money Market Fund) $ 173,118 $ — $ — $ 173,118 Short-term investments (US Treasuries) 192,846 — — 192,846 Total $ 365,964 $ — $ — $ 365,964 Fair Value Measurement at December 31, 2019 Using Level 1 Level 2 Level 3 Total Assets: Cash equivalents (Money Market Fund) $ 197,303 $ — $ — $ 197,303 Short-term investments (US Treasuries) 180,468 — — 180,468 Total $ 377,771 $ — $ — $ 377,771
Summary of Estimated Fair Value and Amortized Cost of Short term Investments by Contractual Maturity	The estimated fair value and amortized cost of the Company’s short-term investments by contractual maturity are summarized as follows (in thousands): March 31, 2020 Amortized Cost Unrealized Gains Unrealized Losses Fair Value Due in one year or less $ 191,275 $ 1,571 $ — $ 192,846 Total $ 191,275 $ 1,571 $ — $ 192,846 December 31, 2019 Amortized Cost Unrealized Gains Unrealized Losses Fair Value Due in one year or less $ 180,463 $ 5 $ — $ 180,468 Total $ 180,463 $ 5 $ — $ 180,468

Commitments and Contingencies (

Commitments and Contingencies (Tables)	3 Months Ended
	Mar. 31, 2020
Commitments And Contingencies Disclosure [Abstract]
Components of Lease Cost	The components of lease cost were as follows (dollar amounts in thousands): Three Months Ended March 31, 2020 Lease Cost Operating lease cost $ 155 Short-term lease cost — Total lease cost $ 155 Other Information Cash paid for amounts included in the measurement of lease liabilities $ 136 Operating lease liabilities arising from obtaining right-of-use assets $ 2,851 Weighted-average remaining lease term 3.69 years Weighted-average discount rate 6.16 %
Schedule of Maturity Analysis of Annual Undiscounted Cash Flows of Operating Lease Liabilities	The following is a maturity analysis of the annual undiscounted cash flows of the operating lease liabilities as of March 31, 2020 (in thousands): Year ended: December 31, 2020 $ 563 December 31, 2021 845 December 31, 2022 860 December 31, 2023 804 Total future minimum lease payments 3,072 Less imputed interest (323 ) Present value of lease liabilities $ 2,749
Schedule of Future Minimum Lease Payments Under Non-Cancelable Operating Lease Agreements	Future minimum lease payments under non-cancelable operating lease agreements as of December 31, 2019 (under ASC 840, prior to the adoption of ASC 842 effective January 1, 2020), were as follows (in thousands): Year ended: December 31, 2020 $ 499 December 31, 2021 506 December 31, 2022 514 December 31, 2023 86 December 31, 2024 and thereafter — $ 1,605

Nature of the Business - Additi

Nature of the Business - Additional Information (Details) $ / shares in Units, $ in Thousands	Nov. 25, 2019USD ($)$ / sharesshares	Jul. 02, 2019USD ($)$ / sharesshares	Jun. 14, 2019	Mar. 31, 2020USD ($)	Mar. 31, 2019USD ($)	Dec. 31, 2019USD ($)
Subsidiary Sale Of Stock [Line Items]
Stock split ratio, description				one-for-1.2987
Stock split, conversion ratio			1.2987
Offering expenses related to initial public offering					$ 97
Cash flows from operating activities				$ 8,341	$ 6,114
Accumulated deficit				84,170		$ 75,512
Cash and cash equivalents and short-term				$ 383,500
Redeemable Convertible Preferred Stock
Subsidiary Sale Of Stock [Line Items]
Temporary Equity, shares outstanding | shares		12,962,045
Redeemable Convertible Preferred Stock | Common Stock
Subsidiary Sale Of Stock [Line Items]
Conversion of stock, shares issued | shares		16,833,790
Initial Public Offering | Common Stock
Subsidiary Sale Of Stock [Line Items]
Shares issued and sold | shares		6,414,842
Public offering price pre share | $ / shares		$ 16
Net proceeds from initial public offering		$ 93,000
Underwriting discounts and commissions		7,200
Offering expenses related to initial public offering		$ 2,400
Underwriters' Over-Allotment Option | Common Stock
Subsidiary Sale Of Stock [Line Items]
Shares issued and sold | shares		836,718
Secondary Public Offering | Common Stock
Subsidiary Sale Of Stock [Line Items]
Shares issued and sold | shares	2,600,000
Public offering price pre share | $ / shares	$ 96
Underwriting discounts and commissions	$ 15,000
Net proceeds from secondary public offering	234,200
Offering expenses related to secondary public offering	$ 400

Summary of Significant Accoun_3

Summary of Significant Accounting Policies - Additional Information (Details) - USD ($) $ in Thousands	Mar. 31, 2020	Jan. 01, 2020
Summary Of Significant Accounting Policies [Line Items]
Outstanding deferred lease obligation	$ 200
Total lease liabilities	2,749
Total right-of-use assets	$ 2,522
ASU 2016-02
Summary Of Significant Accounting Policies [Line Items]
Total lease liabilities		$ 1,500
Total right-of-use assets		$ 1,200

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	Mar. 31, 2020	Dec. 31, 2019
Deferred Costs Capitalized Prepaid And Other Assets Disclosure [Abstract]
Prepaid insurance	$ 1,050	$ 2,130
Prepaid research and development expenses	1,810	694
Other	317	485
Total prepaid expenses and other current assets	$ 3,177	$ 3,309

Prepaid Expenses and Other Cu_4

Prepaid Expenses and Other Current Assets and Accrued Expenses - Schedule of Accrued Expenses (Details) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Payables And Accruals [Abstract]
Accrued payroll and related expenses	$ 572	$ 1,823
Accrued research and development expenses	398	344
Professional fees	267	142
Other	188	44
Total accrued expenses	$ 1,425	$ 2,353

Convertible Notes Payable - Add

Convertible Notes Payable - Additional Information (Details) - 2018 Convertible Note - USD ($)	1 Months Ended					3 Months Ended	12 Months Ended
	Apr. 30, 2019	Mar. 31, 2019	Nov. 30, 2018	Jul. 31, 2018	Jun. 30, 2018	Mar. 31, 2019	Dec. 31, 2018	Mar. 31, 2020
Debt Instrument [Line Items]
Gross proceeds from the issuance of a convertible note						$ 1,564,000
Interest on unpaid principal balance of convertible notes								2.00%
Debt issuance cost								$ 0
Wellcome Trust
Debt Instrument [Line Items]
Gross proceeds from the issuance of a convertible note	$ 1,600,000	$ 1,600,000	$ 2,700,000	$ 2,000,000
Maximum
Debt Instrument [Line Items]
Percentage of debt discount conversion price							25.00%
Maximum | Wellcome Trust
Debt Instrument [Line Items]
Gross proceeds from the issuance of a convertible note					$ 8,000,000
Minimum
Debt Instrument [Line Items]
Percentage of debt discount conversion price							0.00%

Convertible Notes Payable - Sch

Convertible Notes Payable - Schedule of Changes in Convertible Debt (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2019USD ($)
Debt Instrument [Line Items]
Conversion of Wellcome Trust Convertible Notes to redeemable convertible preferred stock	$ (5,016)
2018 Convertible Note
Debt Instrument [Line Items]
Beginning balance	2,516
Issuance of 2018 Convertible Note	1,564
Allocation of proceeds to derivative liability	(228)
Accretion to settlement value	423
Accrued interest	29
Interest forgiven upon conversion	(40)
Conversion of Wellcome Trust Convertible Notes to redeemable convertible preferred stock	$ (4,264)

Redeemable Convertible Prefer_2

Redeemable Convertible Preferred Stock - Additional Information (Details) - USD ($) $ / shares in Units, $ in Thousands	1 Months Ended		3 Months Ended
	Apr. 30, 2019	Mar. 31, 2019	Mar. 31, 2019	Mar. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Temporary Equity [Line Items]
Payments of stock issuance costs			$ 97
Proceeds from issuance of convertible notes			$ 1,564
Wellcome Trust Notes
Temporary Equity [Line Items]
Proceeds from issuance of convertible notes	$ 1,600
Series Seed, Series A and Series B Redeemable Convertible Preferred Stock
Temporary Equity [Line Items]
Redeemable convertible preferred stock, shares issued				0	0	7,539,200
Redeemable convertible preferred stock, shares outstanding		12,824,302	12,824,302	0	0	7,539,200
Redeemable convertible preferred stock, shares authorized				0	0
Series B Redeemable Convertible Preferred Stock
Temporary Equity [Line Items]
Redeemable convertible preferred stock, shares issued		4,953,758	4,953,758
Redeemable convertible preferred stock, shares authorized		5,422,845	5,422,845
Stock issuance price per share		$ 15.14	$ 15.14
Proceeds from issuance of redeemable convertible preferred stock		$ 75,000
Payments of stock issuance costs		$ 200
Number of shares issued upon conversion of debt	137,743	331,344

Stockholders' Equity (Deficit)

Stockholders' Equity (Deficit) - Additional Information (Details) - USD ($)	3 Months Ended
	Mar. 31, 2020	Dec. 31, 2019	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 authorized	150,000,000	150,000,000
Common stock, par value	$ 0.0001	$ 0.0001
Dividends declared	$ 0
Common stock, shares outstanding	26,094,892	26,012,754
Initial Public Offering
Class Of Stock [Line Items]
Preferred stock, shares authorized			10,000,000
Preferred stock, par value			$ 0.0001

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
	Mar. 31, 2020	Mar. 31, 2019
Earnings Per Share Basic And Diluted [Abstract]
Net Loss	$ (8,658)	$ (12,005)
Weighted average common shares outstanding used in computing net loss per share, basic and diluted	26,042,434	2,677
Net loss per share, basic and diluted	$ (0.33)	$ (4,484)

Net Loss Per Share - Schedule_2

Net Loss Per Share - Schedule of Anti-Dilutive Securities Excluded from Calculation of Diluted Net Loss Per Share (Details) - shares	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Anti-dilutive securities excluded from computation of earnings per share, amount	4,974,356	20,410,537
Redeemable convertible preferred stock (as converted to common stock)
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Anti-dilutive securities excluded from computation of earnings per share, amount		16,654,904
Stock Options to Purchase Common Stock
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Anti-dilutive securities excluded from computation of earnings per share, amount	4,974,356	3,755,633

Stock-based Compensation - Addi

Stock-based Compensation - Additional Information (Details) - USD ($) $ in Thousands	1 Months Ended		3 Months Ended		12 Months Ended
	Mar. 31, 2019	Sep. 30, 2009	Mar. 31, 2020	Mar. 31, 2019	Dec. 31, 2018	Dec. 31, 2019	May 30, 2019	Oct. 31, 2016
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of shares outstanding			4,974,356			4,614,544
Unrecognized compensation cost			$ 31,900
Unrecognized compensation costs, weighted average recognition period			3 years 7 months 6 days
Proceeds from exercise of warrant				$ 58
PureTech Health
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Exchange for a warrant to purchase shares of common stock								19,998
Exercise of warrant to purchase shares of common stock	19,986				12
Proceeds from exercise of warrant	$ 100
Outstanding warrants			0			0
2009 Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Aggregate common shares issuable		3,911,138
Share based compensation arrangement by share based payment award termination date		Jul. 31, 2019
2009 Plan | Stock Options to Purchase Common Stock
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of shares outstanding			3,515,882
2019 Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Aggregate common shares issuable			1,428,230
Number of shares outstanding			1,458,474
Common stock reserved for future issuance							1,709,832
Automatic increase in stock issuance as percentage on outstanding stock			4.00%
Stock option and incentive plan expiration date			May 31, 2029
Expiration period			10 years
Vesting period			4 years

Stock-based Compensation - Summ

Stock-based Compensation - Summary of Stock Option Activity (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2020	Dec. 31, 2019
Compensation Related Costs [Abstract]
Number of Shares, Outstanding, beginning of period	4,614,544
Number of Shares, Granted	490,950
Number of Shares, Exercised	(82,138)
Number of Shares, Forfeited	(49,000)
Number of Shares, Outstanding, end of period	4,974,356	4,614,544
Number of Shares, Options vested and expected to vest	4,974,356
Number of Shares, Options exercisable	3,247,651
Weighted-Average Exercise Price Per Share, Outstanding, beginning of period	$ 8.94
Weighted-Average Exercise Price Per Share, Outstanding, Granted	98.88
Weighted-Average Exercise Price Per Share, Outstanding, Exercised	6.29
Weighted-Average Exercise Price Per Share, Outstanding, Forfeited	16
Weighted-Average Exercise Price Per Share, Outstanding, end of period	17.79	$ 8.94
Weighted-Average Exercise Price Per Share, Options vested and expected to vest	17.79
Weighted-Average Exercise Price Per Share, Options exercisable	$ 8.43
Weighted-Average Remaining Contractual Term, Outstanding (Years)	8 years 1 month 6 days	8 years 3 months 18 days
Weighted-Average Remaining Contractual Term, Options vested and expected to vest	8 years 1 month 6 days
Weighted-Average Remaining Contractual Term, Options exercisable	7 years 7 months 6 days
Aggregate Intrinsic Value, Outstanding	$ 282,841	$ 306,395
Aggregate Intrinsic Value, Options vested and expected to vest	282,841
Aggregate Intrinsic Value, Options exercisable	$ 206,439

Stock-based Compensation - Su_2

Stock-based Compensation - Summary of Stock-based Compensation Expense (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock based compensation expense	$ 1,634	$ 3,104
Research and Development
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock based compensation expense	1,285	80
General and Administrative
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock based compensation expense	$ 349	$ 3,024

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) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Assets:
Short-term investments	$ 192,846	$ 180,468
Recurring
Assets:
Total fair value assets	365,964	377,771
Recurring | US Treasuries
Assets:
Short-term investments	192,846	180,468
Recurring | Money Market Fund
Assets:
Cash equivalents	173,118	197,303
Recurring | Level 1
Assets:
Total fair value assets	365,964	377,771
Recurring | Level 1 | US Treasuries
Assets:
Short-term investments	192,846	180,468
Recurring | Level 1 | Money Market Fund
Assets:
Cash equivalents	$ 173,118	$ 197,303

Fair Value of Financial Asset_4

Fair Value of Financial Assets and Liabilities - Summary of Estimated Fair Value and Amortized Cost of Short term Investments by Contractual Maturity (Details) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Abstract]
Due in one year or less, Amortized cost	$ 191,275	$ 180,463
Due in one year or less, Unrealized gains	1,571	5
Due in one year or less, Fair value	192,846	180,468
Amortized Cost	191,275	180,463
Unrealized Gains	1,571	5
Fair Value	$ 192,846	$ 180,468

Fair Value of Financial Asset_5

Fair Value of Financial Assets and Liabilities - Additional Information (Details) - USD ($)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Derivative Liabilities [Abstract]
Derivative Liability	$ 200,000	$ 0	$ 0	$ 400,000
Change in fair value of derivative liability (Note 4)	$ 135,000

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Details)	1 Months Ended				3 Months Ended
	Feb. 29, 2020ft²	Jan. 31, 2020ft²	May 31, 2012USD ($)	Mar. 31, 2011USD ($)	Mar. 31, 2020USD ($)ft²Milestone	Mar. 31, 2019USD ($)	Feb. 01, 2020USD ($)	Dec. 31, 2019USD ($)
Commitments And Contingencies [Line Items]
Operating lease liability remeasurement amount							$ 400,000
Incremental lease liabilities arising from obtaining ROU assets					$ 2,851,000
Contingency reserves for litigation					$ 0
Intellectual Property License Agreement | Eli Lilly and Company
Commitments And Contingencies [Line Items]
Upfront payment			$ 100,000
Royalty expiration term			6 years
Number of milestones reached | Milestone					0
Milestone payments					$ 0
License agreement term					15 years
Intellectual Property License Agreement | Eli Lilly and Company | Maximum
Commitments And Contingencies [Line Items]
Contingent milestone payments payable			$ 16,000,000
Commercial milestone payments payable			$ 54,000,000
Patent License | PureTech Health
Commitments And Contingencies [Line Items]
Expenses incurred					$ 0	$ 0
Outstanding liabilities					0			$ 0
Patent License | Maximum | PureTech Health
Commitments And Contingencies [Line Items]
Contingent milestone payments payable				$ 10,000,000
Percentage of royalties payable on income from sublicensee, excluding royalties				25.00%
Patent License | Minimum | PureTech Health
Commitments And Contingencies [Line Items]
Percentage of royalties payable on income from sublicensee, excluding royalties				15.00%
ASU 2016-02
Commitments And Contingencies [Line Items]
Incremental lease liabilities arising from obtaining ROU assets					$ 1,400,000
Office Space | Massachusetts
Commitments And Contingencies [Line Items]
No. of square feet acquired | ft²		4,175			7,050
Lease commencement period		2020-03			2018-12
Lease expiration period		2023-12			2023-02
Restricted cash					$ 200,000			$ 200,000
Leasehold incentives					$ 100,000
Office Space And Furniture | Carmel, Indiana
Commitments And Contingencies [Line Items]
No. of square feet acquired | ft²	5,050
Lease commencement period	2020-06
Lease expiration period	2023-07

Commitments and Contingencies_2

Commitments and Contingencies - Components of Lease Cost (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2020USD ($)
Lease Cost
Operating lease cost	$ 155
Total lease cost	155
Cash paid for amounts included in the measurement of lease liabilities	136
Operating lease liabilities arising from obtaining right-of-use assets	$ 2,851
Weighted-average remaining lease term	3 years 8 months 8 days
Weighted-average discount rate	6.16%

Commitments and Contingencies_3

Commitments and Contingencies - Schedule of Maturity Analysis of Annual Undiscounted Cash Flows of Operating Lease Liabilities (Details) $ in Thousands	Mar. 31, 2020USD ($)
Commitments And Contingencies Disclosure [Abstract]
December 31, 2020	$ 563
December 31, 2021	845
December 31, 2022	860
December 31, 2023	804
Total future minimum lease payments	3,072
Less imputed interest	(323)
Present value of lease liabilities	$ 2,749

Commitments and Contingencies_4

Commitments and Contingencies - Schedule of Future Minimum Lease Payments Under Non-Cancelable Operating Lease Agreements (Details) $ in Thousands	Dec. 31, 2019USD ($)
Commitments And Contingencies Disclosure [Abstract]
December 31, 2020	$ 499
December 31, 2021	506
December 31, 2022	514
December 31, 2023	86
Total	$ 1,605

Related Party Transactions - Ad

Related Party Transactions - Additional Information (Details) - PureTech Health - USD ($)	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019	Dec. 31, 2019
Related Party Transaction [Line Items]
General and administrative expenses incurred	$ 0
Outstanding current liabilities due to related party	$ 0
Maximum
Related Party Transaction [Line Items]
General and administrative expenses incurred		$ 100,000
Outstanding current liabilities due to related party			$ 100,000

401(k) Savings Plan - Additiona

401(k) Savings Plan - Additional Information (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Defined Benefit Plan Disclosure [Line Items]
Defined contribution plan, plan name	401(k)
Maximum
Defined Benefit Plan Disclosure [Line Items]
Total contribution matching expense	$ 0.1	$ 0.1