0001437402-26-000013 | 10-K | XBRL Viewer

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Leases - Narrative (Details)	Dec. 31, 2025 renewal_option
Lessee, Lease, Description [Line Items]
Number of options to extend	1
Term of lease extension	5 years
Minimum
Lessee, Lease, Description [Line Items]
Lease terms	2 years
Maximum
Lessee, Lease, Description [Line Items]
Lease terms	4 years

Insider Trading Policies and Procedures	12 Months Ended
Insider Trading Policies and Procedures	Dec. 31, 2025
Insider Trading Policies and Procedures [Line Items]
Insider Trading Policies and Procedures Adopted	true

Fair Value Measurements

12 Months Ended

Dec. 31, 2025

Fair Value Disclosures [Abstract]

Fair Value Measurements

FAIR VALUE MEASUREMENTS

Valuation techniques used to measure fair value must maximize the use of observable inputs and minimize the use of unobservable inputs. The three-level hierarchy for the inputs to valuation techniques is briefly summarized as follows:


Level 1 –			Valuations are based on quoted prices in active markets for identical assets or liabilities and readily accessible by us at the reporting date.

Level 2 –			Valuations based on inputs other than Level 1 that are observable, either directly or indirectly, such as quoted prices for similar assets or liabilities; quoted prices in markets that are not active; or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities.

Level 3 –			Valuations based on unobservable inputs for which there is little or no market data, which require us to develop our own assumptions.

The following table sets forth the fair value of our financial assets that are measured or disclosed on a recurring basis by level within the fair value hierarchy:


	December 31, 2025								December 31, 2024
(in thousands)	Total Fair Value		Level 1		Level 2		Level 3		Total Fair Value		Level 1		Level 2		Level 3
Assets
Money market funds	$	49,430	$	49,430	$	—	$	—	$	48,650	$	48,650	$	—	$	—
U.S. treasury securities	95,157		—		95,157		—		79,773		—		79,773		—
Commercial paper	46,450		—		46,450		—		37,065		—		37,065		—
U.S. government-sponsored agency bonds	27,366		—		27,366		—		45,962		—		45,962		—
Corporate bonds	22,582		—		22,582		—		17,413		—		17,413		—
Yankee bonds	5,135		—		5,135		—		1,970		—		1,970		—
Asset-backed securities	—		—		—		—		2,985		—		2,985		—
Total	$	246,120	$	49,430	$	196,690	$	—	$	233,818	$	48,650	$	185,168	$	—

Fair Value of Debt

The principal outstanding under our 2022 Loan Agreement is subject to a variable interest rate and therefore, we believe the carrying amount of the term loan approximates fair value as of December 31, 2025 and 2024. See Note 9. Borrowing for a description of the Level 2 inputs used to estimate the fair value of the liability.

The carrying value of the deferred royalty obligation related to the sale of future royalties approximates its fair value as of December 31, 2025 and 2024 and is based on our current estimate of future royalties and commercialization milestones expected to be received by HCR over the life of the HCR Agreement. See Note 8. Deferred Royalty Obligation Related to the Sale of Future Royalties for a description of the Level 3 inputs used to estimate the fair value of the liability.

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

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+ Details

Deferred Royalty Obligation Related to the Sale of Future Royalties - Financial Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Non-cash interest expense related to the sale of future royalties	$ (8,296)	$ (7,088)	$ (3,924)
Healthcare royalty partners IV, L.P \| Licensing revenue
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Amortization, effective interest rate, percent	25.40%	31.00%	34.70%

Cover - USD ($)	12 Months Ended
Cover - USD ($)	Dec. 31, 2025	Feb. 12, 2026	Jun. 30, 2025
Cover [Abstract]
Document Type	10-K
Document Annual Report	true
Document Period End Date	Dec. 31, 2025
Current Fiscal Year End Date	--12-31
Document Transition Report	false
Entity File Number	001-36485
Entity Registrant Name	ARDELYX, INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	26-1303944
Entity Address, Address Line One	400 Fifth Avenue
Entity Address, Address Line Two	Suite 210
Entity Address, City or Town	Waltham
Entity Address, State or Province	MA
Entity Address, Postal Zip Code	02451
City Area Code	510
Local Phone Number	745-1700
Title of 12(b) Security	Common Stock, par value $0.0001 per share
Trading Symbol	ARDX
Security Exchange Name	NASDAQ
Entity Well-known Seasoned Issuer	Yes
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
ICFR Auditor Attestation Flag	true
Document Financial Statement Error Correction [Flag]	false
Entity Shell Company	false
Entity Public Float			$ 923,706,456
Entity Common Stock, Shares Outstanding		245,247,427
Entity Central Index Key	0001437402
Document Fiscal Year Focus	2025
Document Fiscal Period Focus	FY
Amendment Flag	false
Documents Incorporated by Reference	Portions of the Registrant’s Definitive Proxy Statement for its 2026 Annual Meeting of Stockholders, which will be filed with the Commission within 120 days of December 31, 2025, the close of the Registrant’s 2025 fiscal year, are incorporated by reference into Part III of this Report.

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2025

Income Tax Disclosure [Abstract]

Schedule of Components of Provision for Income Taxes

The components of our provision for income taxes were as follows:


	Year Ended December 31,
(in thousands)	2025		2024		2023
Loss before provision for income taxes
U.S.	$	(60,630)	$	(38,870)	$	(65,520)

Provision for income taxes
Current
State	$	469	$	266	$	47
Foreign	500		—		500
Total current	969		266		547
Deferred
Federal	—		—		—
Total deferred	—		—		—
Total provision for income taxes	$	969	$	266	$	547

Schedule of Reconciliation of Effective Tax Rate

A reconciliation of the statutory federal income tax rate to our effective tax rate is as follows:


	Year Ended December 31,
	2025				2024				2023
($ in thousands)	$		%		$		%		$		%
Income tax at the federal statutory rate	$	(12,732)	21.0	%	$	(8,163)	21.0	%	$	(13,759)	21.0	%
State and local income taxes, net of federal effect(1)	401		(0.7)	%	191		(0.5)	%	13		—	%
Foreign tax effects	500		(0.8)	%	—		—	%	500		(0.8)	%
Tax credits
Research and development tax credits	(936)		1.5	%	—		—	%	(215)		0.3	%
Other	(500)		0.8	%	—		—	%	(500)		0.8	%
Changes in valuation allowance	9,367		(15.4)	%	8,023		(20.6)	%	13,601		(20.8)	%
Nontaxable or nondeductible items
Section 162(m) limitation	1,322		(2.2)	%	2,247		(5.8)	%	1,217		(1.9)	%
Stock-based compensation	3,672		(6.1)	%	(2,003)		5.2	%	(65)		0.1	%
Other	(125)		0.2	%	(29)		0.1	%	(245)		0.4	%
Effective tax rate	$	969	(1.7)	%	$	266	(0.6)	%	$	547	(0.9)	%

(1)State and local income taxes that made up the majority (greater than 50%) of the tax effect in this category included: Kentucky in 2025 and 2024; and South Carolina and Kentucky in 2023.

Schedule of Cash Flow, Supplemental Disclosures

The following table presents our income taxes paid, net of refunds, which are all attributable to state and local:


	Year Ended December 31,
(in thousands)	2025		2024		2023


Kentucky	$	391	$	50	*
Texas	41		18		5
South Carolina	*		105		18
New Jersey	*		*		8
New York	*		40		7
Massachusetts	*		20		*
Other	53		33		13


Total	$	485	$	266	$	51

*Jurisdiction below the threshold for the period presented.

Schedule of Components of Deferred Tax Assets

Significant components of our deferred tax assets were as follows:


	December 31,
(in thousands)	2025		2024
Deferred tax assets
Net operating loss carryforwards	$	124,100	$	103,643
Amortization and depreciation	44,703		64,237
Tax credits	17,109		15,529
Stock-based compensation	13,446		11,226
Deferred royalty obligation	6,497		6,409
Other	14,941		8,122
Deferred tax assets	220,796		209,166
Valuation allowance	(219,592)		(208,568)
Deferred tax assets net of valuation allowance	1,204		598
Deferred tax liabilities
Right-of-use asset	(1,204)		(598)

Deferred tax liabilities	(1,204)		(598)
Net deferred taxes	$	—	$	—

Schedule of Reconciliation of Unrecognized Tax Benefits

A reconciliation of the beginning and ending amount of unrecognized tax benefits is as follows:


(in thousands)	2025		2024		2023
Balance as of January 1,	$	22,919	$	23,625	$	24,075
Additions based on tax positions related to current year	864		105		262
Additions based on tax positions related to prior year	—		—		99
Subtractions based on tax positions related to prior year	(811)		(811)		(811)
Balance as of December 31,	$	22,972	$	22,919	$	23,625

Deferred Royalty Obligation Related to the Sale of Future Royalties - Narrative (Details) - Healthcare royalty partners IV, L.P - License - USD ($) $ in Millions	1 Months Ended
	Jun. 30, 2022	Dec. 31, 2025	Oct. 31, 2023
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Royalty payments and commercial milestone payments	$ 20.0
Upfront payment	10.0		$ 5.0
Payment to be received	$ 5.0
Transaction costs		$ 0.4

Income Taxes - Reconciliation of Unrecognized Tax Benefits (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Reconciliation of Unrecognized Tax Benefits
Balance as of January 1,	$ 22,919	$ 23,625	$ 24,075
Additions based on tax positions related to current year	864	105	262
Additions based on tax positions related to prior year	0	0	99
Subtractions based on tax positions related to prior year	(811)	(811)	(811)
Balance as of December 31,	$ 22,972	$ 22,919	$ 23,625

Leases - Additional Lease Information (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Facilities
Right-of-use assets	$ 4,795	$ 2,380
Current portion of lease liabilities	1,479	1,562
Operating lease liability, net of current portion	3,641	1,023
Total operating lease liabilities	$ 5,120	$ 2,585
Additional details
Weighted-average remaining term (in years)	3 years 1 month 6 days	1 year 9 months 18 days
Weighted-average discount rate	5.60%	6.50%

Accrued Expenses and Other Current Liabilities (Tables)

12 Months Ended

Dec. 31, 2025

Payables and Accruals [Abstract]

Schedule of Accrued Expenses and Other Current Liabilities

Accrued expenses and other current liabilities consisted of the following:


	December 31,
(in thousands)	2025		2024
Accrued gross to net revenue liabilities	$	30,272	$	10,112
Accrued sales and marketing expenses	4,598		3,696
Accrued contract manufacturing expenses	2,821		1,402
Accrued medical affairs expenses	2,538		817
Accrued payments due to AstraZeneca	—		12,077



Other	7,348		6,538
Total accrued expenses and other current liabilities	$	47,577	$	34,642

Leases - Undiscounted Cash Payment Obligations (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Operating Leases
2026	$ 1,784
2027	1,836
2028	1,402
2029	575
Thereafter	0
Total undiscounted operating lease payments	5,597
Imputed interest expenses	(477)
Total operating lease liabilities	5,120	$ 2,585
Less: Current portion of operating lease liability	(1,479)	(1,562)
Operating lease liability, net of current portion	$ 3,641	$ 1,023

Revenue

12 Months Ended

Dec. 31, 2025

Revenue from Contract with Customer [Abstract]

Revenue

REVENUE

Disaggregation of total revenues by nature is as follows:


	Year Ended December 31,
(in thousands)	2025		2024		2023
Product sales, net	$	377,808	$	319,196	$	82,526
Product supply revenue	15,879		11,649		6,121
Licensing revenue	5,088		78		35,809
Non-cash royalty revenue related to the sale of future royalties	8,545		2,692		—
Total revenues	$	407,320	$	333,615	$	124,456

Product Sales, Net

Products are primarily sold to wholesalers, GPOs and specialty pharmacies, and to a lesser extent, directly to retailers, hospitals, clinics and government agencies. Customer orders are generally fulfilled within a few days from receipt. Contractual performance obligations are fulfilled once our Customers receive the product and obtain legal title, at which point, they are able to direct the use of and obtain substantially all of the remaining benefits of the product.

Total product sales, net was as follows:


	Year Ended December 31,
(in thousands)	2025			2024			2023
Product sales, net
IBSRELA	$	274,207		$	158,286		$	80,062
XPHOZAH	103,601			160,910			2,464
Total product sales, net	$	377,808		$	319,196		$	82,526
Product sales, net as a percentage of total revenues	92.8		%	95.7		%	66.3		%

GTN Adjustments

We recognize revenue from product sales at the net sales price which includes estimates of variable consideration related to the following GTN adjustments:

•Discounts and chargebacks: We offer prompt pay discounts to our Customers for payment within a specified period, generally approximating two percent of the invoiced sales price. Our payment terms are generally 30 to 60 days. Chargebacks represent the estimated liability to wholesalers resulting from the difference between the wholesale acquisition cost and the lower program price offered to qualified government healthcare providers.

•Rebates, wholesaler and GPO fees: We are subject to discount obligations under governmental programs, such as Medicare and Medicaid. For the Medicaid program, we estimate the portion of sales attributed to Medicaid patients as rebates to be paid to the respective state. For the Medicare Part D program, beginning in 2025, we estimate the percentage of products sold to patients in the initial coverage and catastrophic coverage phases and adjust the transaction price for such discount at the time of sale. Prior to 2025, we paid a 70% discount to CMS when the Medicare Part D beneficiaries were in the coverage gap. Wholesaler and GPO fees are based on contracts and therefore require less estimation.

•Copay assistance and returns: We estimate the expected cost under the copay assistance program for qualified commercially-insured patients based on the terms of the program and redemption information provided by third-party claims processing organizations. We estimate products’ returns based on products’ actual returns history and other factors, including levels of our inventory in the distribution channel, estimated shelf life and historical sales returns of similar products.

Discounts, chargebacks, returns and wholesaler and GPO fees are reflected as reductions to receivables and are typically settled within contractual terms through credits to our Customers. All other GTN adjustments are reflected as a liability and settled through cash payments to our Customers or governmental payor programs, typically over various time periods that may span for multiple quarters.

The activities and ending reserve balances for each significant category of GTN adjustments on product sales, net, which constitute variable consideration, were as follows:


(in thousands)	Discounts and Chargebacks		Rebates, Wholesaler and GPO Fees		Copay Assistance and Returns		Total
Balance as of December 31, 2023	$	478	$	4,234	$	3,916	$	8,628
Provisions	15,099		65,833		28,925		109,857
Credits/payments	(13,934)		(55,592)		(21,671)		(91,197)
Balance as of December 31, 2024	1,643		14,475		11,170		27,288
Provisions(1)	23,356		108,547		31,667		163,570
Credits/payments	(23,306)		(88,566)		(33,563)		(145,435)
Balance as of December 31, 2025	$	1,693	$	34,456	$	9,274	$	45,423

(1)Provisions included approximately $4.4 million of net favorable adjustment resulting from changes in prior periods’ estimates.

Geographic Information and Concentrations

Revenues are attributed to geographical areas based on the location at which we earned revenue for product sales of IBSRELA and XPHOZAH or the domicile of our collaboration partners. A summary of our revenues by geographic area is as follows:


	Year Ended December 31,
(in thousands)	2025		2024		2023
United States(1)	$	377,808	$	319,196	$	83,276
International
Asia Pacific(2)	29,170		14,341		41,121
North America(3)	342		78		59
Total revenues	$	407,320	$	333,615	$	124,456

(1)Revenues from the United States were comprised of amounts earned from sales of IBSRELA and XPHOZAH.

(2)Revenues from Asia Pacific were comprised of amounts earned in accordance with the Kyowa Kirin Agreement and the Fosun Agreement.

(3)Revenues from North America were comprised of amounts earned from Canada in accordance with the Knight Agreement.

Gross product sales from Customers and revenues from collaboration partners, each accounting for more than 10% of total revenues, were as follows:


	Year Ended December 31,
	2025		2024		2023
Customers(1)
BioRidge Pharma, LLC	65.9	%	75.4	%	24.0	%
Cardinal Health	21.4	%	14.5	%	19.8	%
McKesson Corporation	17.9	%	14.1	%	15.7	%
Cencora (formerly AmerisourceBergen Drug Corporation)	17.3	%	16.4	%	19.1	%


Collaboration partners
Kyowa Kirin	5.9	%	4.3	%	29.0	%

(1)The total of the above percentages exceeds 100% as the numerators used in the calculations represent gross product sales for each Customer, as opposed to product sales, net as presented on our statements of operations and comprehensive loss.

- Definition

The entire disclosure of revenue from contract with customer to transfer good or service and to transfer nonfinancial asset. Includes, but is not limited to, disaggregation of revenue, credit loss recognized from contract with customer, judgment and change in judgment related to contract with customer, and asset recognized from cost incurred to obtain or fulfill contract with customer. Excludes insurance and lease contracts.

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-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (b)(2)
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Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Name Accounting Standards Codification
-Topic 606
-Publisher FASB
-URI https://asc.fasb.org/606/tableOfContent

+ Details

Equity Incentive Plans - Valuation Assumptions for ESPP (Details) - ESPP	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term (in years)	6 months	6 months	6 months
Expected volatility	72.60%	82.80%	86.00%
Risk-free interest rate	4.20%	5.00%	5.30%
Dividend yield	0.00%	0.00%	0.00%

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Borrowing

12 Months Ended

Dec. 31, 2025

Debt Disclosure [Abstract]

Borrowing

BORROWING

Long-term borrowing was as follows:


	December 31,
(in thousands)	2025		2024		Interest rate
Principal
Term A Loan	$	27,500	$	27,500	7.95% + 0.022% + SOFR (subject to a floor of 1.0%)
Term B Loan	22,500		22,500		7.95% + 0.022% + SOFR (subject to a floor of 1.0%)
Term C Loan	50,000		50,000		4.25% + 0.022% + SOFR (subject to a floor of 4.7%)
Term D Loan	50,000		50,000		4.00% + 0.022% + SOFR (subject to a floor of 4.7%)
Term E Loan	50,000		—		4.00% + 0.022% + SOFR (subject to a floor of 4.7%)
Total principal	200,000		150,000
Adjustments to principal value
Unamortized discount and debt issuance costs	(1,127)		(1,136)
Accreted value of final fee	3,961		1,989
Total long-term debt	202,834		150,853
Less: Current portion of long-term debt	—		—
Long-term debt, net of current portion	$	202,834	$	150,853

We have a loan and security agreement (as amended, 2022 Loan Agreement) with SLR, as collateral agent, and the lenders listed in the 2022 Loan Agreement (collectively, the 2022 Lenders).

On June 30, 2025, we entered into an amendment to our 2022 Loan Agreement (the Fifth Amendment), by and between us and the 2022 Lenders. The Fifth Amendment, among other things, (i) provided for the immediate draw of the principal amount of $50.0 million (the Term E Loan and together with the Term A, B, C and D Loans, the Five Loans) on the closing date of the Fifth Amendment; and (ii) provides us with the option to draw an additional $100.0 million of committed senior secured term loans, consisting of two separate term loans, each in a principal amount of $50.0 million: (a) the first of which is available at our election through June 30, 2026 (the Term F Loan) and (b) the second of which is available at our election through

December 20, 2026 (the Term G Loan and, together with the Term F Loan, the Incremental Term Loans). We concluded that the Fifth Amendment was a modification to the 2022 Loan Agreement and is accounted for accordingly.

The interest rate for each of the Incremental Term Loans, if drawn, will be 4.95% plus the 1-month CME Term SOFR reference rate as published by the CME Term SOFR Administrator on the CME Term SOFR Administrator’s Website, subject to a SOFR floor of 3.50%.

Under the Fifth Amendment, the maturity date for the Term E Loan (and the other outstanding term loans) remains July 1, 2028. We are permitted to make interest-only payments on the Term E Loan (and the other outstanding term loans) through July 1, 2028. The maturity date for each of the Incremental Term Loans will be July 1, 2030. We will be permitted to make interest-only payments on the Incremental Term Loans from the date each of the Incremental Term Loans is drawn through July 1, 2030.

We paid fees of $0.2 million, $0.1 million, $0.3 million, $0.3 million and $0.3 million on each funding date of the Term A, Term B, Term C, Term D and Term E Loans, respectively. In addition, we paid a facility fee of $1.0 million with respect to the Incremental Term Loans on the closing date of the Fifth Amendment.

We are obligated to pay a final fee equal to 4.95% of the aggregate original principal amount of the Five Loans, upon the earliest to occur of July 1, 2028, the acceleration of the Five Loans, and the prepayment, refinancing, substitution, or replacement of the Five Loans. We will be obligated to pay a final fee equal to 3.45% of the aggregate original principal amount of the Incremental Term Loans, to the extent such loans are funded, upon the earliest of any final termination, acceleration, prepayment or July 1, 2030.

We may voluntarily prepay all amounts outstanding under the Five Loans, subject to a prepayment premium of one percent of the outstanding principal amount of the Five Loans if prepaid prior to July 1, 2028. We may voluntarily prepay all amounts outstanding under the Incremental Term Loans, if drawn, subject to a prepayment premium of two percent of the outstanding principal amount of the Incremental Term Loans if prepaid prior to June 30, 2026 and one percent of the outstanding principal amount of the Incremental Term Loans if prepaid after June 30, 2026 and prior to July 1, 2030.

The 2022 Loan Agreement contains certain covenants, including a single financial covenant that the sum of our net product revenue, calculated on a trailing six-month basis, plus unrestricted cash and cash equivalents that are subject to a first-priority perfected lien in favor of SLR, shall be greater than or equal to 100% of the principal amount outstanding under the 2022 Loan Agreement. In addition, the 2022 Loan Agreement contains subjective acceleration clauses to accelerate the maturity of outstanding principal amount in the event that a material adverse change has occurred within the business, operations or financial condition of the Company. As of December 31, 2025, we believe that the likelihood of the acceleration of the maturity due to subjective acceleration clauses is remote.

The total unaccreted final fee was $5.9 million and $5.4 million as of December 31, 2025 and 2024, respectively.

As of December 31, 2025, our total future payment obligation related to the outstanding balance of the term loans, excluding interest payments, was $209.9 million, which is due on July 1, 2028.

- Definition

The entire disclosure for information about short-term and long-term debt arrangements, which includes amounts of borrowings under each line of credit, note payable, commercial paper issue, bonds indenture, debenture issue, own-share lending arrangements and any other contractual agreement to repay funds, and about the underlying arrangements, rationale for a classification as long-term, including repayment terms, interest rates, collateral provided, restrictions on use of assets and activities, whether or not in compliance with debt covenants, and other matters important to users of the financial statements, such as the effects of refinancing and noncompliance with debt covenants.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 815
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-Name Accounting Standards Codification
-Section 50
-Paragraph 8A
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+ Details

Cash, Cash Equivalents and Short-Term Investments

12 Months Ended

Dec. 31, 2025

Cash and Cash Equivalents [Abstract]

Cash, Cash Equivalents and Short-Term Investments

CASH, CASH EQUIVALENTS AND SHORT-TERM INVESTMENTS

The following table summarizes our cash, cash equivalents and short-term investments:


	December 31, 2025								December 31, 2024
			Gross Unrealized								Gross Unrealized
(in thousands)	Amortized Cost		Gains		Losses		Fair Value		Amortized Cost		Gains		Losses		Fair Value
Cash and cash equivalents
Cash	$	18,569	$	—	$	—	$	18,569	$	16,282	$	—	$	—	$	16,282
Money market funds	49,430		—		—		49,430		48,650		—		—		48,650
Total cash and cash equivalents	67,999		—		—		67,999		64,932		—		—		64,932
Short-term investments
U.S. treasury securities	$	95,052	$	105	$	—	$	95,157	$	79,720	$	58	$	(5)	$	79,773
Commercial paper	46,421		32		(3)		46,450		37,061		19		(15)		37,065
U.S. government-sponsored agency bonds	27,330		36		—		27,366		45,960		29		(27)		45,962
Corporate bonds	22,557		25		—		22,582		17,415		4		(6)		17,413
Yankee bonds	5,132		3		—		5,135		1,972		—		(2)		1,970
Asset-backed securities	—		—		—		—		2,983		2		—		2,985
Total short-term investments	196,492		201		(3)		196,690		185,111		112		(55)		185,168


Total cash, cash equivalents and investments	$	264,491	$	201	$	(3)	$	264,689	$	250,043	$	112	$	(55)	$	250,100

Realized gains or losses have not been significant and are included in other income, net on our statements of operations and comprehensive loss.

Unrealized losses in 2025 and 2024 were not material. All of the short-term available-for-sale securities held as of December 31, 2025 and 2024 had contractual maturities of less than one year. We determined that none of our available-for-sale securities were other-than-temporarily impaired as of December 31, 2025 and 2024, and no investment was in a continuous unrealized loss position for more than one year. Therefore, we believe that it is more likely than not that the investments will be held until maturity or a forecasted recovery of fair value.

Based on our procedures under the expected credit loss model, including an assessment of unrealized losses in our portfolio, we concluded that any unrealized losses on our marketable securities were not attributable to credit and, therefore, we have not recorded an allowance for credit losses as of December 31, 2025 and 2024.

Income Taxes

12 Months Ended

Dec. 31, 2025

Income Tax Disclosure [Abstract]

Income Taxes

INCOME TAXES

The components of our provision for income taxes were as follows:


	Year Ended December 31,
(in thousands)	2025		2024		2023
Loss before provision for income taxes
U.S.	$	(60,630)	$	(38,870)	$	(65,520)

Provision for income taxes
Current
State	$	469	$	266	$	47
Foreign	500		—		500
Total current	969		266		547
Deferred
Federal	—		—		—
Total deferred	—		—		—
Total provision for income taxes	$	969	$	266	$	547

A reconciliation of the statutory federal income tax rate to our effective tax rate is as follows:


	Year Ended December 31,
	2025				2024				2023
($ in thousands)	$		%		$		%		$		%
Income tax at the federal statutory rate	$	(12,732)	21.0	%	$	(8,163)	21.0	%	$	(13,759)	21.0	%
State and local income taxes, net of federal effect(1)	401		(0.7)	%	191		(0.5)	%	13		—	%
Foreign tax effects	500		(0.8)	%	—		—	%	500		(0.8)	%
Tax credits
Research and development tax credits	(936)		1.5	%	—		—	%	(215)		0.3	%
Other	(500)		0.8	%	—		—	%	(500)		0.8	%
Changes in valuation allowance	9,367		(15.4)	%	8,023		(20.6)	%	13,601		(20.8)	%
Nontaxable or nondeductible items
Section 162(m) limitation	1,322		(2.2)	%	2,247		(5.8)	%	1,217		(1.9)	%
Stock-based compensation	3,672		(6.1)	%	(2,003)		5.2	%	(65)		0.1	%
Other	(125)		0.2	%	(29)		0.1	%	(245)		0.4	%
Effective tax rate	$	969	(1.7)	%	$	266	(0.6)	%	$	547	(0.9)	%

(1)State and local income taxes that made up the majority (greater than 50%) of the tax effect in this category included: Kentucky in 2025 and 2024; and South Carolina and Kentucky in 2023.

The following table presents our income taxes paid, net of refunds, which are all attributable to state and local:


	Year Ended December 31,
(in thousands)	2025		2024		2023


Kentucky	$	391	$	50	*
Texas	41		18		5
South Carolina	*		105		18
New Jersey	*		*		8
New York	*		40		7
Massachusetts	*		20		*
Other	53		33		13


Total	$	485	$	266	$	51

*Jurisdiction below the threshold for the period presented.

Deferred income tax balances reflect the effects of temporary differences between the carrying amounts of assets and liabilities and their income tax bases, as well as from net operating loss and tax credit carryforwards. Significant components of our deferred tax assets were as follows:


	December 31,
(in thousands)	2025		2024
Deferred tax assets
Net operating loss carryforwards	$	124,100	$	103,643
Amortization and depreciation	44,703		64,237
Tax credits	17,109		15,529
Stock-based compensation	13,446		11,226
Deferred royalty obligation	6,497		6,409
Other	14,941		8,122
Deferred tax assets	220,796		209,166
Valuation allowance	(219,592)		(208,568)
Deferred tax assets net of valuation allowance	1,204		598
Deferred tax liabilities
Right-of-use asset	(1,204)		(598)

Deferred tax liabilities	(1,204)		(598)
Net deferred taxes	$	—	$	—

Realization of deferred tax assets is dependent on future taxable income, if any, the timing and the amount of which are uncertain. We assess the available positive and negative evidence to estimate whether sufficient future taxable income will be generated to permit use of the existing deferred tax assets. A significant component of objective negative evidence evaluated was our cumulative loss incurred over the three-year period ended December 31, 2025. Such objective evidence limits the ability to consider other subjective evidence, such as our projections for future growth. On the basis of this evaluation, as of December 31, 2025, 2024 and 2023, a full valuation allowance has been recorded against our deferred tax assets. The valuation allowance increased by $11.0 million in 2025, primarily attributable to net operating loss carryforwards and stock-based compensation. The amount of the deferred tax assets considered realizable could be adjusted if estimates of future taxable income during the carryforward period are reduced or increased, or if objective negative evidence, such as cumulative losses, are no longer present. In such cases, additional weight may be given to subjective evidence, such as our projections for growth.

As of December 31, 2025, we had net operating loss carryforwards for federal income tax purposes of approximately $572.8 million, of which approximately $422.7 million can be carried forward indefinitely and the remaining net operating losses begin to expire in 2030, if not utilized. We had approximately $19.5 million of federal research and development tax credit carryforwards and approximately $2.2 million of foreign tax credit carryforwards that begin to expire in 2027, if not utilized.

In addition, we had net operating loss carryforwards for California income tax purposes of approximately $101.6 million that begin to expire in 2030, if not utilized, and state research and development tax credit carryforwards of approximately $9.4 million that do not expire. We had approximately $0.1 million of minimum tax credit carryovers for California income tax purposes that do not expire. We had other state net operating losses of approximately $128.6 million that begin to expire in 2031.

The future utilization of net operating loss and tax credit carryforwards may be subject to an annual limitation, pursuant to Internal Revenue Code Sections 382 and 383, as a result of ownership changes that may have occurred previously or that could occur in the future. Due to the existence of the valuation allowance, limitations under Section 382 and 383 will not impact our effective tax rate.

In July 2025, the One Big Beautiful Bill Act (OBBBA) was enacted into law. The OBBBA makes permanent many of the expired and expiring tax provisions of the Tax Cuts and Jobs Act and restores certain business provisions, including the immediate expensing of domestic research and development costs. In addition, the OBBBA allows for an accelerated deduction of the unamortized domestic research and development costs capitalized during the 2022 through 2024 tax years. The legislation has multiple effective dates, with certain provisions effective in 2025 and others implemented through 2027. The enactment of the OBBBA did not have a material impact on our financial statements.

A reconciliation of the beginning and ending amount of unrecognized tax benefits is as follows:


(in thousands)	2025		2024		2023
Balance as of January 1,	$	22,919	$	23,625	$	24,075
Additions based on tax positions related to current year	864		105		262
Additions based on tax positions related to prior year	—		—		99
Subtractions based on tax positions related to prior year	(811)		(811)		(811)
Balance as of December 31,	$	22,972	$	22,919	$	23,625

We recognize a tax benefit from an uncertain tax position when it is more likely than not that the position will be sustained upon examination, including resolutions of any related appeals or litigation processes, based on the technical merits. Income tax positions must meet a more likely than not recognition at the effective date to be recognized. None of our unrecognized tax benefits would impact the effective tax rate if recognized, because the benefit would be offset by an increase in the valuation allowance.

We have elected to include interest and penalties as a component of tax expense. During the years ended December 31, 2025, 2024 and 2023, we did not recognize accrued interest and penalties related to unrecognized tax benefits.

We file a U.S. federal income tax return and income tax returns in various state and local jurisdictions. Due to our net operating loss and tax credit carryforwards, the income tax returns remain open to U.S. federal and state tax examinations. We are not currently under examination in any tax jurisdiction.

- Definition

The entire disclosure for income tax.

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+ Details

Net Loss Per Share - Computation of Net Loss Per Common Share (Details) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Numerator
Net loss	$ (61,599)	$ (39,136)	$ (66,067)
Denominator
Weighted average common shares outstanding - basic (in shares)	241,033,750	235,232,927	219,331,253
Weighted average common shares outstanding - diluted (in shares)	241,033,750	235,232,927	219,331,253
Net loss per share of common stock - basic (in dollars per share)	$ (0.26)	$ (0.17)	$ (0.30)
Net loss per share of common stock - diluted (in dollars per share)	$ (0.26)	$ (0.17)	$ (0.30)

- Definition

The amount of net income (loss) for the period per each share of common stock or unit outstanding during the reporting period.

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- Definition

The amount of net income (loss) for the period available to each share of common stock or common unit outstanding during the reporting period and to each share or unit that would have been outstanding assuming the issuance of common shares or units for all dilutive potential common shares or units outstanding during the reporting period.

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- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

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+ Details

Revenue - Revenue Collaboration Partnership Concentration (Details) - Revenue	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Customer \| BioRidge Pharma, LLC
Disaggregation of Revenue [Line Items]
Concentration risk (percent)	65.90%	75.40%	24.00%
Customer \| Cardinal Health
Disaggregation of Revenue [Line Items]
Concentration risk (percent)	21.40%	14.50%	19.80%
Customer \| McKesson Corporation
Disaggregation of Revenue [Line Items]
Concentration risk (percent)	17.90%	14.10%	15.70%
Customer \| Cencora (formerly AmerisourceBergen Drug Corporation)
Disaggregation of Revenue [Line Items]
Concentration risk (percent)	17.30%	16.40%	19.10%
Collaboration partners \| Kyowa Kirin
Disaggregation of Revenue [Line Items]
Concentration risk (percent)	5.90%	4.30%	29.00%

Equity Incentive Plans (Tables)

12 Months Ended

Dec. 31, 2025

Share-Based Payment Arrangement [Abstract]

Schedule of Stock Option Activity

A summary of our stock option activity and related information for the year ended December 31, 2025 is as follows:


	Number of Shares (in thousands)	Weighted-Average Exercise Price per Share		Weighted-Average Remaining Contractual Term (in years)	Aggregate Intrinsic Value (in thousands)
Balance as of December 31, 2024	28,085	$	5.63

Options granted	9,011	$	5.08
Options exercised	(1,880)	$	2.20
Options forfeited or canceled	(6,239)	$	6.29


Balance as of December 31, 2025	28,977	$	5.54	6.4	$	37,405
Vested and expected to vest as of December 31, 2025	28,977	$	5.54	6.4	$	37,405
Exercisable as of December 31, 2025	18,133	$	5.43	5.1	$	28,181

Schedule of Valuation Assumptions for Stock Options

The estimated grant date fair value of employee stock options was calculated using the Black-Scholes option-pricing model, based on the following weighted-average assumptions:


	Year Ended December 31,
	2025		2024		2023
Expected term (in years)	4.0		5.4		5.1
Expected volatility	77.6	%	100.8	%	97.6	%
Risk-free interest rate	3.1	%	4.0	%	3.8	%
Dividend yield	—	%	—	%	—	%

Schedule of Restricted Stock Units Activity

A summary of our RSUs activity and related information for the year ended December 31, 2025 is as follows:


	Number of RSUs (in thousands)	Weighted-Average Grant Date Fair Value per Share
Non-vested restricted stock units as of December 31, 2024	8,013	$	6.59
Granted	11,291	$	5.15
Vested	(4,070)	$	5.75
Forfeited	(2,651)	$	5.93
Non-vested restricted stock units as of December 31, 2025	12,583	$	5.71
Restricted stock units exercisable (vested and deferred) as of December 31, 2025	21

Schedule of Valuation Assumptions for Employee Stock Purchase Plan

The following table illustrates the weighted-average assumptions for the Black-Scholes option-pricing model used in determining the fair value of ESPP purchase rights granted to our employees:


	Year Ended December 31,
	2025		2024		2023
Expected term (in years)	0.5		0.5		0.5
Expected volatility	72.6	%	82.8	%	86.0	%
Risk-free interest rate	4.2	%	5.0	%	5.3	%
Dividend yield	—	%	—	%	—	%

Schedule of Stock-Based Compensation Recognized

Stock-based compensation expense for stock options, RSUs and our ESPP included in our statements of operations and comprehensive loss was as follows:


	Year Ended December 31,
(in thousands)	2025		2024		2023
Selling, general and administrative	$	38,650	$	27,791	$	9,952
Research and development	10,312		9,590		3,578
Total	$	48,962	$	37,381	$	13,530

Schedule of Total Unrecognized Stock-Based Compensation Expense, Net of Estimated Forfeitures

A summary of our total unrecognized stock-based compensation expense, net of estimated forfeitures, as of December 31, 2025 is as follows:


	Unrecognized Compensation Expense (in thousands)		Average Remaining Vesting Period (in years)
Stock option grants	$	46,330	2.53
RSU grants	$	67,104	2.88
ESPP	$	107	0.17

Derivative Liabilities - Narrative (Details) - USD ($) $ in Thousands	1 Months Ended	12 Months Ended
	Oct. 31, 2024	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Derivative [Line Items]
Exit fee payment		$ 0	$ 1,000	$ 1,500
2022 Term Loan \| Term loan
Derivative [Line Items]
Loan agreement, covenant, sum of net product revenue and unrestricted cash as percentage of outstanding loan balance, calculation period (in months)		6 months
Exit Fee 2018
Derivative [Line Items]
Exit fee payment				$ 1,500
Changes in estimated fair value
Derivative [Line Items]
Exit fee payment	$ 1,000
Exit fee (percent)		2.00%
Exit fee, net product revenue threshold		$ 100,000

STATEMENTS OF OPERATIONS AND COMPREHENSIVE LOSS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Revenues
Total revenues	$ 407,320	$ 333,615	$ 124,456
Costs and operating expenses
Cost of sales	39,537	50,556	17,795
Research and development	71,527	52,317	35,536
Selling, general and administrative	337,233	258,692	134,401
Total costs and operating expenses	448,297	361,565	187,732
Loss from operations	(40,977)	(27,950)	(63,276)
Interest expense	(20,102)	(13,006)	(4,950)
Non-cash interest expense related to the sale of future royalties	(8,296)	(7,088)	(3,924)
Other income, net	8,745	9,174	6,630
Loss before provision for income taxes	(60,630)	(38,870)	(65,520)
Provision for income taxes	969	266	547
Net loss	$ (61,599)	$ (39,136)	$ (66,067)
Net loss per share of common stock - basic (in dollars per share)	$ (0.26)	$ (0.17)	$ (0.30)
Net loss per share of common stock - diluted (in dollars per share)	$ (0.26)	$ (0.17)	$ (0.30)
Shares used in computing net loss per share - basic (in shares)	241,033,750	235,232,927	219,331,253
Shares used in computing net loss per share - diluted (in shares)	241,033,750	235,232,927	219,331,253
Comprehensive loss
Net loss	$ (61,599)	$ (39,136)	$ (66,067)
Unrealized gains (losses) on available-for-sale securities	141	(167)	278
Comprehensive loss	(61,458)	(39,303)	(65,789)
Product sales, net
Revenues
Total revenues	377,808	319,196	82,526
Product supply revenue
Revenues
Total revenues	15,879	11,649	6,121
Licensing revenue
Revenues
Total revenues	5,088	78	35,809
Non-cash royalty revenue related to the sale of future royalties
Revenues
Total revenues	$ 8,545	$ 2,692	$ 0

Fair Value Measurements (Tables)

12 Months Ended

Dec. 31, 2025

Fair Value Disclosures [Abstract]

Schedule of Fair Value of Financial Assets Measured on a Recurring Basis

The following table sets forth the fair value of our financial assets that are measured or disclosed on a recurring basis by level within the fair value hierarchy:


	December 31, 2025								December 31, 2024
(in thousands)	Total Fair Value		Level 1		Level 2		Level 3		Total Fair Value		Level 1		Level 2		Level 3
Assets
Money market funds	$	49,430	$	49,430	$	—	$	—	$	48,650	$	48,650	$	—	$	—
U.S. treasury securities	95,157		—		95,157		—		79,773		—		79,773		—
Commercial paper	46,450		—		46,450		—		37,065		—		37,065		—
U.S. government-sponsored agency bonds	27,366		—		27,366		—		45,962		—		45,962		—
Corporate bonds	22,582		—		22,582		—		17,413		—		17,413		—
Yankee bonds	5,135		—		5,135		—		1,970		—		1,970		—
Asset-backed securities	—		—		—		—		2,985		—		2,985		—
Total	$	246,120	$	49,430	$	196,690	$	—	$	233,818	$	48,650	$	185,168	$	—

Property and Equipment, Net (Tables)

12 Months Ended

Dec. 31, 2025

Property, Plant and Equipment [Abstract]

Schedule of Property and Equipment

Property and equipment consisted of the following:


	December 31,
(in thousands)	2025		2024
Office equipment and furniture	$	2,686	$	2,923
Leasehold improvements	2,148		9,144
Laboratory equipment	—		46
Property and equipment, gross	4,834		12,113
Less: Accumulated depreciation	(2,650)		(10,618)
Total property and equipment, net	$	2,184	$	1,495

Property and Equipment, Net - Narrative (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Property, Plant and Equipment [Abstract]
Depreciation	$ 0.8	$ 0.5	$ 0.6

Cash, Cash Equivalents and Short-Term Investments - Narrative (Details)	Dec. 31, 2025 USD ($) investment	Dec. 31, 2024 USD ($) investment
Cash and Cash Equivalents [Abstract]
Investment in continuous unrealized loss position for more than one year \| investment	0	0
Allowance for credit loss \| $	$ 0	$ 0

Equity Incentive Plans - Restricted Stock Units (Details) - RSUs shares in Thousands	12 Months Ended
	Dec. 31, 2025 $ / shares shares
Number of RSUs (in thousands)
Nonvested balance, beginning (shares)	8,013
Granted (shares)	11,291
Vested (shares)	(4,070)
Forfeited (shares)	(2,651)
Nonvested balance, ending (shares)	12,583
Restricted stock units exercisable (vested and deferred) (shares)	21
Weighted-Average Grant Date Fair Value per Share
Nonvested balance, beginning (in dollars per share) \| $ / shares	$ 6.59
Granted (in dollars per share) \| $ / shares	5.15
Vested (in dollars per share) \| $ / shares	5.75
Forfeited (in dollars per share) \| $ / shares	5.93
Nonvested balance, ending (in dollars per share) \| $ / shares	$ 5.71

Nature of Operations	12 Months Ended
Nature of Operations	Dec. 31, 2025
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Nature of Operations	NATURE OF OPERATIONS We are a commercial-stage biopharmaceutical company focused on the development and commercialization of innovative medicines that meet significant unmet medical needs. We currently market two therapies from the active ingredient tenapanor, an NHE3 inhibitor that was discovered and developed by Ardelyx. NHE3 is an antiporter expressed on the apical surface of the small and large intestines. Tenapanor is a minimally absorbed, first-in-class, oral, small molecule therapy. Tenapanor, branded as IBSRELA®, is approved in the U.S. for the treatment of adults with irritable bowel syndrome with constipation. We believe that IBSRELA can bring meaningful benefit to the approximately 13 million Americans who suffer from the symptoms of IBS-C, many of whom continue to experience symptoms despite intervention with other therapies. We are seeking to further expand the IBSRELA eligible patient population to include patients with CIC, and have initiated a Phase 3 clinical trial evaluating tenapanor in adult CIC patients. Tenapanor, branded as XPHOZAH®, is approved in the U.S. to reduce serum phosphorus in adults with chronic kidney disease on dialysis as add-on therapy in patients who have an inadequate response to phosphate binders or who are intolerant of any dose of phosphate binder therapy. We believe XPHOZAH can bring meaningful relief to adult chronic kidney disease patients on dialysis, the vast majority of whom have elevated levels of serum phosphorus and are unable to achieve target serum phosphorus levels with phosphate binders alone. Continually elevated levels of serum phosphorus can result in severe cardiovascular health complications. In addition to commercializing IBSRELA and XPHOZAH, we are also developing a next-generation NHE3 inhibitor that we believe can have application across multiple therapeutic areas. We operate in one business segment, which is the development and commercialization of biopharmaceutical products. Refer to Note 17. Segment Reporting for further segment reporting information.

Revenue - Geographic Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Disaggregation of Revenue [Line Items]
Total revenues	$ 407,320	$ 333,615	$ 124,456
United States
Disaggregation of Revenue [Line Items]
Total revenues	377,808	319,196	83,276
Asia Pacific
Disaggregation of Revenue [Line Items]
Total revenues	29,170	14,341	41,121
North America
Disaggregation of Revenue [Line Items]
Total revenues	$ 342	$ 78	$ 59

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

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+ Details

- Definition

Amount, excluding tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value added and excise.

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+ Details

Leases

12 Months Ended

Dec. 31, 2025

Leases [Abstract]

Leases

LEASES

Our lease obligation is comprised of operating leases for our offices with remaining lease terms ranging from approximately two years to four years and each containing customary rent escalation clauses. Each of our leases contains one renewal, at our option, for a five-year period. We have not included these renewal periods in the calculation of the right-of-use assets and lease liabilities since it is uncertain whether we will exercise the renewal options.

The following table provides additional details of our facility leases presented in our balance sheets:


($ in thousands)	December 31,
Facilities	2025			2024
Right-of-use assets	$	4,795		$	2,380

Current portion of lease liabilities	$	1,479		$	1,562
Operating lease liability, net of current portion	3,641			1,023
Total lease liabilities	$	5,120		$	2,585

Weighted-average remaining term (in years)	3.1			1.8
Weighted-average discount rate	5.6		%	6.5		%

The lease costs, which are included in our statements of operations and comprehensive loss, and the supplemental cash flow information related to the leases were as follows:


	Year Ended December 31,
(in thousands)	2025		2024		2023
Operating lease expense	$	2,211	$	4,699	$	3,857
Cash paid for operating leases	$	2,093	$	4,931	$	4,481

The following table summarizes our undiscounted cash payment obligations for our operating lease liabilities as of December 31, 2025:


(in thousands)	Operating Leases
2026	$	1,784
2027	1,836
2028	1,402
2029	575
Thereafter	—
Total undiscounted operating lease payments	5,597
Imputed interest expenses	(477)
Total operating lease liabilities	5,120
Less: Current portion of operating lease liability	(1,479)
Operating lease liability, net of current portion	$	3,641

BALANCE SHEETS (Parenthetical) - $ / shares	Dec. 31, 2025	Dec. 31, 2024
Statement of Financial Position [Abstract]
Common stock, par value (in dollars per share)	$ 0.0001	$ 0.0001
Common stock, shares authorized (in shares)	500,000,000	500,000,000
Common stock, shares issued (in shares)	244,351,501	238,015,825
Common stock, shares outstanding (in shares)	244,351,501	238,015,825

Collaboration and Licensing Agreements (Tables)

12 Months Ended

Dec. 31, 2025

Collaboration and Licensing Agreements [Abstract]

Schedule of Revenue

Disaggregation of total revenues by nature is as follows:


	Year Ended December 31,
(in thousands)	2025		2024		2023
Product sales, net	$	377,808	$	319,196	$	82,526
Product supply revenue	15,879		11,649		6,121
Licensing revenue	5,088		78		35,809
Non-cash royalty revenue related to the sale of future royalties	8,545		2,692		—
Total revenues	$	407,320	$	333,615	$	124,456

Total product sales, net was as follows:


	Year Ended December 31,
(in thousands)	2025			2024			2023
Product sales, net
IBSRELA	$	274,207		$	158,286		$	80,062
XPHOZAH	103,601			160,910			2,464
Total product sales, net	$	377,808		$	319,196		$	82,526
Product sales, net as a percentage of total revenues	92.8		%	95.7		%	66.3		%

The following table summarizes total revenues by collaboration partner:


	Year Ended December 31,
(in thousands)	2025		2024		2023
Licensing revenue
Kyowa Kirin	$	—	$	—	$	30,000
Fosun Pharma	5,000		—		5,000
METiS	—		—		750
Knight	88		78		59
Total licensing revenue	$	5,088	$	78	$	35,809
Product supply revenue
Kyowa Kirin	$	15,625	$	11,649	$	6,092
Knight	254		—		29
Total supply revenue	$	15,879	$	11,649	$	6,121
Non-cash royalty revenue related to the sale of future royalties
Kyowa Kirin	$	8,545	$	2,692	$	—

Schedule of Deferred Revenue Balances

The following table presents changes in our current and non-current deferred revenue balances, which are primarily attributable to Kyowa Kirin:


	2025				2024
(in thousands)	Current		Non-Current		Current		Non-Current
Deferred revenue balance as of January 1,	$	10,686	$	7,232	$	7,182	$	8,644
Prepaid product supply	1,433		6,467		3,716		8,212
Product supply delivered	(10,913)		—		(9,836)		—
Reclassify amounts to be recognized in the next twelve months	—		—		9,624		(9,624)
Deferred revenue balance as of December 31,	$	1,206	$	13,699	$	10,686	$	7,232

Collaboration and Licensing Agreements

12 Months Ended

Dec. 31, 2025

Collaboration and Licensing Agreements [Abstract]

Collaboration and Licensing Agreements

COLLABORATION AND LICENSING AGREEMENTS

We have out-licensed to external partners for the development and commercialization of tenapanor outside of the U.S. We recognize revenue from our agreements with Kyowa Kirin, Fosun Pharma and Knight as licensing revenue, product supply revenue or non-cash royalty revenue related to the sale of future royalties. Refer to Note 2. Summary of Significant Accounting Policies for more information about our significant accounting policies for such revenue streams.

The following table summarizes total revenues by collaboration partner:


	Year Ended December 31,
(in thousands)	2025		2024		2023
Licensing revenue
Kyowa Kirin	$	—	$	—	$	30,000
Fosun Pharma	5,000		—		5,000
METiS	—		—		750
Knight	88		78		59
Total licensing revenue	$	5,088	$	78	$	35,809
Product supply revenue
Kyowa Kirin	$	15,625	$	11,649	$	6,092
Knight	254		—		29
Total supply revenue	$	15,879	$	11,649	$	6,121
Non-cash royalty revenue related to the sale of future royalties
Kyowa Kirin	$	8,545	$	2,692	$	—

The following table presents changes in our current and non-current deferred revenue balances, which are primarily attributable to Kyowa Kirin:


	2025				2024
(in thousands)	Current		Non-Current		Current		Non-Current
Deferred revenue balance as of January 1,	$	10,686	$	7,232	$	7,182	$	8,644
Prepaid product supply	1,433		6,467		3,716		8,212
Product supply delivered	(10,913)		—		(9,836)		—
Reclassify amounts to be recognized in the next twelve months	—		—		9,624		(9,624)
Deferred revenue balance as of December 31,	$	1,206	$	13,699	$	10,686	$	7,232

Kyowa Kirin

We granted Kyowa Kirin an exclusive license (Kyowa Kirin Agreement) to develop and commercialize certain NHE3 inhibitors including tenapanor in Japan for the treatment of cardiorenal diseases and conditions, excluding cancer, in exchange for (i) future royalties defined below; (ii) an upfront license fee of $30.0 million, recognized upon execution of the agreement; (iii) potential future development and regulatory milestones of up to $55.0 million, of which $35.0 million has been recognized as revenue to date; and (iv) commercialization milestones of up to ¥8.5 billion (or approximately $54.5 million at the currency exchange rate as of December 31, 2025), of which $3.4 million has been recognized as revenue to date. In addition, we are eligible to receive royalties on net sales of tenapanor in Japan throughout the term of the agreement. Under a Commercial Supply Agreement, we supply tenapanor drug substance that will be used to satisfy Kyowa Kirin’s commercial needs which includes advanced payments for reimbursement of costs plus a reasonable overhead for the supply of product.

The Kyowa Kirin Agreement was amended to reduce the royalty rate Kyowa Kirin would pay on tenapanor sales in Japan from high teens to low double digits for a two-year period of time following the first commercial sale in Japan, and then to mid-single digits for the remainder of the royalty term. As consideration for the reduced royalty rate, Kyowa Kirin agreed to pay us up to an additional $40.0 million payable in two tranches: (i) the first payment due following Kyowa Kirin’s filing with the Japanese MHLW of its application for marketing approval for tenapanor, recognized as revenue in 2022; and (ii) the second payment due following Kyowa Kirin’s receipt of regulatory approval to market tenapanor for hyperphosphatemia in Japan, recognized as revenue in 2023. As discussed in Note 8. Deferred Royalty Obligation Related to the Sale of Future Royalties, future royalties and commercialization milestone payments we may receive under the license, as amended, will be remitted to HCR pursuant to the HCR Agreement.

In February 2024, Kyowa Kirin announced the launch of tenapanor, marketed as PHOZEVEL®, for patients with CKD with hyperphosphatemia in Japan. Following the launch, we began to recognize earned royalties and commercialization milestones from sales of tenapanor in Japan, which are remitted to HCR in accordance with the HCR Agreement.

The first commercialization milestone was achieved in the 2025 third quarter, triggering a ¥500.0 million payment to us, or approximately $3.4 million at the currency exchange rate as of September 30, 2025. This milestone was recorded as non-cash royalty revenue related to the sale of future royalties on our statements of operations and comprehensive loss and was remitted to HCR upon receipt.

Fosun Pharma

We have an exclusive license agreement with Fosun Pharma (Fosun Agreement) for the development, commercialization and distribution of tenapanor in China for both hyperphosphatemia and IBS-C. The Fosun Agreement granted exclusive license rights to Fosun Pharma in exchange for (i) an upfront license fee of $12.0 million, recognized upon execution of the agreement; and (ii) potential future development and commercialization milestones of up to $113.0 million, of which $13.0 million has been recognized as revenue to date. In addition, we are eligible to receive reimbursement of cost plus a reasonable overhead for the supply of product and tiered royalties on net sales ranging from the mid-teens to 20%.

In February 2025, we announced the NDA approval by China’s Center for Drug Evaluation of the NMPA for tenapanor in the control of serum phosphorus in adult patients with CKD on hemodialysis. This approval triggered a $5.0 million milestone to us, which was recorded as licensing revenue on our statements of operations and comprehensive loss when earned during the 2025 first quarter and was received in April 2025.

Knight

We have an exclusive license agreement with Knight (Knight Agreement) for the development, commercialization and distribution of tenapanor in Canada for hyperphosphatemia and IBS-C. The Knight Agreement granted exclusive license rights to Knight in exchange for (i) an upfront license fee of $2.3 million, recognized upon execution of the agreement; and (ii) potential future development and commercialization milestones of up to CAD 22.2 million (or approximately $16.2 million at the currency exchange rate as of December 31, 2025), of which $0.7 million has been recognized as revenue to date. In addition, we are eligible to receive royalties ranging from the mid-single digits to the low twenties throughout the term of the agreement and a transfer price for manufacturing supply services.

METiS

We have an exclusive license agreement with METiS Therapeutics Inc., (METiS Agreement) for the development and commercialization of a portfolio of TGR5 agonist compounds that we discovered and developed for all therapeutic areas in exchange for (i) an upfront license fee of $0.8 million, recognized upon execution of the agreement in 2023; and (ii) potential future development and commercialization milestones of up to $243.0 million. In addition, we are also eligible to receive royalties ranging within the mid-single digits throughout the term of the agreement.

AstraZeneca

We had a termination agreement with AstraZeneca (AstraZeneca Termination Agreement), pursuant to which we agreed to pay AstraZeneca (i) future royalties at a royalty rate of 10% of net sales of tenapanor or other NHE3 products by us or our licensees; and (ii) 20% of non-royalty revenue received from a new collaboration partner should we elect to license, or otherwise provide rights to develop and commercialize tenapanor or other NHE3 products, up to a maximum of $75.0 million in aggregate for (i) and (ii). Royalty expense recognized under this agreement as cost of sales on our statements of operations and comprehensive loss was $12.7 million, $34.7 million and $12.4 million in 2025, 2024 and 2023, respectively. As of the end of the 2025 second quarter, we had fully recognized the maximum $75.0 million royalty obligation, which had been fully remitted as of the end of the 2025 third quarter.

Derivative Liabilities	12 Months Ended
Derivative Liabilities	Dec. 31, 2025
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Derivative Liabilities	DERIVATIVE LIABILITIES 2018 Exit Fee In October 2023, we received approval from the FDA for XPHOZAH to reduce serum phosphorus in adults with CKD on dialysis as add-on therapy in patients who have an inadequate response to phosphate binders or who are intolerant of any dose of phosphate binder therapy. In connection with a previous loan agreement (2018 Loan Agreement), we became obligated to pay an exit fee of $1.5 million, which was paid in October 2023. 2022 Exit Fee The 2022 Loan Agreement obligated us to pay an exit fee in the amount of two percent of the Original Loans funded upon (i) any change of control transaction or (ii) our achievement of net revenue from the sale of any products equal to or greater than $100.0 million, measured on a six-month basis (Revenue Milestone), tested monthly at the end of each month. The Revenue Milestone was achieved in the 2024 second quarter, resulting in a $1.0 million payment that was settled in October 2024.

- Definition

The entire disclosure for derivative instruments and hedging activities including, but not limited to, risk management strategies, non-hedging derivative instruments, assets, liabilities, revenue and expenses, and methodologies and assumptions used in determining the amounts.

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+ Details

Summary of Significant Accounting Policies (Policies)

12 Months Ended

Dec. 31, 2025

Accounting Policies [Abstract]

Basis of Presentation

The accompanying financial statements have been prepared in accordance with U.S. GAAP.

Reclassification

Certain prior year amounts have been reclassified to conform to the current year presentation on the statements of operations and comprehensive loss to include the “cost of product sales” and the “other cost of revenue” captions within the “cost of sales” caption. This reclassification had no effect on the previously reported results of operations. Prior to the end of the 2025 second quarter, the “other cost of revenue” caption was primarily comprised of royalty expenses recognized under the AstraZeneca Termination Agreement.

Use of Estimates

The preparation of financial statements requires management to make estimates, judgments and assumptions. Significant estimates include those used in our revenue gross-to-net adjustments and other estimates. Management bases its estimates on historical experience and on various relevant assumptions that management believes to be reasonable under the circumstances. Actual results could materially differ from those estimates.

Cash Equivalents

Cash equivalents consist of highly liquid investments purchased with an original maturity date of 90 days or less and are recognized at cost, which approximates fair value.

Short-Term Investments

Short-term investments consist of debt securities classified as available-for-sale and have maturities greater than 90 days, but less than one year, from the date of acquisition. Short-term investments are carried at fair value based upon quoted market prices or other observable market data. Unrealized gains (losses) on available-for-sale securities are included in accumulated other comprehensive income on our balance sheets. The cost of available-for-sale securities sold is based on the specific-identification method.

Marketable debt securities are reviewed for impairment by determining whether the decline in their market value below carrying value is other-than-temporary. This assessment considers the intent and ability to retain the investment for a period of time sufficient for an anticipated recovery in market value; the duration and extent that the market value has been below cost; and the investee’s financial condition. Other-than-temporary impairments and credit losses are recorded in the statements of operations and comprehensive loss.

Concentration of Credit Risk

Financial instruments that potentially subject us to significant concentrations of credit risk consist primarily of cash, cash equivalents, short-term investments and accounts receivable. We are exposed to credit risks in the event of default by the counterparties to the extent of the amount recorded in our balance sheets. Cash, cash equivalents and short-term investments are invested through banks and other financial institutions in the U.S.

Foreign Currency

Our business is conducted in U.S. dollars; however, a portion of our expense and capital activities are transacted in foreign currencies which are subject to exchange rate fluctuations that can affect cash or earnings. Foreign currency transactions are translated into the functional currency using exchange rates prevailing at the dates of the transactions. At the end of each reporting period, monetary assets and liabilities that are denominated in foreign currencies are translated at the rates prevailing at that date. All gains and losses on these foreign currency transactions are recorded as other income, net on our statements of operations and comprehensive loss.

Property and Equipment

Expenditures for property and equipment are capitalized at cost. Depreciation is computed using the straight-line method over the estimated useful lives of the respective assets, ranging from three to five years for laboratory equipment and office equipment and furniture. Leasehold improvements are amortized over the lesser of the estimated useful lives or the related remaining lease term.

Impairment of Long-Lived Assets

The carrying values of long-lived assets, including property and equipment, are reviewed for impairment whenever events or changes in circumstances indicate that the asset may not be recoverable. An impairment loss is recognized when the total of estimated future undiscounted cash flows, expected to result from the use of the asset and its eventual disposition, is less than the asset’s carrying amount. Impairment, if any, would be assessed using discounted cash flows or other appropriate measures of fair value.

Income Taxes

The asset and liability method of accounting is used for income taxes. Deferred tax assets and liabilities are determined based on the differences between the financial reporting and the tax basis of assets and liabilities and are measured using the enacted tax rates and laws that will be in effect when the differences are expected to be reversed. A valuation allowance is provided when it is more likely than not that a portion or all of a deferred tax asset will not be realized.

Accounts Receivable

Accounts receivable are stated at amortized cost less allowance for credit losses. An allowance for credit losses reflects our best estimate of future credit losses over the contractual life of outstanding accounts receivable under the assumption that the current conditions as of the balance sheet date do not change for the remaining life of the asset. An allowance for credit losses is determined based on various factors, such as historical experience, specific allowances for known troubled accounts, customers’ financial condition and both current and forecasted economic conditions. To date, we have determined that an allowance for doubtful accounts is not required.

Inventory

Inventory costs incurred are capitalized after regulatory approval, or if based on management’s judgment, future commercialization is considered probable and future economic benefit is expected to be realized. We began to capitalize inventory costs associated with IBSRELA during the 2021 fourth quarter, when our intent to commercialize IBSRELA was established and we commenced preparation for the launch of IBSRELA. We began to capitalize inventory costs associated with XPHOZAH during the 2023 fourth quarter, following approval by the FDA to market XPHOZAH in the U.S. Inventory costs incurred prior to regulatory approval were expensed as research and development.

Inventories are stated at the lower of cost or estimated net realizable value with cost determined under the specific identification method. A portion of inventory that represents product that is not expected to be sold or used within the next 12 months is classified as non-current assets in our balance sheets.

Revenue Recognition

The application of ASC 606 Revenue from Contracts with Customers substantially impacts our reported results, particularly product sales, net, which requires certain estimates in determining the transaction price. Total revenues are recognized following a five-step model: (i) identify the customer contract, (ii) identify the contract’s performance obligations, (iii) determine the transaction price, (iv) allocate the transaction price to the performance obligations and (v) recognize revenue when or as a performance obligation is satisfied.

Product Sales, Net

We apply the ASC 606 five-step process above to the contracts with our Customers. Product revenue is recognized when Customers take control of the product, which typically occurs upon delivery to the Customers. The transaction price for product sales is reduced for estimates of variable consideration related to (i) discounts and chargebacks, (ii) rebates, wholesaler and GPO fees, and (iii) copay assistance and returns (collectively, gross-to-net adjustments or GTN adjustments). Except for certain wholesaler and GPO fees and discounts, which are based on contracts, our estimates of GTN adjustments involve assumptions and judgments. Our estimates of GTN adjustments for rebates, copay assistance and chargebacks require significant assumptions and judgments, considering factors such as legal interpretations of applicable laws and regulations, historical experience, payor mix (e.g., Medicare or Medicaid), current contract prices under applicable programs, unbilled claims, processing time lags and inventory levels in the distribution channel.

Estimates are assessed each period and adjusted as required to revise information or actual experience.

Collaboration and Licensing Revenue

Our collaboration and licensing arrangements may include the grant of licenses for use of our intellectual property and manufacturing supply services. Considerations for such arrangements may include non-refundable upfront license fees; payments based upon the achievement of development, regulatory, or commercialization milestones; payments for manufacturing supply services; and future royalties on net sales of licensed products. We perform the ASC 606 five-step process above to determine the appropriate amount of revenue to be recognized under our collaboration and licensing arrangements. For performance obligations that are satisfied over time, we recognize revenue using an input or output measure of progress that best depicts the satisfaction of the relevant performance obligation.

We evaluate performance obligations by assessing whether promised goods or services are both (i) capable of being distinct and (ii) distinct in the context of the arrangement. Goods or services that meet these criteria are considered distinct performance obligations. Judgment is required to determine whether promised goods or services represent distinct performance obligations. We estimate the transaction price based on expected consideration, which may include fixed or variable consideration. At the inception of each arrangement that includes variable consideration, we evaluate the amount of potential transaction price and the likelihood that the transaction price will be received. The amount of variable consideration that is included in the transaction price only to the extent that it is probable that a significant reversal in the amount of the cumulative revenue recognized will not occur in a future period. After contract inception, the transaction price is reassessed at every period end and updated for changes such as resolution of uncertain events.

Licensing Revenue:

•Non-refundable upfront license fees: For arrangements that include a license of intellectual property, and it is determined to be distinct from the other performance obligations identified in the arrangement, we recognize the transaction price allocated to the license as licensing revenue upon transfer of control of the license.

•Milestone payments: Contingent milestones at contract inception are estimated at the amount which is not probable of a material reversal and included in the transaction price using the most likely amount method. Milestone payments that are not within our control, such as regulatory approvals, are not considered probable of being achieved until those approvals are received and therefore, the variable consideration is constrained. At the end of each subsequent reporting period, we re-evaluate the probability of achievement of such contingent milestones and any related constraints, and if necessary, adjust our estimate of the overall transaction price. Any such adjustments are recorded on a cumulative catch-up basis, which would affect earnings in the period of adjustment.

•Royalties: For arrangements that include sales-based royalties and a license of intellectual property that is deemed to be the predominant item to which the royalties relate, revenue is recognized at the later of when the related sales occur or when the performance obligation to which some or all of the royalties have been allocated has been satisfied (or partially satisfied). To date, royalty revenue resulting from licensing arrangements has not been material.

Product Supply Revenue: For arrangements that include a promise for the future supply of drug substance or drug product for either clinical development or commercial supply at the customer’s discretion (manufacturing supply services), and it is determined to be distinct from the other performance obligations identified in the arrangement, we recognize the transaction price allocated to the manufacturing supply services as product supply revenue upon transfer of control of the product to the customer, which is upon delivery. Advanced payments from customers for the manufacturing of drug substance are recognized as deferred revenue until delivery.

Non-Cash Royalty Revenue Related to the Sale of Future Royalties: Royalties and commercialization milestones earned from Kyowa Kirin are recorded as non-cash royalty revenue. As discussed in Note 8. Deferred Royalty Obligation Related to the Sale of Future Royalties, future royalties and commercialization milestone payments we may receive under the Kyowa Kirin Agreement will be remitted to HCR pursuant to the HCR Agreement.

Accrued Expenses

As part of the process of preparing our financial statements, we are required to estimate our accrued expenses, which involves reviewing open contracts and purchase orders, communicating with our personnel to identify services that have been performed on our behalf and estimating the level of service performed and the associated cost incurred for the service when we have not yet been invoiced or otherwise notified of the actual cost. The majority of our service providers invoice us monthly in arrears for services performed or when contractual milestones are met. We estimate our accrued expenses as of each balance sheet date based on facts and circumstances known to us at that time. We periodically confirm the accuracy of our estimates with our service providers and make adjustments if necessary.

Service fee accruals are estimated based on the period over which each component of service will be performed, with vendor input if appropriate. If the actual timing of the performance of services or the level of effort varies from our estimate, we adjust the accrued or prepaid expense balance accordingly. Although we do not expect our estimates to be materially different from amounts actually incurred, our estimates of the status and timing may differ from the actual status and timing of services performed.

Retirement Savings Plan

We offer retirement saving plans through our 401(k) plan, which is available to all full-time employees. In June 2023, we expanded the benefit with the inclusion of a company matching contribution. We contribute to tax-qualified retirement plans for the benefit of employees who meet certain eligibility requirements and choose to participate in the plans. Participating employees specify the percentage of salary they wish to contribute from their compensation, and we make matching contributions.

Stock-Based Compensation

Stock-based compensation expense is recognized for all stock-based payment awards made to employees, non-employees and directors based on estimated fair values. The grant date fair value of the awards is determined using the Black-Scholes option-pricing model. Stock-based compensation expense is recognized on a straight-line basis over the requisite service period

and is reduced for estimated forfeitures at the date of grant and revised, if necessary, in subsequent periods if actual forfeitures differ from those estimates.

Non-cash Interest Expense on Deferred Royalty Obligation

Non-Cash Interest Expense on Deferred Royalty Obligation

In connection with the HCR Agreement, as discussed further in Note 8. Deferred Royalty Obligation Related to the Sale of Future Royalties, we recorded a liability related to the sale of future royalties and commercialization milestones that is amortized using the effective interest method over the estimated life of the HCR Agreement. As a result, we impute interest on proceeds received from HCR and record non-cash interest expense at the effective interest rate derived from estimated amounts and timing of future royalties and commercialization payments expected to be received by HCR.

Leases

Operating leases are included in right-of-use assets, current portion of operating lease liability and operating lease liability, net of current portion on our balance sheets. Right-of-use assets represent our right to use an underlying asset for the lease term and lease liabilities represent our obligation to make lease payments arising from the lease. Operating lease right-of-use assets and liabilities are recognized at the lease commencement date based on the present value of lease payments over the lease term. In determining the present value of lease payments, we use our incremental borrowing rate based on information available at the lease commencement date. Operating lease right-of-use assets also include any lease payments made and exclude lease incentives. Our lease terms may include options to extend or terminate a lease when it is reasonably certain that we will exercise any such option. Leases with an initial term of 12 months or less are not recorded on the balance sheets. Lease expense is recognized on a straight-line basis over the expected lease term. We have elected not to separate lease and non-lease components, such as common area maintenance charges, and instead account for these as a single lease component.

Net Loss per Share

Basic net loss per common share is calculated by dividing the net loss by the weighted-average number of shares of common stock outstanding during the period, without consideration of potential shares of common stock. Diluted net loss per common share in the periods presented is the same as basic net loss per common share because the effects of potentially dilutive securities are antidilutive due to net losses recognized for each period presented.

Recent Accounting Pronouncements

New Accounting Pronouncements Recently Adopted

In December 2023, the FASB issued ASU No. 2023-09, Income Taxes (Topic 740) - Improvements to Income Tax Disclosures. The ASU provides additional transparency within the income tax disclosures, primarily related to the rate reconciliation and income taxes paid information. We adopted ASU 2023-09 retrospectively in the 2025 fourth quarter and determined that the adoption did not have a material impact on our financial statements. Refer to the related disclosures presented in Note 16. Income Taxes.

Recent Accounting Pronouncements Not Yet Adopted

In November 2024, the FASB issued ASU No. 2024-03, Income Statement (Topic 220) - Reporting Comprehensive Income - Expense Disaggregation Disclosures, Disaggregation of Income Statement Expenses, which requires public companies to disclose, in interim and annual reporting periods, additional information about certain expenses in the financial statements. The new disclosure requirements are effective for our annual periods beginning January 1, 2027, and interim periods beginning January 1, 2028, with early adoption permitted, and may be applied either prospectively or retrospectively. We are in the process of evaluating the impact of this new guidance on our disclosures.

Fair Value Measurements


Level 1 –			Valuations are based on quoted prices in active markets for identical assets or liabilities and readily accessible by us at the reporting date.

Level 2 –			Valuations based on inputs other than Level 1 that are observable, either directly or indirectly, such as quoted prices for similar assets or liabilities; quoted prices in markets that are not active; or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities.

Level 3 –			Valuations based on unobservable inputs for which there is little or no market data, which require us to develop our own assumptions.

Income Taxes - Components of Provision for Income Taxes (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Loss before provision for income taxes
U.S.	$ (60,630)	$ (38,870)	$ (65,520)
Current
State	469	266	47
Foreign	500	0	500
Total current	969	266	547
Deferred
Federal	0	0	0
Total deferred	0	0	0
Effective tax rate	$ 969	$ 266	$ 547

Net Loss Per Share

12 Months Ended

Dec. 31, 2025

Earnings Per Share [Abstract]

Net Loss Per Share

NET LOSS PER SHARE

Basic net loss per share is calculated by dividing net loss by the weighted-average number of common shares outstanding during the period and excludes any dilutive effects of stock-based awards. Diluted net loss per common share is computed giving effect to all potential dilutive common shares, including common stock issuable upon exercise of stock options, unvested restricted stock units and ESPP shares issuable pursuant to the current purchase period. As we had net losses for the years ended December 31, 2025, 2024 and 2023, all potential common shares were determined to be anti-dilutive.

The following table sets forth the computation of net loss per common share:


	Year Ended December 31,
(in thousands, except per share amounts)	2025		2024		2023
Numerator
Net loss	$	(61,599)	$	(39,136)	$	(66,067)
Denominator
Weighted average common shares outstanding - basic and diluted	241,034		235,233		219,331

Net loss per share of common stock - basic and diluted	$	(0.26)	$	(0.17)	$	(0.30)

The total numbers of securities that could potentially dilute net income per share in the future that were not considered in the diluted net loss per share calculations because the effect would have been anti-dilutive were as follows:


	Year Ended December 31,
(in thousands)	2025	2024	2023
Options to purchase common stock	29,904	27,800	20,877
Restricted stock units	12,703	7,883	3,086
ESPP shares issuable	165	230	249

Total	42,772	35,913	24,212

The number of potential common shares that would have been included in diluted income per share had it not been for the anti-dilutive effect caused by the net loss, computed by converting these securities using the treasury stock method during the years ended December 31, 2025, 2024 and 2023, was approximately 5.7 million, 9.2 million and 6.3 million, respectively.

Net Loss Per Share - Antidilutive Securities and Potential Common Shares (Details) - shares shares in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Anti-dilutive securities not included in computation of diluted net loss per share	42,772	35,913	24,212
Potential common shares that would have been included if not for anti-dilutive effect of securities	5,700	9,200	6,300
Options to purchase common stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Anti-dilutive securities not included in computation of diluted net loss per share	29,904	27,800	20,877
Restricted stock units
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Anti-dilutive securities not included in computation of diluted net loss per share	12,703	7,883	3,086
ESPP shares issuable
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Anti-dilutive securities not included in computation of diluted net loss per share	165	230	249

Revenue - Schedule of Revenue (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Disaggregation of Revenue [Line Items]
Total revenues	$ 407,320	$ 333,615	$ 124,456
Product sales, net
Disaggregation of Revenue [Line Items]
Total revenues	$ 377,808	$ 319,196	$ 82,526
Product sales, net \| Gross product revenue \| Product Concentration Risk
Disaggregation of Revenue [Line Items]
Concentration risk (percent)	92.80%	95.70%	66.30%
IBSRELA
Disaggregation of Revenue [Line Items]
Total revenues	$ 274,207	$ 158,286	$ 80,062
XPHOZAH
Disaggregation of Revenue [Line Items]
Total revenues	103,601	160,910	2,464
Product supply revenue
Disaggregation of Revenue [Line Items]
Total revenues	15,879	11,649	6,121
Licensing revenue
Disaggregation of Revenue [Line Items]
Total revenues	5,088	78	35,809
Non-cash royalty revenue related to the sale of future royalties
Disaggregation of Revenue [Line Items]
Total revenues	$ 8,545	$ 2,692	$ 0

Segment Reporting (Tables)

12 Months Ended

Dec. 31, 2025

Segment Reporting [Abstract]

Schedule of Information Regarding Operating Segment

Detailed information regarding our single operating segment’s significant revenues, expenses and operating loss is as follows:


	Year Ended December 31,
(in thousands)	2025		2024		2023
Revenues
Product sales, net	$	377,808	$	319,196	$	82,526
Other revenues(1)	29,512		14,419		41,930
Total revenues	407,320		333,615		124,456
Less
Cost of product sales(2)	11,185		6,851		2,323
Other cost of revenue(3)	28,352		43,705		15,472
Research and development(4)	58,429		39,480		29,231
Selling(4)	226,925		162,957		80,028
General and administrative(4)	58,662		52,916		34,020
Stock-based compensation	48,962		37,381		13,530
Other segment expenses(5)	15,782		18,275		13,128
Total costs and operating expenses	448,297		361,565		187,732
Consolidated loss from operations	(40,977)		(27,950)		(63,276)
Other reconciliation items(6)	(20,622)		(11,186)		(2,791)
Consolidated net loss	$	(61,599)	$	(39,136)	$	(66,067)

(1)Other revenues includes revenues from our collaboration partnerships, including licensing revenue, product supply revenue and non-cash royalty revenue related to the sale of future royalties.

(2)Cost of product sales includes the cost of commercial goods sold to our Customers, such as the cost of materials, third-party contract manufacturing, third-party packaging services, freight, labor costs for personnel involved in the manufacturing process and indirect overhead costs.

(3)Other cost of revenue includes the cost of materials sold to our collaboration partners under product supply agreements, certain costs related to capacity expansion at current and future CMOs and payments due to AstraZeneca. As of the end of the 2025 second quarter, the maximum $75.0 million royalty obligation under the AstraZeneca Termination Agreement had been fully recognized.

(4)Research and development, selling and general administrative expenses herein do not include certain allocated items, such as stock-based compensation expenses.

(5)Other segment expenses primarily consists of allocated facilities, information technology, and employee costs of approximately $14.8 million, $16.9 million and $12.3 million in 2025, 2024 and 2023, respectively.

(6)Other reconciliation items includes interest expense, non-cash interest expense related to the sale of future royalties, provision for income taxes and other income, net.

Borrowing (Tables)

12 Months Ended

Dec. 31, 2025

Debt Disclosure [Abstract]

Schedule of Long-Term Debt Borrowings

Long-term borrowing was as follows:


	December 31,
(in thousands)	2025		2024		Interest rate
Principal
Term A Loan	$	27,500	$	27,500	7.95% + 0.022% + SOFR (subject to a floor of 1.0%)
Term B Loan	22,500		22,500		7.95% + 0.022% + SOFR (subject to a floor of 1.0%)
Term C Loan	50,000		50,000		4.25% + 0.022% + SOFR (subject to a floor of 4.7%)
Term D Loan	50,000		50,000		4.00% + 0.022% + SOFR (subject to a floor of 4.7%)
Term E Loan	50,000		—		4.00% + 0.022% + SOFR (subject to a floor of 4.7%)
Total principal	200,000		150,000
Adjustments to principal value
Unamortized discount and debt issuance costs	(1,127)		(1,136)
Accreted value of final fee	3,961		1,989
Total long-term debt	202,834		150,853
Less: Current portion of long-term debt	—		—
Long-term debt, net of current portion	$	202,834	$	150,853

- Definition

Tabular disclosure of long-debt instruments or arrangements, including identification, terms, features, collateral requirements and other information necessary to a fair presentation. These are debt arrangements that originally required repayment more than twelve months after issuance or greater than the normal operating cycle of the entity, if longer.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.5-02(22))
-SubTopic 10
-Topic 210
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480566/210-10-S99-1

Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 942
-SubTopic 235
-Name Accounting Standards Codification
-Section S99
-Paragraph 2
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477314/942-235-S99-2

Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S50
-Paragraph 4
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480738/235-10-S50-4

Reference 4: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 3
-Subparagraph (SX 210.12-04(a))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480678/235-10-S99-3

Reference 5: http://www.xbrl.org/2003/role/exampleRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 55
-Paragraph 69B
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481568/470-20-55-69B

Reference 6: http://www.xbrl.org/2003/role/exampleRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 55
-Paragraph 69E
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481568/470-20-55-69E

Reference 7: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 835
-SubTopic 30
-Name Accounting Standards Codification
-Section 45
-Paragraph 2
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482925/835-30-45-2

Reference 8: http://fasb.org/us-gaap/role/ref/legacyRef
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 3
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-3

Reference 9: http://fasb.org/us-gaap/role/ref/legacyRef
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-Topic 942
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-Section 50
-Paragraph 3
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477734/942-470-50-3

Reference 10: http://fasb.org/us-gaap/role/ref/legacyRef
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 8
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-8

Reference 11: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 12: http://fasb.org/us-gaap/role/ref/legacyRef
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-7

+ Details

Inventory - Narrative (Details) - USD ($) $ in Millions	Dec. 31, 2025	Dec. 31, 2024
Inventory Disclosure [Abstract]
Prepaid commercial manufacturing	$ 14.5	$ 16.4
Prepaid commercial manufacturing, non-current	$ 0.0	$ 0.0

Commitments and Contingencies	12 Months Ended
Commitments and Contingencies	Dec. 31, 2025
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	COMMITMENTS AND CONTINGENCIES Guarantees and Indemnifications We indemnify each of our officers and directors for certain events or occurrences, subject to certain limits, while the officer or director is or was serving at our request in such capacity, as permitted under Delaware law and in accordance with our certificate of incorporation and bylaws. The term of the indemnification period lasts as long as an officer or director may be subject to any proceeding arising out of acts or omissions of such officer or director in such capacity. The maximum amount of potential future indemnification is unlimited; however, we currently hold director and officer liability insurance, which allows the transfer of risk associated with our exposure and may enable us to recover a portion of any future amounts paid. We believe that the fair value of these indemnification obligations is minimal. Accordingly, we have not recognized any liabilities relating to these obligations for any period presented. Legal Proceedings and Claims On December 7, 2021 and March 29, 2022, two verified shareholder derivative lawsuits were filed in the U.S. District Court for the Northern District of California purportedly on behalf of Ardelyx against certain of Ardelyx’s executive officers and members of our board of directors, captioned Go v. Raab, et al., Case No. 4:21-cv-09455-HSG, and Morris v. Raab, et al., Case No. 4:22-cv-01988-JSC (together, the Go and Morris actions). The complaints allege that the defendants’ violations of Section 14(a) of the Exchange Act, breaches of fiduciary duties, unjust enrichment, abuse of control, gross mismanagement, and waste of corporate assets for personally making and/or causing Ardelyx to make materially false and misleading statements regarding the Company’s business, operations and prospects. The complaint seeks contribution under Sections 10(b) and 21D of the Exchange Act from two executive officers. On January 19, 2022 and April 27, 2022, the court granted the parties’ stipulation to stay the Go and Morris actions, respectively, until resolution of the motion(s) to dismiss in the lawsuits captioned Strezsak v. Ardelyx, Inc., et al., Case No. 4:21-cv-05868-HSG and Siegel v. Ardelyx, Inc., et al., Case No. 5:21-cv-06228-HSG (together, the Securities Class Actions). On October 25, 2022, the parties filed a stipulation to consolidate and stay the Go and Morris actions, and on October 27, 2022, the court consolidated the Go and Morris actions and stayed the consolidated action pending resolution of the anticipated motion(s) to dismiss in the Securities Class Action. The Securities Class Actions were voluntarily dismissed on March 5, 2025. The court dismissed the Go and Morris actions on April 30, 2025. On July 17, 2024, in partnership with the AAKP and the NMQF, we filed a lawsuit in the U.S. District Court for the District of Columbia against CMS, claiming that CMS has violated its statutory and regulatory authority under MIPPA, which established the ESRD PPS bundled payment system for dialysis services in 2008. Specifically, the lawsuit claims that moving XPHOZAH, along with all oral-only drugs, into the ESRD PPS is inconsistent with MIPPA’s statutory provision, and contradicts CMS’s own regulations. XPHOZAH and other oral-only drugs are not administered by dialysis providers and cannot be taken during the delivery of maintenance dialysis. On November 8, 2024, the U.S. District Court for the District of Columbia granted defendants’ Motion to Dismiss and denied plaintiffs’ Motion for Preliminary Injunction, or in the Alternative, for Expedited Summary Judgment. Following the District Court’s denial of plaintiffs’ Motion to Alter or Amend the Judgment, or in the Alternative, for an Injunction Pending Appeal, plaintiffs filed an Emergency Motion for an Administrative Stay and Injunction Pending Appeal, which was denied by the United States Court of Appeals for the District of Columbia Circuit. Appellants filed an initial brief in the appeal on February 4, 2025; Appellees filed an initial brief on March 6, 2025; and Appellants filed a reply brief on March 27, 2025. Both Appellees and Appellants filed a final brief on April 10, 2025. Oral argument in the case was heard on September 25, 2025. On August 16, 2024, a complaint was filed against us in the U.S. District Court of Massachusetts, captioned Yarborough v. Ardelyx, Inc., et al., No. 24-cv-12119 (D. Mass.). The complaint names the Company, Michael Raab, and Justin Renz as defendants and alleges violations of Sections 10(b) and 20(a) of the Exchange Act and Rule 10b-5 promulgated thereunder, related to our announcement on July 2, 2024 that it had chosen not to file an application for Transitional Drug Add-on Payment Adjustment for XPHOZAH (the Yarborough Action). The plaintiffs seek damages and interest, and an award of costs, including attorneys’ fees. The Court appointed Tate Wood as lead plaintiff on October 30, 2024. The lead plaintiff filed an amended complaint on January 13, 2025, in which he added Susan Rodriguez, Laura Williams and Elizabeth Grammer as additional defendants and removed Justin Renz as a defendant. The lead plaintiff purports to bring claims on behalf of all those who acquired Ardelyx common stock between February 22, 2024 and July 1, 2024. Defendants filed a motion to dismiss the amended complaint on March 14, 2025. Plaintiffs filed a response on May 13, 2025. Defendants filed a reply in support of their motion to dismiss on June 23, 2025. A hearing on the motion to dismiss was held on September 25, 2025, and on December 24, 2025, the Court granted defendants’ motion to dismiss and issued an order dismissing the case with prejudice. On January 21, 2026, Plaintiffs appealed the District Court’s decisions to the United States Court of Appeals for the First Circuit. On September 6 and 13, 2024, certain Ardelyx shareholders filed two verified derivative complaints purportedly on behalf of the Company in the United States District Court for the District of Massachusetts alleging violations of Sections 10(b) and/or 14(a) of the Exchange Act, breaches of fiduciary duty, unjust enrichment, waste, and aiding and abetting breaches of fiduciary duty against certain members of our board of directors and management based on substantially the same factual allegations in the Yarborough Action. The complaints seek unspecified damages and corporate governance reforms, as well as costs and attorneys’ fees. On September 25, 2024, the Court consolidated the two derivative actions into the case In re Ardelyx, Inc. Stockholder Derivative Litigation, Case No. 1:24-cv-12302-LTS (D. Mass.). On November 7, 2024, the Court stayed the consolidated derivative action pending resolution of any and all motion(s) to dismiss in the Yarborough Action. We believe the plaintiffs’ claims are without merit. From time to time, we may be involved in legal proceedings arising in the ordinary course of business. As of December 31, 2025, there is no litigation pending that would reasonably be expected to have a material adverse effect on our results of operations and financial condition.

Income Taxes - Reconciliation of Effective Tax Rate (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Amount
Income tax at the federal statutory rate	$ (12,732)	$ (8,163)	$ (13,759)
State and local income taxes, net of federal effect	401	191	13
Foreign tax effects	500	0	500
Tax credits
Research and development tax credits	(936)	0	(215)
Other	(500)	0	(500)
Changes in valuation allowance	9,367	8,023	13,601
Nontaxable or nondeductible items
Section 162(m) limitation	1,322	2,247	1,217
Stock-based compensation	3,672	(2,003)	(65)
Other	(125)	(29)	(245)
Effective tax rate	$ 969	$ 266	$ 547
Percent
Income tax at the federal statutory rate	21.00%	21.00%	21.00%
State and local income taxes, net of federal effect (percent)	(0.70%)	(0.50%)	0.00%
Foreign tax effects	(0.80%)	0.00%	(0.80%)
Tax credits
Research and development tax credits	1.50%	0.00%	0.30%
Other	0.80%	0.00%	0.80%
Changes in valuation allowance	(15.40%)	(20.60%)	(20.80%)
Nontaxable or nondeductible items
Section 162(m) limitation	(2.20%)	(5.80%)	(1.90%)
Stock-based compensation	(6.10%)	5.20%	0.10%
Other	0.20%	0.10%	0.40%
Effective tax rate	(1.70%)	(0.60%)	(0.90%)

Fair Value Measurements - Financial Assets and Liabilities Measured on a Recurring Basis (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Assets
Assets	$ 196,690	$ 185,168
Total	246,120	233,818
U.S. treasury securities
Assets
Assets	95,157	79,773
Commercial paper
Assets
Assets	46,450	37,065
U.S. government-sponsored agency bonds
Assets
Assets	27,366	45,962
Corporate bonds
Assets
Assets	22,582	17,413
Yankee bonds
Assets
Assets	5,135	1,970
Asset-backed securities
Assets
Assets	0	2,985
Money market funds
Assets
Money market funds	49,430	48,650
Level 1
Assets
Total	49,430	48,650
Level 1 \| U.S. treasury securities
Assets
Assets	0	0
Level 1 \| Commercial paper
Assets
Assets	0	0
Level 1 \| U.S. government-sponsored agency bonds
Assets
Assets	0	0
Level 1 \| Corporate bonds
Assets
Assets	0	0
Level 1 \| Yankee bonds
Assets
Assets	0	0
Level 1 \| Asset-backed securities
Assets
Assets	0	0
Level 1 \| Money market funds
Assets
Money market funds	49,430	48,650
Level 2
Assets
Total	196,690	185,168
Level 2 \| U.S. treasury securities
Assets
Assets	95,157	79,773
Level 2 \| Commercial paper
Assets
Assets	46,450	37,065
Level 2 \| U.S. government-sponsored agency bonds
Assets
Assets	27,366	45,962
Level 2 \| Corporate bonds
Assets
Assets	22,582	17,413
Level 2 \| Yankee bonds
Assets
Assets	5,135	1,970
Level 2 \| Asset-backed securities
Assets
Assets	0	2,985
Level 2 \| Money market funds
Assets
Money market funds	0	0
Level 3
Assets
Total	0	0
Level 3 \| U.S. treasury securities
Assets
Assets	0	0
Level 3 \| Commercial paper
Assets
Assets	0	0
Level 3 \| U.S. government-sponsored agency bonds
Assets
Assets	0	0
Level 3 \| Corporate bonds
Assets
Assets	0	0
Level 3 \| Yankee bonds
Assets
Assets	0	0
Level 3 \| Asset-backed securities
Assets
Assets	0	0
Level 3 \| Money market funds
Assets
Money market funds	$ 0	$ 0

Accrued Expenses and Other Current Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Payables and Accruals [Abstract]
Accrued gross to net revenue liabilities	$ 30,272	$ 10,112
Accrued sales and marketing expenses	4,598	3,696
Accrued contract manufacturing expenses	2,821	1,402
Accrued medical affairs expenses	2,538	817
Accrued payments due to AstraZeneca	0	12,077
Other	7,348	6,538
Accrued expenses and other current liabilities	$ 47,577	$ 34,642

Cybersecurity Risk Management and Strategy Disclosure	12 Months Ended
Cybersecurity Risk Management and Strategy Disclosure	Dec. 31, 2025
Cybersecurity Risk Management, Strategy, and Governance [Line Items]
Cybersecurity Risk Management Processes for Assessing, Identifying, and Managing Threats [Text Block]	We maintain a comprehensive cybersecurity risk management program designed to protect the confidentiality, integrity and availability of our systems and information. We design, assess and benchmark our program based on the National Institute of Standards and Technology (NIST) Cybersecurity Framework. This does not imply that we meet any particular technical standards, specifications or requirements, only that we use NIST as a guide to help us identify, assess and manage cybersecurity risks relevant to our business. Our cybersecurity risk management program is integrated into our overall risk management program, and shares common methodologies, reporting channels and governance processes that apply across the risk management program, in areas such as legal, compliance, strategic, operational and financial risk. Key elements of our cybersecurity program include but are not limited to the following: •risk assessments designed to help identify material risks from cybersecurity threats to our critical systems and information; •a security team principally responsible for managing (1) our cybersecurity risk assessment processes, (2) our security controls and (3) our response to cybersecurity incidents; •the use of external service providers, where appropriate, to assess, test or otherwise assist with aspects of our security processes; •cybersecurity awareness training of our employees, including incident response personnel and senior management; •a cybersecurity incident response plan that includes procedures for responding to cybersecurity incidents; and •a third-party risk management process for key service providers based on our assessment of their criticality to our operations and respective risk profile, suppliers and vendors that have access to our critical systems and information based on our assessment of their criticality to our operations and respective risk profile. We have not experienced any cybersecurity incidents that have materially affected our operations, business strategy, financial condition or results of operations. We face risks from cybersecurity threats that, if realized are reasonably likely to materially affect us, including our operations, business strategy, results of operations or financial condition. For more information, see the section titled “Risk Factors— We and our collaborators, CROs and other contractors and consultants depend on information technology systems, and any failure of these systems could harm our business. Security breaches, loss of data, and other disruptions could compromise sensitive information related to our business or prevent us from accessing critical information and expose us to liability, which could adversely affect our business, results of operations and financial condition.”
Cybersecurity Risk Management Processes Integrated [Flag]	true
Cybersecurity Risk Management Processes Integrated [Text Block]	Our cybersecurity risk management program is integrated into our overall risk management program, and shares common methodologies, reporting channels and governance processes that apply across the risk management program, in areas such as legal, compliance, strategic, operational and financial risk.
Cybersecurity Risk Management Third Party Engaged [Flag]	true
Cybersecurity Risk Third Party Oversight and Identification Processes [Flag]	true
Cybersecurity Risk Materially Affected or Reasonably Likely to Materially Affect Registrant [Flag]	false
Cybersecurity Risk Board of Directors Oversight [Text Block]	Our board of directors considers cybersecurity risk as part of its risk oversight function and has delegated to the Audit and Compliance Committee (Audit Committee) oversight of cybersecurity risks, including oversight of management’s implementation of our cybersecurity risk management program, maintains a strategic role in coordinating cyber risk initiatives and policies, and confirming their efficacy. The Audit Committee receives annual reports from management on our cybersecurity posture. In addition, management updates the Committee where it deems appropriate regarding any cybersecurity incidents it considers to be significant or potentially significant. The Audit Committee reports to the full board of directors regarding its activities, including those related to cybersecurity. The board of directors also receives periodic briefings from management on our cybersecurity program. The board members receive presentations on cybersecurity topics from our Chief Information Officer, internal security personnel or external experts as part of the board of directors’ continuing education on topics that impact public companies. Our cybersecurity risk management program operates through a structured governance framework with oversight at multiple organizational levels. The IT Steering Committee, comprised of our Chief Information Officer, Chief Financial Officer and other members of management, meets quarterly to provide strategic oversight on technology investments, risk management and cybersecurity initiatives. The Audit Committee maintains independent oversight through quarterly reviews of security maturity, incidents and strategic investments. Ongoing governance includes monthly executive dashboards, Sarbanes-Oxley IT controls monitoring and annual security tabletop exercises. Our Chief Information Officer leads the program day-to-day, supervising internal cybersecurity personnel and external consultants, supported by cross-functional leadership with decades of combined experience in cybersecurity and risk management across commercial biotechnology organizations. Our Chief Information Officer has over 25 years of experience in overseeing cybersecurity and risk management.
Cybersecurity Risk Board Committee or Subcommittee Responsible for Oversight [Text Block]	Our board of directors considers cybersecurity risk as part of its risk oversight function and has delegated to the Audit and Compliance Committee (Audit Committee) oversight of cybersecurity risks, including oversight of management’s implementation of our cybersecurity risk management program, maintains a strategic role in coordinating cyber risk initiatives and policies, and confirming their efficacy.
Cybersecurity Risk Process for Informing Board Committee or Subcommittee Responsible for Oversight [Text Block]	Our board of directors considers cybersecurity risk as part of its risk oversight function and has delegated to the Audit and Compliance Committee (Audit Committee) oversight of cybersecurity risks, including oversight of management’s implementation of our cybersecurity risk management program, maintains a strategic role in coordinating cyber risk initiatives and policies, and confirming their efficacy. The Audit Committee receives annual reports from management on our cybersecurity posture. In addition, management updates the Committee where it deems appropriate regarding any cybersecurity incidents it considers to be significant or potentially significant. The Audit Committee reports to the full board of directors regarding its activities, including those related to cybersecurity. The board of directors also receives periodic briefings from management on our cybersecurity program. The board members receive presentations on cybersecurity topics from our Chief Information Officer, internal security personnel or external experts as part of the board of directors’ continuing education on topics that impact public companies. Our cybersecurity risk management program operates through a structured governance framework with oversight at multiple organizational levels. The IT Steering Committee, comprised of our Chief Information Officer, Chief Financial Officer and other members of management, meets quarterly to provide strategic oversight on technology investments, risk management and cybersecurity initiatives. The Audit Committee maintains independent oversight through quarterly reviews of security maturity, incidents and strategic investments. Ongoing governance includes monthly executive dashboards, Sarbanes-Oxley IT controls monitoring and annual security tabletop exercises. Our Chief Information Officer leads the program day-to-day, supervising internal cybersecurity personnel and external consultants, supported by cross-functional leadership with decades of combined experience in cybersecurity and risk management across commercial biotechnology organizations. Our Chief Information Officer has over 25 years of experience in overseeing cybersecurity and risk management.
Cybersecurity Risk Role of Management [Text Block]	Our cybersecurity risk management program operates through a structured governance framework with oversight at multiple organizational levels. The IT Steering Committee, comprised of our Chief Information Officer, Chief Financial Officer and other members of management, meets quarterly to provide strategic oversight on technology investments, risk management and cybersecurity initiatives. The Audit Committee maintains independent oversight through quarterly reviews of security maturity, incidents and strategic investments. Ongoing governance includes monthly executive dashboards, Sarbanes-Oxley IT controls monitoring and annual security tabletop exercises. Our Chief Information Officer leads the program day-to-day, supervising internal cybersecurity personnel and external consultants, supported by cross-functional leadership with decades of combined experience in cybersecurity and risk management across commercial biotechnology organizations. Our Chief Information Officer has over 25 years of experience in overseeing cybersecurity and risk management. Our management team takes steps to stay informed about and monitor efforts to prevent, detect, mitigate, and remediate cybersecurity risks and incidents through various means, which may include briefings from internal security personnel, threat intelligence and other information obtained from governmental, public or private sources, including external consultants engaged by us and alerts and reports produced by security tools deployed in our IT environment.
Cybersecurity Risk Management Positions or Committees Responsible [Flag]	true
Cybersecurity Risk Management Positions or Committees Responsible [Text Block]	Our board of directors considers cybersecurity risk as part of its risk oversight function and has delegated to the Audit and Compliance Committee (Audit Committee) oversight of cybersecurity risks, including oversight of management’s implementation of our cybersecurity risk management program, maintains a strategic role in coordinating cyber risk initiatives and policies, and confirming their efficacy. The Audit Committee receives annual reports from management on our cybersecurity posture. In addition, management updates the Committee where it deems appropriate regarding any cybersecurity incidents it considers to be significant or potentially significant. The Audit Committee reports to the full board of directors regarding its activities, including those related to cybersecurity. The board of directors also receives periodic briefings from management on our cybersecurity program. The board members receive presentations on cybersecurity topics from our Chief Information Officer, internal security personnel or external experts as part of the board of directors’ continuing education on topics that impact public companies. Our cybersecurity risk management program operates through a structured governance framework with oversight at multiple organizational levels. The IT Steering Committee, comprised of our Chief Information Officer, Chief Financial Officer and other members of management, meets quarterly to provide strategic oversight on technology investments, risk management and cybersecurity initiatives. The Audit Committee maintains independent oversight through quarterly reviews of security maturity, incidents and strategic investments. Ongoing governance includes monthly executive dashboards, Sarbanes-Oxley IT controls monitoring and annual security tabletop exercises. Our Chief Information Officer leads the program day-to-day, supervising internal cybersecurity personnel and external consultants, supported by cross-functional leadership with decades of combined experience in cybersecurity and risk management across commercial biotechnology organizations. Our Chief Information Officer has over 25 years of experience in overseeing cybersecurity and risk management. Our management team takes steps to stay informed about and monitor efforts to prevent, detect, mitigate, and remediate cybersecurity risks and incidents through various means, which may include briefings from internal security personnel, threat intelligence and other information obtained from governmental, public or private sources, including external consultants engaged by us and alerts and reports produced by security tools deployed in our IT environment.
Cybersecurity Risk Management Expertise of Management Responsible [Text Block]	Our Chief Information Officer has over 25 years of experience in overseeing cybersecurity and risk management.
Cybersecurity Risk Process for Informing Management or Committees Responsible [Text Block]	The Audit Committee receives annual reports from management on our cybersecurity posture. In addition, management updates the Committee where it deems appropriate regarding any cybersecurity incidents it considers to be significant or potentially significant. The Audit Committee reports to the full board of directors regarding its activities, including those related to cybersecurity. The board of directors also receives periodic briefings from management on our cybersecurity program. The board members receive presentations on cybersecurity topics from our Chief Information Officer, internal security personnel or external experts as part of the board of directors’ continuing education on topics that impact public companies. Our cybersecurity risk management program operates through a structured governance framework with oversight at multiple organizational levels. The IT Steering Committee, comprised of our Chief Information Officer, Chief Financial Officer and other members of management, meets quarterly to provide strategic oversight on technology investments, risk management and cybersecurity initiatives. The Audit Committee maintains independent oversight through quarterly reviews of security maturity, incidents and strategic investments. Ongoing governance includes monthly executive dashboards, Sarbanes-Oxley IT controls monitoring and annual security tabletop exercises. Our Chief Information Officer leads the program day-to-day, supervising internal cybersecurity personnel and external consultants, supported by cross-functional leadership with decades of combined experience in cybersecurity and risk management across commercial biotechnology organizations. Our Chief Information Officer has over 25 years of experience in overseeing cybersecurity and risk management.
Cybersecurity Risk Management Positions or Committees Responsible Report to Board [Flag]	true

Borrowing - Narrative (Details) $ in Thousands		12 Months Ended
Borrowing - Narrative (Details) $ in Thousands	Jun. 30, 2025 USD ($) termLoan	Dec. 31, 2025 USD ($)	Dec. 31, 2024 USD ($)
Term Loans
Final fee		$ 3,961	$ 1,989
Future payment obligation, excluding interest payments		209,900
Term loan
Term Loans
Total principal		200,000	150,000
Term E Loan \| Term loan
Term Loans
Total principal	$ 50,000	$ 50,000	0
Interest rate		4.00%
Closing fee		$ 300
Term E Loan \| Term loan \| Secured Overnight Financing Rate (SOFR)
Term Loans
Floating per annum rate (percent)		0.022%
Term E Loan \| Term loan \| Floor Rate
Term Loans
Floating per annum rate (percent)		4.70%
Term Loans 2022 F and G \| Term loan
Term Loans
Term loan face amount	$ 100,000
Number of new loans \| termLoan	2
Facility fee		$ 1,000
Final fee due upon maturity, acceleration, prepayment, or termination (percent)		3.45%
Term Loan 2022 G \| Term loan
Term Loans
Term loan face amount	$ 50,000
Term Loan 2022 G \| Term loan \| Secured Overnight Financing Rate (SOFR)
Term Loans
Interest rate	4.95%
Term Loan 2022 G \| Term loan \| Floor Rate
Term Loans
Floating per annum rate (percent)	3.50%
Term Loan 2022 F \| Term loan
Term Loans
Term loan face amount	$ 50,000
Term Loan 2022 F \| Term loan \| Secured Overnight Financing Rate (SOFR)
Term Loans
Interest rate	4.95%
Term Loan 2022 F \| Term loan \| Floor Rate
Term Loans
Floating per annum rate (percent)	3.50%
Term A Loan \| Term loan
Term Loans
Total principal		$ 27,500	27,500
Interest rate		7.95%
Closing fee		$ 200
Term A Loan \| Term loan \| Secured Overnight Financing Rate (SOFR)
Term Loans
Floating per annum rate (percent)		0.022%
Term A Loan \| Term loan \| Floor Rate
Term Loans
Floating per annum rate (percent)		1.00%
Term B Loan \| Term loan
Term Loans
Total principal		$ 22,500	22,500
Interest rate		7.95%
Closing fee		$ 100
Term B Loan \| Term loan \| Secured Overnight Financing Rate (SOFR)
Term Loans
Floating per annum rate (percent)		0.022%
Term B Loan \| Term loan \| Floor Rate
Term Loans
Floating per annum rate (percent)		1.00%
Term C Loan \| Term loan
Term Loans
Total principal		$ 50,000	50,000
Interest rate		4.25%
Closing fee		$ 300
Term C Loan \| Term loan \| Secured Overnight Financing Rate (SOFR)
Term Loans
Floating per annum rate (percent)		0.022%
Term C Loan \| Term loan \| Floor Rate
Term Loans
Floating per annum rate (percent)		4.70%
Term D Loan \| Term loan
Term Loans
Total principal		$ 50,000	50,000
Interest rate		4.00%
Closing fee		$ 300
Term D Loan \| Term loan \| Secured Overnight Financing Rate (SOFR)
Term Loans
Floating per annum rate (percent)		0.022%
Term D Loan \| Term loan \| Floor Rate
Term Loans
Floating per annum rate (percent)		4.70%
2022 Term Loan \| Term loan
Term Loans
Final fee due upon maturity, acceleration, prepayment, or termination (percent)		4.95%
Loan agreement, covenant, sum of net product revenue and unrestricted cash as percentage of outstanding loan balance, calculation period (in months)		6 months
Loan agreement covenant, sum of net product revenue and unrestricted cash as percentage of outstanding loan balance, minimum		100.00%
Final fee		$ 5,900	$ 5,400
2022 Term Loan \| Term loan \| Prior to first anniversary of closing date
Term Loans
Prepayment premium (as a percent)		1.00%
2022 Term Loan \| Term loan \| After first anniversary through second anniversary of closing date
Term Loans
Prepayment premium (as a percent)		2.00%
2022 Term Loan \| Term loan \| After second anniversary to maturity date
Term Loans
Prepayment premium (as a percent)		1.00%

Segment Reporting - Schedule of Operating Segment (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2025 USD ($) segment	Dec. 31, 2024 USD ($)	Dec. 31, 2023 USD ($)	Jun. 30, 2025 USD ($)
Segment Reporting [Abstract]
Number of reportable segments \| segment	1
Number of operating segments \| segment	1
Revenues
Total revenues	$ 407,320	$ 333,615	$ 124,456
Less
Cost of sales	39,537	50,556	17,795
Total costs and operating expenses	448,297	361,565	187,732
Loss before provision for income taxes	(60,630)	(38,870)	(65,520)
Net loss	(61,599)	(39,136)	(66,067)
AstraZeneca \| AZ Termination Agreement
Less
Maximum potential payment per agreement				$ 75,000
Reportable Segment
Revenues
Total revenues	407,320	333,615	124,456
Less
Research and development	58,429	39,480	29,231
Selling expenses	226,925	162,957	80,028
General and administrative	58,662	52,916	34,020
Stock-based compensation	48,962	37,381	13,530
Other segment expenses	15,782	18,275	13,128
Total costs and operating expenses	448,297	361,565	187,732
Loss before provision for income taxes	(40,977)	(27,950)	(63,276)
Other reconciliation items	(20,622)	(11,186)	(2,791)
Net loss	(61,599)	(39,136)	(66,067)
Allocated facilities, information technology, and human resources	14,800	16,900	12,300
Product sales, net
Revenues
Total revenues	377,808	319,196	82,526
Product sales, net \| Reportable Segment
Revenues
Total revenues	377,808	319,196	82,526
Less
Cost of sales	11,185	6,851	2,323
Other cost of revenue \| Reportable Segment
Revenues
Total revenues	29,512	14,419	41,930
Less
Cost of sales	$ 28,352	$ 43,705	$ 15,472

Income Taxes - Narrative (Details) $ in Millions	12 Months Ended
Income Taxes - Narrative (Details) $ in Millions	Dec. 31, 2025 USD ($)
Income Tax Disclosure [Line Items]
Increase in valuation allowance	$ 11.0
Domestic Tax Jurisdiction
Income Tax Disclosure [Line Items]
Net operating loss carryforwards	572.8
Net operating loss carryforwards, indefinite	422.7
Domestic Tax Jurisdiction \| Research and development tax credit
Income Tax Disclosure [Line Items]
Tax credit carryforwards	19.5
Foreign
Income Tax Disclosure [Line Items]
Tax credit carryforwards	2.2
State \| California
Income Tax Disclosure [Line Items]
Net operating loss carryforwards	101.6
State \| California \| Research and development tax credit
Income Tax Disclosure [Line Items]
Tax credit carryforwards	9.4
State \| California \| Minimum tax credit carryforwards
Income Tax Disclosure [Line Items]
Tax credit carryforwards	0.1
State \| Other states
Income Tax Disclosure [Line Items]
Net operating loss carryforwards	$ 128.6

Commitments and Contingencies (Details)			4 Months Ended
Commitments and Contingencies (Details)	Sep. 25, 2024 claim	Sep. 13, 2024 claim	Mar. 29, 2022 claim defendant
Go v. Raab
Contingencies [Line Items]
Number of lawsuits			2
Number of defendants \| defendant			2
Ardelyx, Inc. Stockholder Derivative Litigation
Contingencies [Line Items]
Number of lawsuits	2	2

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 275
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 9
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482861/275-10-50-9

Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 450
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 4
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483076/450-20-50-4

Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 450
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-Section 50
-Paragraph 9
-Subparagraph (a)
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-URI https://asc.fasb.org/1943274/2147483076/450-20-50-9

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483359/720-20-50-1

Reference 5: http://www.xbrl.org/2003/role/exampleRef
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-Name Accounting Standards Codification
-Section 55
-Paragraph 27
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482395/460-10-55-27

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
-Section 50
-Paragraph 9
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483076/450-20-50-9

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
-Section 50
-Paragraph 4
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483076/450-20-50-4

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
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-Paragraph 3
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 450
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483076/450-20-50-1

+ Details

Inventory (Tables)

12 Months Ended

Dec. 31, 2025

Inventory Disclosure [Abstract]

Schedule of Current Inventory

Inventory consisted of the following:


	December 31,
(in thousands)	2025		2024
Raw materials	$	28,009	$	30,792
Work in process	88,259		58,685
Finished goods	6,839		1,707
Total	$	123,107	$	91,184
Reported as
Inventory	$	17,735	$	21,173
Inventory, non-current	105,372		70,011
Total	$	123,107	$	91,184

Schedule of Noncurrent Inventory

Inventory consisted of the following:


	December 31,
(in thousands)	2025		2024
Raw materials	$	28,009	$	30,792
Work in process	88,259		58,685
Finished goods	6,839		1,707
Total	$	123,107	$	91,184
Reported as
Inventory	$	17,735	$	21,173
Inventory, non-current	105,372		70,011
Total	$	123,107	$	91,184

Insider Trading Arrangements

3 Months Ended

Dec. 31, 2025

Trading Arrangements, by Individual

Material Terms of Trading Arrangement

During the three months ended December 31, 2025, our Section 16 officers and directors adopted or terminated contracts, instructions or written plans for the purchase or sale of our securities as noted below.

Name and Title of Director or Officer

Action

Date

Trading Arrangement

Total Shares Available to be Sold

Expiration Date

Rule 10b5-1*

Non-Rule 10b5-1**

John Bishop, Chief Technical and Quality Officer

Adoption

November 6, 2025

156,687

November 6, 2026

Michael Raab, President and Chief Executive Officer and Director

Adoption

November 7, 2025

500,000

February 15, 2027

Elizabeth Grammer, former Chief Legal Officer

Adoption

November 11, 2025

114,638

August 30, 2026

* Intended to satisfy the affirmative defense conditions of Rule 10b5-1(c)

** Not intended to satisfy the affirmative defense conditions of Rule 10b5-1(c)

Non-Rule 10b5-1 Arrangement Adopted

false

Rule 10b5-1 Arrangement Terminated

false

Non-Rule 10b5-1 Arrangement Terminated

false

John Bishop [Member]

Trading Arrangements, by Individual

Name

John Bishop

Title

Chief Technical and Quality Officer

Rule 10b5-1 Arrangement Adopted

true

November 6, 2025

November 6, 2026

365 days

156,687

Michael Raab [Member]

Trading Arrangements, by Individual

Name

Michael Raab

Title

President and Chief Executive Officer and Director

Rule 10b5-1 Arrangement Adopted

true

November 7, 2025

February 15, 2027

465 days

500,000

Elizabeth Grammer [Member]

Trading Arrangements, by Individual

Name

Elizabeth Grammer

Title

former Chief Legal Officer

Rule 10b5-1 Arrangement Adopted

true

November 11, 2025

August 30, 2026

292 days

114,638

Accrued Expenses and Other Current Liabilities

12 Months Ended

Dec. 31, 2025

Payables and Accruals [Abstract]

Accrued Expenses and Other Current Liabilities

ACCRUED EXPENSES AND OTHER CURRENT LIABILITIES

Accrued expenses and other current liabilities consisted of the following:


	December 31,
(in thousands)	2025		2024
Accrued gross to net revenue liabilities	$	30,272	$	10,112
Accrued sales and marketing expenses	4,598		3,696
Accrued contract manufacturing expenses	2,821		1,402
Accrued medical affairs expenses	2,538		817
Accrued payments due to AstraZeneca	—		12,077



Other	7,348		6,538
Total accrued expenses and other current liabilities	$	47,577	$	34,642

Income Taxes - Incomes Taxes Paid (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Effective Income Tax Rate Reconciliation [Line Items]
Total	$ 485	$ 266	$ 51
Kentucky
Effective Income Tax Rate Reconciliation [Line Items]
Total	391	50
Texas
Effective Income Tax Rate Reconciliation [Line Items]
Total	41	18	5
South Carolina
Effective Income Tax Rate Reconciliation [Line Items]
Total		105	18
New Jersey
Effective Income Tax Rate Reconciliation [Line Items]
Total			8
New York
Effective Income Tax Rate Reconciliation [Line Items]
Total		40	7
Massachusetts
Effective Income Tax Rate Reconciliation [Line Items]
Total		20
Other
Effective Income Tax Rate Reconciliation [Line Items]
Total	$ 53	$ 33	$ 13

Income Taxes - Components of Deferred Tax Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Deferred tax assets
Net operating loss carryforwards	$ 124,100	$ 103,643
Amortization and depreciation	44,703	64,237
Tax credits	17,109	15,529
Stock-based compensation	13,446	11,226
Deferred royalty obligation	6,497	6,409
Other	14,941	8,122
Deferred tax assets	220,796	209,166
Valuation allowance	(219,592)	(208,568)
Deferred tax assets net of valuation allowance	1,204	598
Deferred tax liabilities
Right-of-use asset	(1,204)	(598)
Deferred tax liabilities	(1,204)	(598)
Net deferred taxes	$ 0	$ 0

Segment Reporting

12 Months Ended

Dec. 31, 2025

Segment Reporting [Abstract]

Segment Reporting

SEGMENT REPORTING

We operate in a single reportable segment with a mission to develop and commercialize innovative medicines that meet significant unmet medical needs. A centralized research and development organization, supply chain organization and commercial organization are all responsible for the development, manufacturing, supply and sale of our products. Our business is also supported by centralized corporate functions. We currently operate primarily in the U.S. and earn revenues from sales of IBSRELA and XPHOZAH, both branded products derived from tenapanor, a molecule developed from our unique and innovative platform. In addition to commercializing IBSRELA and XPHOZAH, we are also developing a next-generation NHE3 inhibitor that we believe can have application across multiple therapeutic areas. Collaboration and licensing agreements with external partners are utilized for development and commercialization activities outside the U.S. Currently, we maintain such agreements for certain indications of tenapanor in Japan (Kyowa Kirin), China (Fosun Pharma) and Canada (Knight), as discussed further in Note 7. Collaboration and Licensing Agreements. We recognize other revenues in the form of licensing revenue, product supply revenue or non-cash royalty revenue related to the sale of future royalties under such agreements. Royalties and commercialization milestones earned under the Kyowa Kirin Agreement are subject to a separate agreement where such revenue payments are sold to HCR, as discussed further in Note 8. Deferred Royalty Obligation Related to the Sale of Future Royalties.

Our Chief Executive Officer (CEO) is our Chief Operating Decision Maker (CODM), responsible for allocating resources and assessing the Company’s performance using aggregated financial information. Utilizing aggregated financial information enables the CODM to determine the most appropriate resource allocation across the commercial organization, research and development projects or other initiatives consistent with our long-term corporate wide strategic goals. The CODM primarily uses aggregated net loss as reported on the statements of operations and comprehensive loss to measure segment loss, supplemented by certain additional significant expense details reflected in the table below.

Detailed information regarding our single operating segment’s significant revenues, expenses and operating loss is as follows:


	Year Ended December 31,
(in thousands)	2025		2024		2023
Revenues
Product sales, net	$	377,808	$	319,196	$	82,526
Other revenues(1)	29,512		14,419		41,930
Total revenues	407,320		333,615		124,456
Less
Cost of product sales(2)	11,185		6,851		2,323
Other cost of revenue(3)	28,352		43,705		15,472
Research and development(4)	58,429		39,480		29,231
Selling(4)	226,925		162,957		80,028
General and administrative(4)	58,662		52,916		34,020
Stock-based compensation	48,962		37,381		13,530
Other segment expenses(5)	15,782		18,275		13,128
Total costs and operating expenses	448,297		361,565		187,732
Consolidated loss from operations	(40,977)		(27,950)		(63,276)
Other reconciliation items(6)	(20,622)		(11,186)		(2,791)
Consolidated net loss	$	(61,599)	$	(39,136)	$	(66,067)

(1)Other revenues includes revenues from our collaboration partnerships, including licensing revenue, product supply revenue and non-cash royalty revenue related to the sale of future royalties.

(4)Research and development, selling and general administrative expenses herein do not include certain allocated items, such as stock-based compensation expenses.

(6)Other reconciliation items includes interest expense, non-cash interest expense related to the sale of future royalties, provision for income taxes and other income, net.

- Definition

The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
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-Section 50
-Paragraph 21
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-Publisher FASB
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Reference 2: http://www.xbrl.org/2003/role/disclosureRef
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-In Capital	Accumulated Deficit	Accumulated Other Comprehensive (Loss) Income
Beginning balance (in shares) at Dec. 31, 2022		198,575,016
Beginning balance at Dec. 31, 2022	$ 98,329	$ 20	$ 878,500	$ (780,137)	$ (54)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock under employee stock purchase plan (in shares)		435,708
Issuance of common stock under employee stock purchase plan	808		808
Issuance of common stock for services (in shares)		86,095
Issuance of common stock for services	337		337
Issuance of common stock upon exercise of options (in shares)		225,988
Issuance of common stock upon exercise of options	365		365
Issuance of common stock upon vesting of restricted stock units (in shares)		855,642
Issuance of common stock in at-the-market offering (in shares)		32,274,741
Issuance of common stock in at-the-market offering	119,236	$ 3	119,233
Stock-based compensation	13,530		13,530
Unrealized gains (losses) on available-for-sale securities	278				278
Net loss	(66,067)			(66,067)
Ending balance (in shares) at Dec. 31, 2023		232,453,190
Ending balance at Dec. 31, 2023	166,816	$ 23	1,012,773	(846,204)	224
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock under employee stock purchase plan (in shares)		479,609
Issuance of common stock under employee stock purchase plan	2,227		2,227
Issuance of common stock for services (in shares)		40,549
Issuance of common stock for services	257		257
Issuance of common stock upon exercise of options (in shares)		2,654,370
Issuance of common stock upon exercise of options	5,911	$ 1	5,910
Issuance of common stock upon vesting of restricted stock units (in shares)		2,388,107
Stock-based compensation	37,381		37,381
Unrealized gains (losses) on available-for-sale securities	(167)				(167)
Net loss	(39,136)			(39,136)
Ending balance (in shares) at Dec. 31, 2024		238,015,825
Ending balance at Dec. 31, 2024	173,289	$ 24	1,058,548	(885,340)	57
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock under employee stock purchase plan (in shares)		385,593
Issuance of common stock under employee stock purchase plan	1,718		1,718
Issuance of common stock for services (in shares)		87,256
Issuance of common stock for services	$ 315		315
Issuance of common stock upon exercise of options (in shares)	1,880,000	1,880,472
Issuance of common stock upon exercise of options	$ 4,123		4,123
Issuance of common stock upon vesting of restricted stock units (in shares)		3,982,355
Stock-based compensation	48,962		48,962
Unrealized gains (losses) on available-for-sale securities	141				141
Net loss	(61,599)			(61,599)
Ending balance (in shares) at Dec. 31, 2025		244,351,501
Ending balance at Dec. 31, 2025	$ 166,949	$ 24	$ 1,113,666	$ (946,939)	$ 198

Stockholders' Equity (Details) - USD ($)	1 Months Ended	12 Months Ended			35 Months Ended
Stockholders' Equity (Details) - USD ($)	Nov. 30, 2025	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2025
Subsidiary, Sale of Stock [Line Items]
Gross proceeds		$ 0	$ 0	$ 119,236,000
2023 Open Market Sales Agreement
Subsidiary, Sale of Stock [Line Items]
Common stock sold and issued (in shares)		0			16,800,000
Gross proceeds					$ 70,000,000.0
Weighted-average share price (in dollars per share)					$ 4.17
2025 Open Market Sales Agreement
Subsidiary, Sale of Stock [Line Items]
Common stock sold and issued (in shares)		0
Maximum aggregate offering price	$ 100,000,000.0
Offering sales commission (percent)	3.00%

BALANCE SHEETS - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Current assets
Cash and cash equivalents	$ 67,999	$ 64,932
Short-term investments	196,690	185,168
Accounts receivable	71,848	57,705
Inventory	17,735	21,173
Prepaid commercial manufacturing	14,479	16,378
Prepaid expenses and other current assets	13,566	11,096
Total current assets	382,317	356,452
Property and equipment, net	2,184	1,495
Inventory, non-current	105,372	70,011
Right-of-use assets	4,795	2,380
Other assets	6,936	5,416
Total assets	501,604	435,754
Current liabilities
Accounts payable	19,235	16,000
Accrued compensation and benefits	19,108	14,940
Current portion of operating lease liability	1,479	1,562
Deferred revenue	1,206	10,686
Accrued expenses and other current liabilities	47,577	34,642
Total current liabilities	88,605	77,830
Operating lease liability, net of current portion	3,641	1,023
Long-term debt	202,834	150,853
Deferred revenue, non-current	13,699	7,232
Deferred royalty obligation related to the sale of future royalties	25,876	25,527
Total liabilities	334,655	262,465
Commitments and contingencies (Note 19)
Stockholders’ equity
Common stock, $0.0001 par value per share; 500,000,000 shares authorized; 244,351,501 and 238,015,825 shares issued and outstanding as of December 31, 2025 and December 31, 2024, respectively	24	24
Additional paid-in capital	1,113,666	1,058,548
Accumulated deficit	(946,939)	(885,340)
Accumulated other comprehensive income	198	57
Total stockholders’ equity	166,949	173,289
Total liabilities and stockholders’ equity	$ 501,604	$ 435,754

Stockholders' Equity	12 Months Ended
Stockholders' Equity	Dec. 31, 2025
Stockholders' Equity Note [Abstract]
Stockholders' Equity	STOCKHOLDERS’ EQUITY In January 2023, we entered into the 2023 Open Market Sales Agreement with Jefferies with respect to an “at-the-market offering” program, which was established under the Company’s shelf registration statement on Form S-3 and expired in January 2026. Under the 2023 Open Market Sales Agreement, we sold a total of 16.8 million shares of our common stock and received gross proceeds of $70.0 million at a weighted average sales price of approximately $4.17. During the year ended December 31, 2025, we did not sell any shares under the 2023 Open Market Sales Agreement. In November 2025, we filed an automatic shelf registration statement on Form S-3ASR, which became effective upon filing, containing (i) a base prospectus, which covers the offering, issuance and sale from time to time in one or more offerings of our common stock, preferred stock, debt securities, warrants and/or units; and (ii) a prospectus supplement for the offering, issuance and sale of up to a maximum aggregate offering price of $100.0 million of our common stock that may be issued and sold from time to time, under the 2025 Open Market Sales Agreement, deemed to be “at-the-market offerings.” Pursuant to the 2025 Open Market Sales Agreement, Jefferies, as sales agent, may receive a commission of up to three percent of the gross sales price for shares of our common stock sold under the 2025 Open Market Sales Agreement. As of December 31, 2025, there have been no sales of our common stock under the 2025 Open Market Sales Agreement.

- Definition

The entire disclosure for equity.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 815
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 8A
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480434/815-10-50-8A

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
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-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-13

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
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-Name Accounting Standards Codification
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-Paragraph 13
-Subparagraph (h)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-13

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
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-Paragraph 14
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-14

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 235
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477968/946-235-50-2

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 235
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477968/946-235-50-2

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 505
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147478448/946-505-50-6

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 815
-SubTopic 40
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480237/815-40-50-6

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.3-04)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480008/505-10-S99-1

Reference 10: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 505
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org/505/tableOfContent

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-13

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (g)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-13

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (i)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-13

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 14
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-14

Reference 15: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 14
-Subparagraph (c)
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-URI https://asc.fasb.org/1943274/2147481112/505-10-50-14

Reference 16: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
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-Name Accounting Standards Codification
-Section 50
-Paragraph 16
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-16

Reference 17: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
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-Name Accounting Standards Codification
-Section 50
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-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-18

Reference 18: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 18
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-18

Reference 19: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 18
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-18

+ Details

Deferred Royalty Obligation Related to the Sale of Future Royalties

12 Months Ended

Dec. 31, 2025

Advance Royalties [Abstract]

Deferred Royalty Obligation Related to the Sale of Future Royalties

DEFERRED ROYALTY OBLIGATION RELATED TO THE SALE OF FUTURE ROYALTIES

We and HCR have an agreement in which HCR agreed to pay up to $20.0 million in exchange for future royalties and commercialization milestone payments that we may receive under our Kyowa Kirin Agreement, as discussed further in Note 7. Collaboration and Licensing Agreements. The $20.0 million was payable as follows: (i) $10.0 million upfront upon agreement execution, received in June 2022; (ii) $5.0 million upon Kyowa Kirin’s receipt of regulatory approval to market tenapanor for hyperphosphatemia in Japan, received in October 2023; and (iii) $5.0 million in the event net sales of tenapanor in Japan by Kyowa Kirin exceeded a defined annual target level by the end of 2025, which was not achieved as of December 31, 2025. The HCR Agreement is effective until terminated by the mutual agreement of the parties and contains customary representations and warranties and customary affirmative and negative covenants.

Payments received from HCR are recorded as a deferred royalty obligation on our balance sheets. Due to our ongoing manufacturing obligations under the Kyowa Kirin Agreement, we account for the proceeds as imputed debt and therefore recognize royalties and commercialization milestones earned under the Kyowa Kirin Agreement as non-cash royalty revenue. Non-cash interest expense is recorded at the imputed interest rate derived from estimated amounts and timing of future royalties and commercialization milestone payments expected to be received by HCR. In conjunction with the HCR Agreement, we incurred approximately $0.4 million in transaction costs, which, along with the deferred royalty obligation, are being amortized as non-cash interest expense over the estimated life of the HCR Agreement using the effective interest method. The deferred royalty obligation will be effectively repaid over the life of the HCR Agreement as we remit to HCR royalties and commercialization milestones paid to us by Kyowa Kirin. We periodically assess the estimated amounts and timing of future royalties and commercialization milestone payments from Kyowa Kirin and, to the extent that the amount or timing of such payments is materially different than our original estimates, we prospectively adjust the imputed interest rate and the related amortization of the deferred royalty obligation.

A summary of financial information related to the HCR Agreement is as follows:


	Year Ended December 31,
($ in thousands)	2025			2024			2023
Non-cash interest expense related to the sale of future royalties	$	(8,296)		$	(7,088)		$	(3,924)
Effective interest rate	25.4		%	31.0		%	34.7		%

Audit Information	12 Months Ended
Audit Information	Dec. 31, 2025
Audit Information [Abstract]
Auditor Name	Ernst & Young LLP
Auditor Location	Boston, Massachusetts
Auditor Firm ID	42

Equity Incentive Plans - Stock Options (Details) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2025 USD ($) $ / shares shares
Number of Shares (in thousands)
Options issued and outstanding balance, beginning (shares) \| shares	28,085,000
Options granted (shares) \| shares	9,011,000
Options exercised (shares) \| shares	(1,880,000)
Options forfeited or canceled (shares) \| shares	(6,239,000)
Options issued and outstanding balance, ending (shares) \| shares	28,977,000
Options vested and expected to vest (shares) \| shares	28,977,000
Options exercisable (shares) \| shares	18,133,000
Weighted-Average Exercise Price per Share
Options issued and outstanding balance, beginning (in dollars per share) \| $ / shares	$ 5.63
Options granted (in dollars per share) \| $ / shares	5.08
Options exercised (in dollars per share) \| $ / shares	2.20
Options forfeited or canceled (in dollars per share) \| $ / shares	6.29
Options issued and outstanding balance, ending (in dollars per share) \| $ / shares	5.54
Options vested and expected to vest (in dollars per share) \| $ / shares	5.54
Options exercisable (in dollars per share) \| $ / shares	$ 5.43
Weighted-Average Remaining Contractual Term (in years)
Options issued and outstanding (in years)	6 years 4 months 24 days
Options vest and expected to vest (in years)	6 years 4 months 24 days
Options exercisable (in years)	5 years 1 month 6 days
Aggregate Intrinsic Value (in thousands)
Options issued and outstanding \| $	$ 37,405
Options vested and expected to vest \| $	37,405
Options exercisable \| $	$ 28,181

Inventory - Schedule (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Inventory Disclosure [Abstract]
Raw materials	$ 28,009	$ 30,792
Work in process	88,259	58,685
Finished goods	6,839	1,707
Inventory	17,735	21,173
Inventory, non-current	105,372	70,011
Total	$ 123,107	$ 91,184

Collaboration and Licensing Agreements - Recognized Revenue (Details) $ in Thousands, ¥ in Millions	3 Months Ended			12 Months Ended			98 Months Ended
	Sep. 30, 2025 USD ($)	Sep. 30, 2025 JPY (¥)	Mar. 31, 2025 USD ($)	Dec. 31, 2025 USD ($)	Dec. 31, 2024 USD ($)	Dec. 31, 2023 USD ($)	Dec. 31, 2025 USD ($)
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues				$ 407,320	$ 333,615	$ 124,456
2017 KKC Agreement \| Kyowa Kirin
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues							$ 35,000
Licensing revenue
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues				5,088	78	35,809
Licensing revenue \| METiS Therapeutics Inc
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues				0	0	750
Licensing revenue \| 2017 KKC Agreement \| Kyowa Kirin
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues				0	0	30,000
Licensing revenue \| Fosun Agreement \| Fosun Pharma
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues			$ 5,000	5,000	0	5,000
Licensing revenue \| Knight Agreement \| Knight
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues				88	78	59
Product supply revenue
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues				15,879	11,649	6,121
Product supply revenue \| 2017 KKC Agreement \| Kyowa Kirin
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues				15,625	11,649	6,092
Product supply revenue \| Knight Agreement \| Knight
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues				254	0	29
Non-cash royalty revenue related to the sale of future royalties
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues				8,545	2,692	0
Non-cash royalty revenue related to the sale of future royalties \| Kyowa Kirin
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues	$ 3,400			3,400
Non-cash royalty revenue related to the sale of future royalties \| 2017 KKC Agreement \| Kyowa Kirin
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues		¥ 500.0		$ 8,545	$ 2,692	$ 0

Property and Equipment, Net - Balances (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 4,834	$ 12,113
Less: Accumulated depreciation	(2,650)	(10,618)
Total property and equipment, net	2,184	1,495
Office equipment and furniture
Property, Plant and Equipment [Line Items]
Property and equipment, gross	2,686	2,923
Leasehold improvements
Property, Plant and Equipment [Line Items]
Property and equipment, gross	2,148	9,144
Laboratory equipment
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 0	$ 46

Summary of Significant Accounting Policies - Narrative (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023	Jun. 30, 2025
Summary of significant accounting policies
Accounts receivable	$ 71,848	$ 57,705
Compensation costs from contributions	1,400	1,100	$ 200
AstraZeneca \| AZ Termination Agreement
Summary of significant accounting policies
Maximum potential payment per agreement				$ 75,000
Commercial customers
Summary of significant accounting policies
Accounts receivable	66,400	56,700
Collaborators
Summary of significant accounting policies
Accounts receivable	$ 5,400	$ 1,000
Minimum
Summary of significant accounting policies
Estimated useful lives	3 years
Maximum
Summary of significant accounting policies
Estimated useful lives	5 years

Inventory

12 Months Ended

Dec. 31, 2025

Inventory Disclosure [Abstract]

Inventory

INVENTORY

Inventory consisted of the following:


	December 31,
(in thousands)	2025		2024
Raw materials	$	28,009	$	30,792
Work in process	88,259		58,685
Finished goods	6,839		1,707
Total	$	123,107	$	91,184
Reported as
Inventory	$	17,735	$	21,173
Inventory, non-current	105,372		70,011
Total	$	123,107	$	91,184

Prepaid commercial manufacturing with third-party CMOs not included in inventory was $14.5 million and $16.4 million as of December 31, 2025 and 2024, respectively. There were no prepayments expected to be converted into inventory after 12 months as of December 31, 2025 and 2024.

Summary of Significant Accounting Policies	12 Months Ended
Summary of Significant Accounting Policies	Dec. 31, 2025
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES Basis of Presentation The accompanying financial statements have been prepared in accordance with U.S. GAAP. Certain prior year amounts have been reclassified to conform to the current year presentation on the statements of operations and comprehensive loss to include the “cost of product sales” and the “other cost of revenue” captions within the “cost of sales” caption. This reclassification had no effect on the previously reported results of operations. Prior to the end of the 2025 second quarter, the “other cost of revenue” caption was primarily comprised of royalty expenses recognized under the AstraZeneca Termination Agreement. As of the end of the 2025 second quarter, the maximum $75.0 million royalty obligation under this agreement had been fully recognized. Refer to the Summary of Abbreviated Terms at the end of this Annual Report on Form 10-K for definitions of terms used throughout the document. Use of Estimates The preparation of financial statements requires management to make estimates, judgments and assumptions. Significant estimates include those used in our revenue gross-to-net adjustments and other estimates. Management bases its estimates on historical experience and on various relevant assumptions that management believes to be reasonable under the circumstances. Actual results could materially differ from those estimates. Cash Equivalents Cash equivalents consist of highly liquid investments purchased with an original maturity date of 90 days or less and are recognized at cost, which approximates fair value. Short-Term Investments Short-term investments consist of debt securities classified as available-for-sale and have maturities greater than 90 days, but less than one year, from the date of acquisition. Short-term investments are carried at fair value based upon quoted market prices or other observable market data. Unrealized gains (losses) on available-for-sale securities are included in accumulated other comprehensive income on our balance sheets. The cost of available-for-sale securities sold is based on the specific-identification method. Marketable debt securities are reviewed for impairment by determining whether the decline in their market value below carrying value is other-than-temporary. This assessment considers the intent and ability to retain the investment for a period of time sufficient for an anticipated recovery in market value; the duration and extent that the market value has been below cost; and the investee’s financial condition. Other-than-temporary impairments and credit losses are recorded in the statements of operations and comprehensive loss. Concentration of Credit Risk Financial instruments that potentially subject us to significant concentrations of credit risk consist primarily of cash, cash equivalents, short-term investments and accounts receivable. We are exposed to credit risks in the event of default by the counterparties to the extent of the amount recorded in our balance sheets. Cash, cash equivalents and short-term investments are invested through banks and other financial institutions in the U.S. Foreign Currency Our business is conducted in U.S. dollars; however, a portion of our expense and capital activities are transacted in foreign currencies which are subject to exchange rate fluctuations that can affect cash or earnings. Foreign currency transactions are translated into the functional currency using exchange rates prevailing at the dates of the transactions. At the end of each reporting period, monetary assets and liabilities that are denominated in foreign currencies are translated at the rates prevailing at that date. All gains and losses on these foreign currency transactions are recorded as other income, net on our statements of operations and comprehensive loss. Property and Equipment Expenditures for property and equipment are capitalized at cost. Depreciation is computed using the straight-line method over the estimated useful lives of the respective assets, ranging from three to five years for laboratory equipment and office equipment and furniture. Leasehold improvements are amortized over the lesser of the estimated useful lives or the related remaining lease term. Impairment of Long-Lived Assets The carrying values of long-lived assets, including property and equipment, are reviewed for impairment whenever events or changes in circumstances indicate that the asset may not be recoverable. An impairment loss is recognized when the total of estimated future undiscounted cash flows, expected to result from the use of the asset and its eventual disposition, is less than the asset’s carrying amount. Impairment, if any, would be assessed using discounted cash flows or other appropriate measures of fair value. Income Taxes The asset and liability method of accounting is used for income taxes. Deferred tax assets and liabilities are determined based on the differences between the financial reporting and the tax basis of assets and liabilities and are measured using the enacted tax rates and laws that will be in effect when the differences are expected to be reversed. A valuation allowance is provided when it is more likely than not that a portion or all of a deferred tax asset will not be realized. Accounts Receivable Accounts receivable are stated at amortized cost less allowance for credit losses. An allowance for credit losses reflects our best estimate of future credit losses over the contractual life of outstanding accounts receivable under the assumption that the current conditions as of the balance sheet date do not change for the remaining life of the asset. An allowance for credit losses is determined based on various factors, such as historical experience, specific allowances for known troubled accounts, customers’ financial condition and both current and forecasted economic conditions. To date, we have determined that an allowance for doubtful accounts is not required. As of December 31, 2025, our accounts receivable balance was comprised of $66.4 million from commercial customers and $5.4 million from our collaboration partners. As of December 31, 2024, our accounts receivable balance was comprised of $56.7 million from commercial customers and $1.0 million from our collaboration partners. Inventory Inventory costs incurred are capitalized after regulatory approval, or if based on management’s judgment, future commercialization is considered probable and future economic benefit is expected to be realized. We began to capitalize inventory costs associated with IBSRELA during the 2021 fourth quarter, when our intent to commercialize IBSRELA was established and we commenced preparation for the launch of IBSRELA. We began to capitalize inventory costs associated with XPHOZAH during the 2023 fourth quarter, following approval by the FDA to market XPHOZAH in the U.S. Inventory costs incurred prior to regulatory approval were expensed as research and development. Inventories are stated at the lower of cost or estimated net realizable value with cost determined under the specific identification method. A portion of inventory that represents product that is not expected to be sold or used within the next 12 months is classified as non-current assets in our balance sheets. Revenue Recognition The application of ASC 606 Revenue from Contracts with Customers substantially impacts our reported results, particularly product sales, net, which requires certain estimates in determining the transaction price. Total revenues are recognized following a five-step model: (i) identify the customer contract, (ii) identify the contract’s performance obligations, (iii) determine the transaction price, (iv) allocate the transaction price to the performance obligations and (v) recognize revenue when or as a performance obligation is satisfied. Product Sales, Net We apply the ASC 606 five-step process above to the contracts with our Customers. Product revenue is recognized when Customers take control of the product, which typically occurs upon delivery to the Customers. The transaction price for product sales is reduced for estimates of variable consideration related to (i) discounts and chargebacks, (ii) rebates, wholesaler and GPO fees, and (iii) copay assistance and returns (collectively, gross-to-net adjustments or GTN adjustments). Except for certain wholesaler and GPO fees and discounts, which are based on contracts, our estimates of GTN adjustments involve assumptions and judgments. Our estimates of GTN adjustments for rebates, copay assistance and chargebacks require significant assumptions and judgments, considering factors such as legal interpretations of applicable laws and regulations, historical experience, payor mix (e.g., Medicare or Medicaid), current contract prices under applicable programs, unbilled claims, processing time lags and inventory levels in the distribution channel. Estimates are assessed each period and adjusted as required to revise information or actual experience. Collaboration and Licensing Revenue Our collaboration and licensing arrangements may include the grant of licenses for use of our intellectual property and manufacturing supply services. Considerations for such arrangements may include non-refundable upfront license fees; payments based upon the achievement of development, regulatory, or commercialization milestones; payments for manufacturing supply services; and future royalties on net sales of licensed products. We perform the ASC 606 five-step process above to determine the appropriate amount of revenue to be recognized under our collaboration and licensing arrangements. For performance obligations that are satisfied over time, we recognize revenue using an input or output measure of progress that best depicts the satisfaction of the relevant performance obligation. We evaluate performance obligations by assessing whether promised goods or services are both (i) capable of being distinct and (ii) distinct in the context of the arrangement. Goods or services that meet these criteria are considered distinct performance obligations. Judgment is required to determine whether promised goods or services represent distinct performance obligations. We estimate the transaction price based on expected consideration, which may include fixed or variable consideration. At the inception of each arrangement that includes variable consideration, we evaluate the amount of potential transaction price and the likelihood that the transaction price will be received. The amount of variable consideration that is included in the transaction price only to the extent that it is probable that a significant reversal in the amount of the cumulative revenue recognized will not occur in a future period. After contract inception, the transaction price is reassessed at every period end and updated for changes such as resolution of uncertain events. Licensing Revenue: •Non-refundable upfront license fees: For arrangements that include a license of intellectual property, and it is determined to be distinct from the other performance obligations identified in the arrangement, we recognize the transaction price allocated to the license as licensing revenue upon transfer of control of the license. •Milestone payments: Contingent milestones at contract inception are estimated at the amount which is not probable of a material reversal and included in the transaction price using the most likely amount method. Milestone payments that are not within our control, such as regulatory approvals, are not considered probable of being achieved until those approvals are received and therefore, the variable consideration is constrained. At the end of each subsequent reporting period, we re-evaluate the probability of achievement of such contingent milestones and any related constraints, and if necessary, adjust our estimate of the overall transaction price. Any such adjustments are recorded on a cumulative catch-up basis, which would affect earnings in the period of adjustment. •Royalties: For arrangements that include sales-based royalties and a license of intellectual property that is deemed to be the predominant item to which the royalties relate, revenue is recognized at the later of when the related sales occur or when the performance obligation to which some or all of the royalties have been allocated has been satisfied (or partially satisfied). To date, royalty revenue resulting from licensing arrangements has not been material. Product Supply Revenue: For arrangements that include a promise for the future supply of drug substance or drug product for either clinical development or commercial supply at the customer’s discretion (manufacturing supply services), and it is determined to be distinct from the other performance obligations identified in the arrangement, we recognize the transaction price allocated to the manufacturing supply services as product supply revenue upon transfer of control of the product to the customer, which is upon delivery. Advanced payments from customers for the manufacturing of drug substance are recognized as deferred revenue until delivery. Non-Cash Royalty Revenue Related to the Sale of Future Royalties: Royalties and commercialization milestones earned from Kyowa Kirin are recorded as non-cash royalty revenue. As discussed in Note 8. Deferred Royalty Obligation Related to the Sale of Future Royalties, future royalties and commercialization milestone payments we may receive under the Kyowa Kirin Agreement will be remitted to HCR pursuant to the HCR Agreement. Accrued Expenses As part of the process of preparing our financial statements, we are required to estimate our accrued expenses, which involves reviewing open contracts and purchase orders, communicating with our personnel to identify services that have been performed on our behalf and estimating the level of service performed and the associated cost incurred for the service when we have not yet been invoiced or otherwise notified of the actual cost. The majority of our service providers invoice us monthly in arrears for services performed or when contractual milestones are met. We estimate our accrued expenses as of each balance sheet date based on facts and circumstances known to us at that time. We periodically confirm the accuracy of our estimates with our service providers and make adjustments if necessary. Service fee accruals are estimated based on the period over which each component of service will be performed, with vendor input if appropriate. If the actual timing of the performance of services or the level of effort varies from our estimate, we adjust the accrued or prepaid expense balance accordingly. Although we do not expect our estimates to be materially different from amounts actually incurred, our estimates of the status and timing may differ from the actual status and timing of services performed. Retirement Savings Plan We offer retirement saving plans through our 401(k) plan, which is available to all full-time employees. In June 2023, we expanded the benefit with the inclusion of a company matching contribution. We contribute to tax-qualified retirement plans for the benefit of employees who meet certain eligibility requirements and choose to participate in the plans. Participating employees specify the percentage of salary they wish to contribute from their compensation, and we make matching contributions. We recognized compensation costs from our contributions of $1.4 million, $1.1 million and $0.2 million in 2025, 2024 and 2023, respectively. Stock-Based Compensation Stock-based compensation expense is recognized for all stock-based payment awards made to employees, non-employees and directors based on estimated fair values. The grant date fair value of the awards is determined using the Black-Scholes option-pricing model. Stock-based compensation expense is recognized on a straight-line basis over the requisite service period and is reduced for estimated forfeitures at the date of grant and revised, if necessary, in subsequent periods if actual forfeitures differ from those estimates. Non-Cash Interest Expense on Deferred Royalty Obligation In connection with the HCR Agreement, as discussed further in Note 8. Deferred Royalty Obligation Related to the Sale of Future Royalties, we recorded a liability related to the sale of future royalties and commercialization milestones that is amortized using the effective interest method over the estimated life of the HCR Agreement. As a result, we impute interest on proceeds received from HCR and record non-cash interest expense at the effective interest rate derived from estimated amounts and timing of future royalties and commercialization payments expected to be received by HCR. Leases Operating leases are included in right-of-use assets, current portion of operating lease liability and operating lease liability, net of current portion on our balance sheets. Right-of-use assets represent our right to use an underlying asset for the lease term and lease liabilities represent our obligation to make lease payments arising from the lease. Operating lease right-of-use assets and liabilities are recognized at the lease commencement date based on the present value of lease payments over the lease term. In determining the present value of lease payments, we use our incremental borrowing rate based on information available at the lease commencement date. Operating lease right-of-use assets also include any lease payments made and exclude lease incentives. Our lease terms may include options to extend or terminate a lease when it is reasonably certain that we will exercise any such option. Leases with an initial term of 12 months or less are not recorded on the balance sheets. Lease expense is recognized on a straight-line basis over the expected lease term. We have elected not to separate lease and non-lease components, such as common area maintenance charges, and instead account for these as a single lease component. Net Loss per Share Basic net loss per common share is calculated by dividing the net loss by the weighted-average number of shares of common stock outstanding during the period, without consideration of potential shares of common stock. Diluted net loss per common share in the periods presented is the same as basic net loss per common share because the effects of potentially dilutive securities are antidilutive due to net losses recognized for each period presented. Recent Accounting Pronouncements New Accounting Pronouncements Recently Adopted In December 2023, the FASB issued ASU No. 2023-09, Income Taxes (Topic 740) - Improvements to Income Tax Disclosures. The ASU provides additional transparency within the income tax disclosures, primarily related to the rate reconciliation and income taxes paid information. We adopted ASU 2023-09 retrospectively in the 2025 fourth quarter and determined that the adoption did not have a material impact on our financial statements. Refer to the related disclosures presented in Note 16. Income Taxes. Recent Accounting Pronouncements Not Yet Adopted In November 2024, the FASB issued ASU No. 2024-03, Income Statement (Topic 220) - Reporting Comprehensive Income - Expense Disaggregation Disclosures, Disaggregation of Income Statement Expenses, which requires public companies to disclose, in interim and annual reporting periods, additional information about certain expenses in the financial statements. The new disclosure requirements are effective for our annual periods beginning January 1, 2027, and interim periods beginning January 1, 2028, with early adoption permitted, and may be applied either prospectively or retrospectively. We are in the process of evaluating the impact of this new guidance on our disclosures.

Equity Incentive Plans - Unrecognized Stock-Based Compensation (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2025 USD ($)
Stock options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized Compensation Expense (in thousands)	$ 46,330
Average Remaining Vesting Period (in years)	2 years 6 months 10 days
RSUs
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized Compensation Expense (in thousands)	$ 67,104
Average Remaining Vesting Period (in years)	2 years 10 months 17 days
ESPP
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized Compensation Expense (in thousands)	$ 107
Average Remaining Vesting Period (in years)	2 months 1 day

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

+ Details

Property and Equipment, Net

12 Months Ended

Dec. 31, 2025

Property, Plant and Equipment [Abstract]

Property and Equipment, Net

PROPERTY AND EQUIPMENT, NET

Property and equipment consisted of the following:


	December 31,
(in thousands)	2025		2024
Office equipment and furniture	$	2,686	$	2,923
Leasehold improvements	2,148		9,144
Laboratory equipment	—		46
Property and equipment, gross	4,834		12,113
Less: Accumulated depreciation	(2,650)		(10,618)
Total property and equipment, net	$	2,184	$	1,495

We recognized depreciation expense in the amount of $0.8 million, $0.5 million and $0.6 million in 2025, 2024 and 2023, respectively.

Net Loss Per Share (Tables)

12 Months Ended

Dec. 31, 2025

Earnings Per Share [Abstract]

Schedule of Computation of Net Loss Per Common Share

The following table sets forth the computation of net loss per common share:


	Year Ended December 31,
(in thousands, except per share amounts)	2025		2024		2023
Numerator
Net loss	$	(61,599)	$	(39,136)	$	(66,067)
Denominator
Weighted average common shares outstanding - basic and diluted	241,034		235,233		219,331

Net loss per share of common stock - basic and diluted	$	(0.26)	$	(0.17)	$	(0.30)

Schedule of Anti-Dilutive Securities Not Considered in Diluted Net Loss Per Common Share Calculation


	Year Ended December 31,
(in thousands)	2025	2024	2023
Options to purchase common stock	29,904	27,800	20,877
Restricted stock units	12,703	7,883	3,086
ESPP shares issuable	165	230	249

Total	42,772	35,913	24,212

Cash, Cash Equivalents and Short-Term Investments - Securities Classified as Cash and Short-Term Investments (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Cash and cash equivalents
Fair value	$ 67,999	$ 64,932
Short-term investments
Amortized Cost	196,492	185,111
Gross Unrealized Gains	201	112
Gross Unrealized Losses	(3)	(55)
Fair Value	196,690	185,168
Total cash, cash equivalents and investments	264,491	250,043
Total cash, cash equivalents and investments, Gross Unrealized Gains	201	112
Total cash, cash equivalents and investments, Gross Unrealized Losses	(3)	(55)
Total cash, cash equivalents and investments, Fair Value	264,689	250,100
U.S. treasury securities
Short-term investments
Amortized Cost	95,052	79,720
Gross Unrealized Gains	105	58
Gross Unrealized Losses	0	(5)
Fair Value	95,157	79,773
Commercial paper
Short-term investments
Amortized Cost	46,421	37,061
Gross Unrealized Gains	32	19
Gross Unrealized Losses	(3)	(15)
Fair Value	46,450	37,065
U.S. government-sponsored agency bonds
Short-term investments
Amortized Cost	27,330	45,960
Gross Unrealized Gains	36	29
Gross Unrealized Losses	0	(27)
Fair Value	27,366	45,962
Corporate bonds
Short-term investments
Amortized Cost	22,557	17,415
Gross Unrealized Gains	25	4
Gross Unrealized Losses	0	(6)
Fair Value	22,582	17,413
Yankee bonds
Short-term investments
Amortized Cost	5,132	1,972
Gross Unrealized Gains	3	0
Gross Unrealized Losses	0	(2)
Fair Value	5,135	1,970
Asset-backed securities
Short-term investments
Amortized Cost	0	2,983
Gross Unrealized Gains	0	2
Gross Unrealized Losses	0	0
Fair Value	0	2,985
Cash
Cash and cash equivalents
Fair value	18,569	16,282
Money market funds
Cash and cash equivalents
Fair value	$ 49,430	$ 48,650

Equity Incentive Plans - Valuation Assumptions for Stock Options (Details) - Stock options	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term (in years)	4 years	5 years 4 months 24 days	5 years 1 month 6 days
Expected volatility	77.60%	100.80%	97.60%
Risk-free interest rate	3.10%	4.00%	3.80%
Dividend yield	0.00%	0.00%	0.00%

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

+ Details

STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Operating activities
Net loss	$ (61,599)	$ (39,136)	$ (66,067)
Adjustments to reconcile net loss to net cash used in operating activities
Depreciation and amortization expense	3,059	2,063	1,292
Non-cash lease expense	1,947	4,008	3,624
Stock-based compensation	48,962	37,381	13,530
Non-cash interest expense	8,958	7,400	4,220
Non-cash royalty revenue related to the sale of future royalties	(8,545)	(2,692)	0
Other, net	(3,913)	(4,664)	(2,930)
Changes in operating assets and liabilities
Accounts receivable	(14,143)	(35,674)	(14,298)
Inventory	(31,923)	(41,697)	(21,141)
Prepaid commercial manufacturing	1,899	6,782	(9,593)
Prepaid expenses and other assets	(4,293)	(4,543)	(6,035)
Accounts payable	3,235	4,862	279
Accrued compensation and benefits	4,168	2,343	5,049
Operating lease liabilities	(1,827)	(4,588)	(3,928)
Accrued and other liabilities	14,545	21,254	3,691
Deferred revenue	(3,013)	2,092	2,590
Net cash used in operating activities	(42,483)	(44,809)	(89,717)
Investing activities
Proceeds from maturities and redemptions of investments	211,456	177,854	84,321
Purchases of investments	(218,923)	(195,161)	(215,225)
Purchases of property and equipment	(1,492)	(1,011)	(344)
Net cash used in investing activities	(8,959)	(18,318)	(131,248)
Financing activities
Proceeds from issuance of common stock in at the market offering, net of issuance costs	0	0	119,236
Proceeds from 2022 Loan Agreement, net of costs	48,668	99,451	22,386
Proceeds from the sale of future royalties, net of issuance costs	0	0	5,000
Proceeds from issuance of common stock under equity incentive plans	5,841	8,138	1,173
Payments of the previously outstanding exit fees	0	(1,000)	(1,500)
Net cash provided by financing activities	54,509	106,589	146,295
Net increase (decrease) in cash and cash equivalents	3,067	43,462	(74,670)
Cash and cash equivalents at beginning of period	64,932	21,470	96,140
Cash and cash equivalents at end of period	67,999	64,932	21,470
Supplementary disclosure of cash flow information
Cash paid for interest	15,717	11,408	4,240
Cash paid for income taxes	485	266	51
Supplementary disclosure of non-cash activities
Right-of-use assets obtained in exchange for lease obligations	4,362	1,010	339
Issuance of common stock for services	$ 315	$ 257	$ 337

Cash, Cash Equivalents and Short-Term Investments (Tables)

12 Months Ended

Dec. 31, 2025

Cash and Cash Equivalents [Abstract]

Schedule of Securities Classified as Cash, Cash Equivalents and Short-Term Investments

The following table summarizes our cash, cash equivalents and short-term investments:


	December 31, 2025								December 31, 2024
			Gross Unrealized								Gross Unrealized
(in thousands)	Amortized Cost		Gains		Losses		Fair Value		Amortized Cost		Gains		Losses		Fair Value
Cash and cash equivalents
Cash	$	18,569	$	—	$	—	$	18,569	$	16,282	$	—	$	—	$	16,282
Money market funds	49,430		—		—		49,430		48,650		—		—		48,650
Total cash and cash equivalents	67,999		—		—		67,999		64,932		—		—		64,932
Short-term investments
U.S. treasury securities	$	95,052	$	105	$	—	$	95,157	$	79,720	$	58	$	(5)	$	79,773
Commercial paper	46,421		32		(3)		46,450		37,061		19		(15)		37,065
U.S. government-sponsored agency bonds	27,330		36		—		27,366		45,960		29		(27)		45,962
Corporate bonds	22,557		25		—		22,582		17,415		4		(6)		17,413
Yankee bonds	5,132		3		—		5,135		1,972		—		(2)		1,970
Asset-backed securities	—		—		—		—		2,983		2		—		2,985
Total short-term investments	196,492		201		(3)		196,690		185,111		112		(55)		185,168


Total cash, cash equivalents and investments	$	264,491	$	201	$	(3)	$	264,689	$	250,043	$	112	$	(55)	$	250,100

Deferred Royalty Obligation Related to the Sale of Future Royalties - Schedule (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Deferred Royalty Obligation [Roll Forward]
Deferred royalty obligation balance as of January 1,	$ 25,527
Deferred royalty obligation balance as of December 31,	25,876	$ 25,527
Healthcare royalty partners IV, L.P
Deferred Royalty Obligation [Roll Forward]
Deferred royalty obligation balance as of January 1,	25,527	20,179	$ 11,254
Proceeds received from HCR	0	0	5,000
Non-cash interest expense related to the sale of future royalties	8,296	7,088	3,924
Royalty and commercialization milestone payments remitted to HCR	(7,947)	(1,740)	0
Other	0	0	1
Deferred royalty obligation balance as of December 31,	$ 25,876	$ 25,527	$ 20,179

Collaboration and Licensing Agreements - Narrative (Details) $ in Thousands, ¥ in Millions, $ in Millions	1 Months Ended			3 Months Ended			12 Months Ended				32 Months Ended	97 Months Ended	98 Months Ended
	Mar. 31, 2018 USD ($)	Dec. 31, 2017 USD ($)	Nov. 30, 2017 USD ($)	Sep. 30, 2025 USD ($)	Sep. 30, 2025 JPY (¥)	Mar. 31, 2025 USD ($)	Dec. 31, 2025 USD ($) payment_tranche	Dec. 31, 2025 CAD ($)	Dec. 31, 2024 USD ($)	Dec. 31, 2023 USD ($)	Dec. 31, 2025 USD ($) payment_tranche	Dec. 31, 2025 USD ($) payment_tranche	Dec. 31, 2025 USD ($) payment_tranche	Dec. 31, 2025 JPY (¥) payment_tranche	Jun. 30, 2025 USD ($)	Apr. 30, 2023 USD ($)
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues							$ 407,320		$ 333,615	$ 124,456
Non-cash royalty revenue related to the sale of future royalties
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues							8,545		2,692	0
Licensing revenue
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues							5,088		78	35,809
Kyowa Kirin \| Non-cash royalty revenue related to the sale of future royalties
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues				$ 3,400			3,400
Kyowa Kirin \| 2017 KKC Agreement
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Upfront license fees			$ 30,000
Potential development milestones													$ 55,000
Total revenues													35,000
Potential commercialization milestones							$ 54,500				$ 54,500	$ 54,500	54,500	¥ 8,500.0
Period to reduce royalty rate							2 years	2 years
Fee receivable for reduction in royalty rate							$ 40,000				$ 40,000	$ 40,000	$ 40,000
Number of payment tranches for fee receivable for reduction in royalty rate \| payment_tranche							2				2	2	2	2
Kyowa Kirin \| 2017 KKC Agreement \| Non-cash royalty revenue related to the sale of future royalties
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues					¥ 500.0		$ 8,545		2,692	0
Kyowa Kirin \| 2017 KKC Agreement \| Licensing revenue
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues							$ 0		0	30,000
Fosun Pharma \| Fosun Agreement
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Upfront payment received		$ 12,000
Potential development and commercialization milestones												$ 113,000
Proceeds from milestone payments												$ 13,000
Threshold percentage of net sales for tiered royalties							20.00%	20.00%
Fosun Pharma \| Fosun Agreement \| Licensing revenue
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues						$ 5,000	$ 5,000		0	5,000
Knight \| Knight Agreement
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Upfront license fees	$ 2,300
Potential development milestones							700
Potential development and commercialization milestones							16,200	$ 22.2
Knight \| Knight Agreement \| Licensing revenue
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues							$ 88		78	59
AstraZeneca \| AZ Termination Agreement
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Percentage of royalty revenue							10.00%	10.00%
Percentage of non royalty revenue							20.00%	20.00%
Maximum potential payment per agreement															$ 75,000
Cost of revenue							$ 12,700		34,700	12,400
METiS Therapeutics Inc \| Licensing revenue
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenues							$ 0		$ 0	$ 750
Proceeds from milestone payments											$ 243,000
Upfront payment																$ 800

Equity Incentive Plans

12 Months Ended

Dec. 31, 2025

Share-Based Payment Arrangement [Abstract]

Equity Incentive Plans

EQUITY INCENTIVE PLANS

2014 Plan

The 2014 Equity Incentive Plan (2014 Plan), effective on June 18, 2014, provided for the stock-based compensation awards, including stock options, stock appreciation rights, restricted stock, service-based RSUs, performance-based RSUs, deferred stock, deferred stock units, dividend equivalents, stock payments and performance awards. The 2014 Plan initially reserved 1.5 million shares, including the 35 thousand shares remaining for future awards under a previous equity incentive plan (2008 Plan), with up to 1.2 million additional shares which could be added from forfeited or lapsed awards from the 2008 Plan. The 2014 Plan allowed for an annual increase in the number of shares available for issuance on the first day of each year through 2024, equal to the lesser of four percent of our outstanding common stock on the last day of the immediately preceding year or a smaller amount determined by the board of directors (2014 Plan evergreen provision).

On June 14, 2024, stockholders approved the Amended and Restated 2014 Equity Incentive Award Plan (2014 A&R Plan). The key provisions pursuant to the 2014 A&R Plan included (i) an addition of 19.0 million shares to the total existing share reserve; (ii) the removal of the 2014 Plan evergreen provision such that any increase to the total number of shares that may be issued must be approved by our stockholders; and (iii) an increase for the limit of shares that may be issued upon exercise of incentive stock options from 10.7 million to 58.5 million shares. In addition to increases resulting from repurchases, forfeitures, expirations and cancellations of awards under the 2008 Plan, shares reserved for issuance under the 2014 A&R Plan will be increased by the number of shares subject to awards granted under the Inducement Plan, as discussed below, that are repurchased, forfeited, expire or are cancelled on or after June 14, 2024. As a result, no new awards would be made under the Inducement Plan following June 14, 2024.

On June 18, 2025, stockholders approved the Equity Plan Amendment to the 2014 A&R Plan to (i) increase the number of shares reserved for issuance under the 2014 A&R Plan by 10.0 million shares; and (ii) increase the limit of shares that may be issued upon exercise of incentive stock options from 58.5 million to 68.5 million shares. As of December 31, 2025, approximately 16.9 million shares of our common stock were available for future issuance under the 2014 A&R Plan, as amended.

2016 Plan

In November 2016, our board of directors approved the 2016 Employment Commencement Incentive Plan (Inducement Plan) under which 1.0 million shares were reserved. In January 2021, January 2022, December 2022 and January 2024, 0.5 million, 2.0 million, 3.0 million and 5.8 million shares, respectively, were added to the Inducement Plan. As of December 31, 2025, 9.0 million shares of our common stock were subject to inducement grants that were issued pursuant to the Inducement Plan. As of December 31, 2025, no additional shares of our common stock were available for future issuance under the 2016 Plan.

Stock Options

A summary of our stock option activity and related information for the year ended December 31, 2025 is as follows:


	Number of Shares (in thousands)	Weighted-Average Exercise Price per Share		Weighted-Average Remaining Contractual Term (in years)	Aggregate Intrinsic Value (in thousands)
Balance as of December 31, 2024	28,085	$	5.63

Options granted	9,011	$	5.08
Options exercised	(1,880)	$	2.20
Options forfeited or canceled	(6,239)	$	6.29


Balance as of December 31, 2025	28,977	$	5.54	6.4	$	37,405
Vested and expected to vest as of December 31, 2025	28,977	$	5.54	6.4	$	37,405
Exercisable as of December 31, 2025	18,133	$	5.43	5.1	$	28,181

The aggregate intrinsic value represents the difference between the total pre-tax value (i.e., the difference between our stock price and the exercise price) of stock options outstanding as of December 31, 2025, based on our common stock closing price of $5.83 per share, which would have been received by the option holders if all their in-the-money options had been exercised as of that date.

The intrinsic value of options exercised during the years ended December 31, 2025, 2024 and 2023 was $9.6 million, $19.6 million and $1.1 million, respectively. The total fair value of options vested during the years ended December 31, 2025, 2024 and 2023 was $68.1 million, $61.0 million and $24.9 million, respectively.

The weighted-average grant-date estimated fair value of options granted during the years ended December 31, 2025, 2024 and 2023 was $3.19, $6.22 and $2.36 per share, respectively. The estimated grant date fair value of employee stock options was calculated using the Black-Scholes option-pricing model, based on the following weighted-average assumptions:


	Year Ended December 31,
	2025		2024		2023
Expected term (in years)	4.0		5.4		5.1
Expected volatility	77.6	%	100.8	%	97.6	%
Risk-free interest rate	3.1	%	4.0	%	3.8	%
Dividend yield	—	%	—	%	—	%

Expected Term—We estimate the expected term of our options based upon historical exercises and post-vesting termination behavior.

Expected Volatility—We use the historic volatility of our own stock over the retrospective period corresponding to the expected remaining term of the options to compute our expected stock price volatility.

Risk-Free Interest Rate—The risk-free interest rate assumption is based on the zero-coupon U.S. treasury instruments on the date of grant with a maturity date consistent with the expected term of our stock option grants.

Dividend Yield—To date, we have not declared or paid any cash dividends and do not have any plans to do so in the future. Therefore, we use an expected dividend yield of zero.

Restricted Stock Units

A summary of our RSUs activity and related information for the year ended December 31, 2025 is as follows:


	Number of RSUs (in thousands)	Weighted-Average Grant Date Fair Value per Share
Non-vested restricted stock units as of December 31, 2024	8,013	$	6.59
Granted	11,291	$	5.15
Vested	(4,070)	$	5.75
Forfeited	(2,651)	$	5.93
Non-vested restricted stock units as of December 31, 2025	12,583	$	5.71
Restricted stock units exercisable (vested and deferred) as of December 31, 2025	21

The total estimated fair value of RSUs vested during the years ended December 31, 2025, 2024 and 2023 was $21.7 million, $16.4 million and $3.5 million, respectively.

Issuance of Common Stock for Services

During the years ended December 31, 2025, 2024 and 2023, we issued approximately 0.1 million, 41 thousand and 0.1 million shares, respectively, of our common stock to members of the board of directors who elected to receive stock in lieu of their cash fees under our Non-Employee Director Compensation Program, as amended. In 2025, our board of directors adopted the Fifth Amended and Restated Non-Employee Director Compensation Program, under which the board may provide each director with the opportunity to defer the settlement of restricted stock units to be granted to a future date. The shares issued during the years ended December 31, 2025, 2024 and 2023 were valued at $0.3 million, $0.3 million and $0.3 million, respectively, based on the fair value of the common stock on the date of grant.

Employee Stock Purchase Plan

The 2014 ESPP, effective on June 18, 2014, initially reserved approximately 0.2 million shares of our common stock for our eligible employees to purchase shares of our common stock at a discount. If approved by the administrator of the ESPP, on the first day of each calendar year through 2024, the number of shares in the reserve increased by an amount equal to the lesser of (i) one percent of the shares of our common stock outstanding on the last day of the immediately preceding fiscal year; and (ii) such number of shares of our common stock as determined by the board of directors (2014 ESPP evergreen provision); provided, however, no more than 2.2 million shares of our common stock could be issued under the ESPP.

On June 14, 2024, stockholders approved the Amended and Restated 2014 ESPP (A&R ESPP). The key provisions pursuant to the A&R ESPP included (i) an addition of 3.0 million shares to the total existing share reserve; and (ii) the removal of the 2014 ESPP evergreen provision such that no evergreen increases would be made after June 14, 2024.

During the years ended December 31, 2025, 2024 and 2023, we issued approximately 0.4 million, 0.5 million and 0.4 million shares, respectively, at an average share price of $4.46, $4.64 and $1.85, respectively, pursuant to the ESPP. As of December 31, 2025, approximately 3.3 million shares of our common stock were available for future issuance under the A&R ESPP.

The following table illustrates the weighted-average assumptions for the Black-Scholes option-pricing model used in determining the fair value of ESPP purchase rights granted to our employees:


	Year Ended December 31,
	2025		2024		2023
Expected term (in years)	0.5		0.5		0.5
Expected volatility	72.6	%	82.8	%	86.0	%
Risk-free interest rate	4.2	%	5.0	%	5.3	%
Dividend yield	—	%	—	%	—	%

Stock-Based Compensation Expense

Stock-based compensation expense for stock options, RSUs and our ESPP included in our statements of operations and comprehensive loss was as follows:


	Year Ended December 31,
(in thousands)	2025		2024		2023
Selling, general and administrative	$	38,650	$	27,791	$	9,952
Research and development	10,312		9,590		3,578
Total	$	48,962	$	37,381	$	13,530

A summary of our total unrecognized stock-based compensation expense, net of estimated forfeitures, as of December 31, 2025 is as follows:


	Unrecognized Compensation Expense (in thousands)		Average Remaining Vesting Period (in years)
Stock option grants	$	46,330	2.53
RSU grants	$	67,104	2.88
ESPP	$	107	0.17

Collaboration and Licensing Agreements - Deferred Revenue (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Current
Beginning balance	$ 10,686	$ 7,182
Prepaid product supply	1,433	3,716
Product supply delivered	(10,913)	(9,836)
Reclassify amounts to be recognized in the next twelve months	0	9,624
Ending balance	1,206	10,686
Non-Current
Beginning balance	7,232	8,644
Prepaid product supply	6,467	8,212
Product supply delivered	0	0
Reclassify amounts to be recognized in the next twelve months	0	(9,624)
Ending balance	$ 13,699	$ 7,232

Leases (Tables)

12 Months Ended

Dec. 31, 2025

Leases [Abstract]

Summary of Additional Details of the Leases

The following table provides additional details of our facility leases presented in our balance sheets:


($ in thousands)	December 31,
Facilities	2025			2024
Right-of-use assets	$	4,795		$	2,380

Current portion of lease liabilities	$	1,479		$	1,562
Operating lease liability, net of current portion	3,641			1,023
Total lease liabilities	$	5,120		$	2,585

Weighted-average remaining term (in years)	3.1			1.8
Weighted-average discount rate	5.6		%	6.5		%

Summary of Lease Costs

The lease costs, which are included in our statements of operations and comprehensive loss, and the supplemental cash flow information related to the leases were as follows:


	Year Ended December 31,
(in thousands)	2025		2024		2023
Operating lease expense	$	2,211	$	4,699	$	3,857
Cash paid for operating leases	$	2,093	$	4,931	$	4,481

Summary of Undiscounted Cash Payment Obligations for Operating Lease Liabilities

The following table summarizes our undiscounted cash payment obligations for our operating lease liabilities as of December 31, 2025:


(in thousands)	Operating Leases
2026	$	1,784
2027	1,836
2028	1,402
2029	575
Thereafter	—
Total undiscounted operating lease payments	5,597
Imputed interest expenses	(477)
Total operating lease liabilities	5,120
Less: Current portion of operating lease liability	(1,479)
Operating lease liability, net of current portion	$	3,641

Borrowing - Schedule of Borrowings (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Jun. 30, 2025	Dec. 31, 2024
Adjustments to principal value
Unamortized discount and debt issuance costs	$ (1,127)		$ (1,136)
Final fee	3,961		1,989
Total long-term debt	202,834		150,853
Less: Current portion of long-term debt	0		0
Long-term debt	202,834		150,853
Term loan
Term Loans
Total principal	200,000		150,000
Term loan \| Term A Loan
Term Loans
Total principal	$ 27,500		27,500
Adjustments to principal value
Interest rate	7.95%
Term loan \| Term A Loan \| Secured Overnight Financing Rate (SOFR)
Adjustments to principal value
Floating per annum rate (percent)	0.022%
Term loan \| Term A Loan \| Floor Rate
Adjustments to principal value
Floating per annum rate (percent)	1.00%
Term loan \| Term B Loan
Term Loans
Total principal	$ 22,500		22,500
Adjustments to principal value
Interest rate	7.95%
Term loan \| Term B Loan \| Secured Overnight Financing Rate (SOFR)
Adjustments to principal value
Floating per annum rate (percent)	0.022%
Term loan \| Term B Loan \| Floor Rate
Adjustments to principal value
Floating per annum rate (percent)	1.00%
Term loan \| Term C Loan
Term Loans
Total principal	$ 50,000		50,000
Adjustments to principal value
Interest rate	4.25%
Term loan \| Term C Loan \| Secured Overnight Financing Rate (SOFR)
Adjustments to principal value
Floating per annum rate (percent)	0.022%
Term loan \| Term C Loan \| Floor Rate
Adjustments to principal value
Floating per annum rate (percent)	4.70%
Term loan \| Term D Loan
Term Loans
Total principal	$ 50,000		50,000
Adjustments to principal value
Interest rate	4.00%
Term loan \| Term D Loan \| Secured Overnight Financing Rate (SOFR)
Adjustments to principal value
Floating per annum rate (percent)	0.022%
Term loan \| Term D Loan \| Floor Rate
Adjustments to principal value
Floating per annum rate (percent)	4.70%
Term loan \| Term E Loan
Term Loans
Total principal	$ 50,000	$ 50,000	$ 0
Adjustments to principal value
Interest rate	4.00%
Term loan \| Term E Loan \| Secured Overnight Financing Rate (SOFR)
Adjustments to principal value
Floating per annum rate (percent)	0.022%
Term loan \| Term E Loan \| Floor Rate
Adjustments to principal value
Floating per annum rate (percent)	4.70%

Leases - Lease Costs (Details) - USD ($) $ in Thousands	12 Months Ended
Leases - Lease Costs (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Lease costs
Operating lease expense	$ 2,211	$ 4,699	$ 3,857
Cash paid for operating leases	$ 2,093	$ 4,931	$ 4,481

Deferred Royalty Obligation Related to the Sale of Future Royalties (Tables)

12 Months Ended

Dec. 31, 2025

Advance Royalties [Abstract]

Schedule of Deferred Royalty Obligation

A summary of financial information related to the HCR Agreement is as follows:


	Year Ended December 31,
($ in thousands)	2025			2024			2023
Non-cash interest expense related to the sale of future royalties	$	(8,296)		$	(7,088)		$	(3,924)
Effective interest rate	25.4		%	31.0		%	34.7		%


(in thousands)	2025		2024		2023
Deferred royalty obligation balance as of January 1,	$	25,527	$	20,179	$	11,254
Proceeds received from HCR	—		—		5,000
Non-cash interest expense related to the sale of future royalties	8,296		7,088		3,924
Royalty and commercialization milestone payments remitted to HCR	(7,947)		(1,740)		—
Other	—		—		1
Deferred royalty obligation balance as of December 31,	$	25,876	$	25,527	$	20,179

Equity Incentive Plans - Narrative (Details) - USD ($) $ / shares in Units, $ in Thousands		1 Months Ended				12 Months Ended
	Jun. 18, 2014	Jan. 31, 2024	Dec. 31, 2022	Jan. 31, 2022	Jan. 31, 2021	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023	Jun. 18, 2025	Jun. 14, 2024	Jun. 13, 2024	Nov. 30, 2016
Equity Incentive Plans
Common stock closing price (in dollars per share)						$ 5.83
Intrinsic value of options exercised						$ 9,600	$ 19,600	$ 1,100
Fair value of options vested						$ 68,100	$ 61,000	$ 24,900
Weighted-average grant-date estimated fair value of options granted (in dollars per share)						$ 3.19	$ 6.22	$ 2.36
Issuance of common stock for services						$ 315	$ 257	$ 337
2014 Plan
Equity Incentive Plans
Common stock reserved for future issuance (in shares)	1,500,000					16,900,000
Number of shares added to initial reserve	35,000
Potential increase to shares reserved for inclusion of forfeited or unexercised options from prior plan	1,200,000
Potential increase in shares reserved as a percentage of shares outstanding	4.00%
Additional shares added (in shares)									10,000,000.0	19,000,000.0
Shares that may be issued upon exercise (in shares)									68,500,000	58,500,000	10,700,000
Inducement Plan
Equity Incentive Plans
Common stock reserved for future issuance (in shares)						0						1,000,000.0
Number of shares added to initial reserve		5,800,000	3,000,000.0	2,000,000.0	500,000
Share of common stock subject to issued inducement grants						9,000,000.0
ESPP
Equity Incentive Plans
Common stock reserved for future issuance (in shares)	200,000					3,300,000
Potential increase in shares reserved as a percentage of shares outstanding	1.00%
Additional shares added (in shares)										3,000,000.0
Weighted-average grant-date estimated fair value of options granted (in dollars per share)						$ 4.46	$ 4.64	$ 1.85
Dividend yield						0.00%	0.00%	0.00%
Maximum shares to be issued under ESPP	2,200,000
Issuance of common stock under employee stock purchase plan (in shares)						400,000	500,000	400,000
Stock options
Equity Incentive Plans
Dividend yield						0.00%	0.00%	0.00%
RSUs
Equity Incentive Plans
Estimated fair value of RSUs vested						$ 21,700	$ 16,400	$ 3,500
Board of directors
Equity Incentive Plans
Issuance of common stock for services (in shares)						100,000	41,000	100,000
Issuance of common stock for services						$ 300	$ 300	$ 300

Equity Incentive Plans - Stock-Based Compensation (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Stock-based compensation	$ 48,962	$ 37,381	$ 13,530
Selling, general and administrative
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Stock-based compensation	38,650	27,791	9,952
Research and development
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Stock-based compensation	$ 10,312	$ 9,590	$ 3,578

Revenue - Chargebacks, Discounts and Reserve Balances (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Gross-to-net sales accruals and reserves
Beginning balance	$ 27,288	$ 8,628
Provisions	163,570	109,857
Credits/payments	(145,435)	(91,197)
Ending balance	45,423	27,288
Net favorable adjustment from changes in prior periods' estimates	4,400
Discounts and Chargebacks
Gross-to-net sales accruals and reserves
Beginning balance	1,643	478
Provisions	23,356	15,099
Credits/payments	(23,306)	(13,934)
Ending balance	1,693	1,643
Rebates, Wholesaler and GPO Fees
Gross-to-net sales accruals and reserves
Beginning balance	14,475	4,234
Provisions	108,547	65,833
Credits/payments	(88,566)	(55,592)
Ending balance	34,456	14,475
Copay Assistance and Returns
Gross-to-net sales accruals and reserves
Beginning balance	11,170	3,916
Provisions	31,667	28,925
Credits/payments	(33,563)	(21,671)
Ending balance	$ 9,274	$ 11,170

Revenue (Tables)

12 Months Ended

Dec. 31, 2025

Revenue from Contract with Customer [Abstract]

Schedule of Revenue

Disaggregation of total revenues by nature is as follows:


	Year Ended December 31,
(in thousands)	2025		2024		2023
Product sales, net	$	377,808	$	319,196	$	82,526
Product supply revenue	15,879		11,649		6,121
Licensing revenue	5,088		78		35,809
Non-cash royalty revenue related to the sale of future royalties	8,545		2,692		—
Total revenues	$	407,320	$	333,615	$	124,456

Total product sales, net was as follows:


	Year Ended December 31,
(in thousands)	2025			2024			2023
Product sales, net
IBSRELA	$	274,207		$	158,286		$	80,062
XPHOZAH	103,601			160,910			2,464
Total product sales, net	$	377,808		$	319,196		$	82,526
Product sales, net as a percentage of total revenues	92.8		%	95.7		%	66.3		%

The following table summarizes total revenues by collaboration partner:


	Year Ended December 31,
(in thousands)	2025		2024		2023
Licensing revenue
Kyowa Kirin	$	—	$	—	$	30,000
Fosun Pharma	5,000		—		5,000
METiS	—		—		750
Knight	88		78		59
Total licensing revenue	$	5,088	$	78	$	35,809
Product supply revenue
Kyowa Kirin	$	15,625	$	11,649	$	6,092
Knight	254		—		29
Total supply revenue	$	15,879	$	11,649	$	6,121
Non-cash royalty revenue related to the sale of future royalties
Kyowa Kirin	$	8,545	$	2,692	$	—

Schedule of Gross To Net Adjustments of Revenue

The activities and ending reserve balances for each significant category of GTN adjustments on product sales, net, which constitute variable consideration, were as follows:


(in thousands)	Discounts and Chargebacks		Rebates, Wholesaler and GPO Fees		Copay Assistance and Returns		Total
Balance as of December 31, 2023	$	478	$	4,234	$	3,916	$	8,628
Provisions	15,099		65,833		28,925		109,857
Credits/payments	(13,934)		(55,592)		(21,671)		(91,197)
Balance as of December 31, 2024	1,643		14,475		11,170		27,288
Provisions(1)	23,356		108,547		31,667		163,570
Credits/payments	(23,306)		(88,566)		(33,563)		(145,435)
Balance as of December 31, 2025	$	1,693	$	34,456	$	9,274	$	45,423

(1)Provisions included approximately $4.4 million of net favorable adjustment resulting from changes in prior periods’ estimates.

Schedule of Revenue by Geographic Areas

A summary of our revenues by geographic area is as follows:


	Year Ended December 31,
(in thousands)	2025		2024		2023
United States(1)	$	377,808	$	319,196	$	83,276
International
Asia Pacific(2)	29,170		14,341		41,121
North America(3)	342		78		59
Total revenues	$	407,320	$	333,615	$	124,456

(1)Revenues from the United States were comprised of amounts earned from sales of IBSRELA and XPHOZAH.

(2)Revenues from Asia Pacific were comprised of amounts earned in accordance with the Kyowa Kirin Agreement and the Fosun Agreement.

(3)Revenues from North America were comprised of amounts earned from Canada in accordance with the Knight Agreement.

Schedule of Revenue from Customers as a Percentage of Total Product Revenue, Net

Gross product sales from Customers and revenues from collaboration partners, each accounting for more than 10% of total revenues, were as follows:


	Year Ended December 31,
	2025		2024		2023
Customers(1)
BioRidge Pharma, LLC	65.9	%	75.4	%	24.0	%
Cardinal Health	21.4	%	14.5	%	19.8	%
McKesson Corporation	17.9	%	14.1	%	15.7	%
Cencora (formerly AmerisourceBergen Drug Corporation)	17.3	%	16.4	%	19.1	%


Collaboration partners
Kyowa Kirin	5.9	%	4.3	%	29.0	%

Nature of Operations (Details)	12 Months Ended
Nature of Operations (Details)	Dec. 31, 2025 segment
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Number of operating segments	1