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Income Taxes, Reconciliation of Statutory to Effective Tax Rate (Details) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Reconciliation Between Effective and Statutory Tax Rate [Abstract]
Pre-tax loss		$ (76,156)	$ (16,763)	$ (57,466)
Statutory rate		(15,993)	(5,867)	(20,113)
State income tax net of federal benefit		(2,202)	820	95
Foreign		1,735	4,299	0
Net change in valuation allowance	$ 332,100	(277,924)	(86,296)	46,402
Net operating loss expiration		8,864	3,987	0
TEGSEDI licensing gain		59,583	0	0
Tax credits		(73,362)	(32,769)	(26,954)
Deferred tax true-up		9,947	4,848	2,591
Tax rate change		(1,808)	114,832	0
Non-deductible compensation		3,154	1,575	825
Other non-deductible items		(569)	2,548	324
Akcea deconsolidation adjustment at IPO		0	469	0
Stock-based compensation		(4,199)	(14,337)	0
Other		1,633	(89)	(236)
Income tax (benefit) expense		$ (291,141)	$ (5,980)	$ 2,934
Reconciliation Between Effective and Statutory Tax Rate Percentage [Abstract]
Statutory rate		21.00%	35.00%	35.00%
State income tax net of federal benefit		2.90%	(4.90%)	(0.20%)
Foreign		(2.30%)	(25.60%)	0.00%
Net change in valuation allowance		364.90%	514.80%	(80.70%)
Net operating loss expiration		(11.60%)	(23.80%)	0.00%
TEGSEDI licensing gain		(78.20%)	0.00%	0.00%
Tax credits		96.30%	195.50%	46.90%
Deferred tax true-up		(13.10%)	(28.90%)	(4.50%)
Tax rate change		2.40%	(685.00%)	0.00%
Non-deductible compensation		(4.10%)	(9.40%)	(1.40%)
Other nondeductible items		0.70%	(15.20%)	(0.60%)
Akcea deconsolidation adjustment at IPO		0.00%	(2.80%)	0.00%
Stock-based compensation		5.50%	85.50%	0.00%
Other		(2.10%)	0.50%	0.40%
Effective rate		382.30%	35.70%	(5.10%)

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