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Significant Accounting Policies, Basic and Diluted Net Loss per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands | 3 Months Ended |
--- | --- | ---
Mar. 31, 2021 | Mar. 31, 2020 | Dec. 31, 2020
Basic Net Loss per Share [Abstract] |  |  |
Basic net loss per share (in dollars per share) | $ (0.64) | $ (0.28) |
Net loss | $ (89,869) | $ (39,628) |
Net income (loss) available to Ionis common shareholders |  | $ (39,706) |
Weighted average shares outstanding (in shares) | 140,770 | 139,429 |
0.125 Percent Convertible Senior Notes [Member] |  |  |
Basic Net Loss per Share [Abstract] |  |  |
Interest rate on convertible senior notes | 0.125% |  | 0.125%
1 Percent Convertible Senior Notes [Member] |  |  |
Basic Net Loss per Share [Abstract] |  |  |
Interest rate on convertible senior notes | 1.00% |  | 1.00%
Ionis [Member] |  |  |
Basic Net Loss per Share [Abstract] |  |  |
Net loss |  | $ (7,032) |
Akcea [Member] |  |  |
Basic Net Loss per Share [Abstract] |  |  |
Percentage ownership | 100.00% |  |
Net loss |  | $ (32,674) |
Akcea [Member] | Common Stock [Member] |  |  |
Basic Net Loss per Share [Abstract] |  |  |
Weighted average shares owned in Akcea (in shares) |  | 77,095 |
Basic net loss per share (in dollars per share) |  | $ (0.42) |
Net loss |  | $ (32,674) |

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