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Income Taxes - Reconciliation of income tax rate (Details)
12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Reconciliation of the income tax benefit      
Statutory tax rate 21.00% 21.00% 21.00%
State tax, net of federal benefit 10.24% 9.83% 7.45%
Research and development credit 0.65% 0.78% 2.94%
Orphan drug credit 3.37% 2.15% 7.58%
Stock compensation (1.37%) (0.29%) (1.05%)
Other (0.48%) (0.04%) (0.47%)
Rate changes (6.52%)    
Change in valuation allowance (27.10%) (33.44%) (37.45%)
Effective tax rate (0.21%)