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Intangible assets and goodwill - Definite-lived Intangibles (Details) - USD ($)
$ in Thousands
 3 Months Ended
Mar. 31, 2025
Mar. 31, 2024
Dec. 31, 2024
Definite-lived intangible assets      
Accrued royalties $ 7,305   $ 8,953
Definite-lived intangibles      
Amortization (3,798) $ (51,530)  
Finite-Lived Intangible Assets, Net $ 118,448    
Weighted Average      
Definite-lived intangible assets      
Remaining amortization period 8 years 10 months 24 days    
Akcea | Waylivra      
Definite-lived intangible assets      
Royalty payments $ 1,800    
Akcea | Waylivra | Accounts payable and accrued expenses      
Definite-lived intangible assets      
Accrued royalties 1,600    
Akcea | Tegsedi      
Definite-lived intangible assets      
Royalty payments 900    
Akcea | Tegsedi | Accounts payable and accrued expenses      
Definite-lived intangible assets      
Accrued royalties 700    
Definite-lived intangible assets      
Definite-lived intangibles      
Beginning balance - Definite-lived assets, Gross 148,314    
Additions 2,669    
Foreign Currency Translation 1,221    
Ending balance - Definite-lived assets, Gross 152,204    
Beginning balance - Accumulated amortization (29,520)    
Amortization (3,798) $ (51,500)  
Foreign Currency Translation - Accumulated amortization (438)    
Ending balance - Accumulated amortization (33,756)    
Finite-Lived Intangible Assets, Net 118,448    
Definite-lived intangible assets | Waylivra      
Definite-lived intangibles      
Beginning balance - Definite-lived assets, Gross 12,397    
Additions 1,791    
Foreign Currency Translation 495    
Ending balance - Definite-lived assets, Gross 14,683    
Beginning balance - Accumulated amortization (5,273)    
Amortization (540)    
Foreign Currency Translation - Accumulated amortization (212)    
Ending balance - Accumulated amortization (6,025)    
Definite-lived intangible assets | Kebilidi      
Definite-lived intangibles      
Beginning balance - Definite-lived assets, Gross 10,731    
Ending balance - Definite-lived assets, Gross 10,731    
Beginning balance - Accumulated amortization (112)    
Amortization (224)    
Ending balance - Accumulated amortization (336)    
Definite-lived intangible assets | Upstaza      
Definite-lived intangibles      
Beginning balance - Definite-lived assets, Gross 106,937    
Ending balance - Definite-lived assets, Gross 106,937    
Beginning balance - Accumulated amortization (18,526)    
Amortization (2,228)    
Ending balance - Accumulated amortization (20,754)    
Definite-lived intangible assets | Tegsedi      
Definite-lived intangibles      
Beginning balance - Definite-lived assets, Gross 18,249    
Additions 878    
Foreign Currency Translation 726    
Ending balance - Definite-lived assets, Gross 19,853    
Beginning balance - Accumulated amortization (5,609)    
Amortization (806)    
Foreign Currency Translation - Accumulated amortization (226)    
Ending balance - Accumulated amortization $ (6,641)