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Income Taxes - Reconciliation Between Statutory Tax Rate and Effective Tax Rate (Detail) - USD ($) $ in Millions | 12 Months Ended
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Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018
Income Tax Disclosure [Abstract] |  |  |
Federal tax at statutory rate | 21.00% | 21.00% | 21.00%
State taxes | 2.60% | 1.80% | 1.70%
Change in valuation allowance | (3.50%) | (357.60%) | (16.40%)
Research and development credit | (5.40%) | (10.90%) | (9.10%)
Orphan drug credit | (1.30%) | 17.10% | (2.70%)
Section 162(m) limitation | 1.70% | 2.70% | 3.10%
Other tax rate changes | 0.20% | (0.50%) | (0.70%)
Other changes in state deferred taxes | 0.00% | 0.00% | 5.90%
Uncertain tax positions | 4.70% | 26.30% | 0.00%
Stock-based compensation | 5.10% | (1.00%) | (3.90%)
Other items | 1.20% | 3.00% | 1.60%
Effective tax rate | 26.30% | (298.10%) | 0.50%
Income Before Income Taxes, Current Year |  |  |
Valuation Allowance [Line Items] |  |  |
Reduction in valuation allowances |  | $ 7.5 |
Income Tax Credit Carryforwards and Uncertain Tax Positions |  |  |
Valuation Allowance [Line Items] |  |  |
Reduction in valuation allowances |  | 10.7 |
Estimated Realizability of Deferred Tax Asset |  |  |
Valuation Allowance [Line Items] |  |  |
Reduction in valuation allowances |  | $ 85.6 |

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