Quarterly report [Sections 13 or 15(d)]

Commitments and Contingencies - Estimated Contractual Commitments Agreements (Parenthetical) (Details)

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Commitments and Contingencies - Estimated Contractual Commitments Agreements (Parenthetical) (Details) - USD ($)
 3 Months Ended 9 Months Ended
Sep. 30, 2026
Sep. 30, 2025
Sep. 30, 2026
Sep. 30, 2025
Dec. 31, 2025
Other Commitments [Line Items]          
Total commitment $ 132,500,000   $ 132,500,000    
Performance milestones commitment     7,500,000    
Milestone Liability 400,000   400,000    
Prepaid research and development 3,998,159   3,998,159   $ 1,001,993
Clinical research services expenses 14,999,866 $ 7,649,697 39,232,480 $ 23,434,243  
CRO Agreement          
Other Commitments [Line Items]          
Total commitment [1] 132,500,000   132,500,000    
Upfront Payment     6,400,000    
Prepaid research and development 2,800,000   2,800,000    
Clinical research services expenses     3,500,000    
CMO Agreements          
Other Commitments [Line Items]          
Total commitment $ 12,600,000   12,600,000    
Performance milestones commitment     $ 7,500,000    
[1] The total commitment of $132.5 million includes $7.5 million subject to achievement of certain performance milestones associated with IMPROVE-PAH. The amount and timing of any such payments related to the $7.5 million performance milestones are contingent upon the vendor meeting specific criteria. As of September 30, 2026, one milestone of $0.4 million had been achieved and therefore a liability was recognized. The remaining milestones are not considered probable, and the potential payments cannot be reasonably estimated. Accordingly, no liability has been recorded in the accompanying consolidated financial statements for the remaining milestones. The Company will continue to evaluate this arrangement each reporting period and will recognize a liability when achievement of the remaining milestones becomes probable, and the amount can be reasonably estimated.

The estimated remaining contract costs exclude the potential milestone payments. As of September 30, 2026, the Company had a remaining upfront payment balance of $6.4 million to the CROs, of which $2.8 million will be held as a retainer until the end of the study and applied against final invoicing and $3.5 million will be applied to passthrough costs as incurred.