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Stock-based Compensation - Option activity (Details) - USD ($)
$ / shares in Units, $ in Thousands
3 Months Ended 9 Months Ended 12 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Sep. 30, 2025
Sep. 30, 2024
Dec. 31, 2024
Number of Options          
Outstanding beginning     729,010    
Granted 2,000 0 399,940 3,352  
Exercised     (24,517)    
Forfeited/expired     (109,162)    
Options assumed from Cara upon Merger closing     113,487    
Outstanding ending 1,108,758   1,108,758   729,010
Options exercisable 686,194   686,194    
Vested and expected to vest outstanding 1,108,758   1,108,758    
Weighted-Average Exercise Price          
Weighted-average exercise price outstanding beginning     $ 3.21    
Granted     17.14    
Exercised     21.66    
Forfeited/expired     319.57    
Options assumed from Cara upon Merger closing     319.8    
Weighted-average exercise price outstanding ending $ 9.09   9.09   $ 3.21
Options exercisable 4.85   4.85    
Vested and expected to vest outstanding $ 9.09   $ 9.09    
Weighted-Average Remaining Contractual Term and Intrinsic Value          
Weighted-average remaining contractual term (in years)     6 years 9 months 10 days   6 years 21 days
Options exercisable term     5 years 2 months 23 days    
Vested and expected to vest term     6 years 9 months 10 days    
Outstanding intrinsic value $ 34,081   $ 34,081   $ 2,914
Options exercisable intrinsic value 24,366   24,366    
Vested and expected to vest intrinsic value $ 34,081   $ 34,081