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Stock option plans - Stock option activity (Details) - 2019 Equity Incentive Plan - $ / shares
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Dec. 31, 2019
Number of options        
Outstanding, beginning of period 229,308 188,552 174,975  
Granted 96,798 58,980 22,340  
Options assumed in Atrin merger 163,733      
Exercised   (11,319) (8,203)  
Cancelled/Forfeited (9,565) (6,905) (560)  
Outstanding, end of period 480,274 229,308 188,552 174,975
Exercisable 447,721      
Vested or expected to vest 480,274      
Weighted average exercise price per share        
Outstanding, beginning of period (in dollars per share) $ 169.00 $ 182.00 $ 109.80  
Granted (in dollars per share) 31.40 117.40 710.13  
Options assumed in Atrin merger (in dollars per share) 14.21      
Exercised (in dollars per share)   18.40 18.33  
Cancelled/Forfeited (in dollars per share) 118.60 330.60 775.60  
Outstanding, end of period (in dollars per share) 89.49 $ 169.00 $ 182.00 $ 109.80
Exercisable (in dollars per share) 94.41      
Vested or expected to vest (in dollars per share) $ 89.49      
Weighted average remaining contractual term (in years)        
Outstanding 6 years 9 months 18 days 6 years 7 months 6 days 6 years 9 months 18 days 7 years 6 months
Exercisable 6 years 1 month 6 days      
Vested or expected to vest 6 years 9 months 18 days      
Additional Disclosures        
Weighted average grant date fair value of options granted $ 23.68 $ 85.82 $ 484.02