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Segment Information and Concentration of Business Risk, Segment Information (Details)
$ in Thousands
3 Months Ended 5 Months Ended 7 Months Ended 12 Months Ended
Dec. 31, 2017
USD ($)
Sep. 30, 2017
USD ($)
Jun. 30, 2017
USD ($)
Mar. 31, 2017
USD ($)
Dec. 31, 2016
USD ($)
Sep. 30, 2016
USD ($)
Jun. 30, 2016
USD ($)
Mar. 31, 2016
USD ($)
Dec. 31, 2017
USD ($)
Jul. 18, 2017
Dec. 31, 2017
USD ($)
Segment
Dec. 31, 2016
USD ($)
Dec. 31, 2015
USD ($)
Segment Information [Abstract]                          
Number of reportable segments | Segment                     2    
Percentage ownership before IPO                   100.00%      
Percentage of results included in consolidation                   100.00%      
Percentage ownership after IPO                 68.00%        
Commercial Revenue [Abstract]                          
SPINRAZA royalties                     $ 112,540 $ 883 $ 0
Licensing and other royalty revenue                     9,519 19,839 2,343
Total commercial revenue                     122,059 20,722 2,343
R&D revenue under collaborative agreements                     385,607 325,898 281,360
Total segment revenue $ 172,299 $ 120,911 $ 104,152 $ 110,304 $ 160,349 $ 110,927 $ 38,470 $ 36,874     507,666 346,620 283,703
Total operating expenses 173,992 107,002 105,823 96,315 119,194 94,819 87,397 91,526     483,132 392,936 359,465
Income (loss) from operations (1,693) $ 13,909 $ (1,671) $ 13,989 41,155 $ 16,108 $ (48,927) $ (54,652)     24,534 (46,316) (75,762)
Total assets 1,322,024       912,467       $ 1,322,024   1,322,024 912,467  
Operating Segments [Member] | Ionis Core [Member]                          
Commercial Revenue [Abstract]                          
SPINRAZA royalties                     112,540 883  
Licensing and other royalty revenue                     9,519 19,839 2,343
Total commercial revenue                     122,059 20,722  
R&D revenue under collaborative agreements                     384,805 338,546 284,015
Total segment revenue                     506,864 359,268 286,358
Total operating expenses                     373,788 322,192 309,492
Income (loss) from operations                     133,076 37,076 (23,134)
Total assets 1,341,828       1,067,770       1,341,828   1,341,828 1,067,770  
Operating Segments [Member] | Akcea Therapeutics [Member]                          
Commercial Revenue [Abstract]                          
SPINRAZA royalties                     0 0  
Licensing and other royalty revenue                     0 0 0
Total commercial revenue                     0 0  
R&D revenue under collaborative agreements                     55,209 0 0
Total segment revenue                     55,209 0 0
Total operating expenses                     163,871 83,512 52,748
Income (loss) from operations                     (108,662) (83,512) (52,748)
Total assets 268,804       10,684       268,804   268,804 10,684  
Elimination of Intercompany Activity [Member]                          
Commercial Revenue [Abstract]                          
SPINRAZA royalties                     0 0  
Licensing and other royalty revenue                     0 0 0
Total commercial revenue                     0 0  
R&D revenue under collaborative agreements                     (54,407) (12,648) (2,655)
Total segment revenue                     (54,407) (12,648) (2,655)
Total operating expenses                     (54,527) (12,768) (2,775)
Income (loss) from operations                     120 120 $ 120
Total assets $ (288,608)       $ (165,987)       $ (288,608)   $ (288,608) $ (165,987)