Document and Entity Information - shares	9 Months Ended
Document and Entity Information - shares	Sep. 30, 2019	Nov. 01, 2019
Document and Entity Information
Document Type	10-Q
Document Period End Date	Sep. 30, 2019
Entity Registrant Name	Milestone Pharmaceuticals Inc.
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Non-accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	true
Entity Ex Transition Period	true
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		24,493,242
Entity Central Index Key	0001408443
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2019
Document Fiscal Period Focus	Q3
Amendment Flag	false

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Current assets
Cash and cash equivalents	$ 106,501	$ 85,947
Short-term investments (note 3)	30,000	29
Research and development tax credits receivable	456	290
Prepaid expenses	3,517	1,398
Other receivables	497	387
Total current assets	140,971	88,051
Operating lease right-of-use assets (note 2)	593
Property and equipment	328	30
Total assets	141,892	88,081
Current liabilities
Accounts payable and accrued liabilities (note 4)	8,478	4,477
Current portion of operating lease liabilities (note 2)	358
Income taxes payable		56
Total current liabilities	8,836	4,533
Operating lease liabilities (note 2)	224
Total liabilities	9,060	4,533
Convertible Preferred Shares (note 1 and 5)
Convertible preferred shares		138,758
Shareholders’ Equity (Deficit) (note 1 and 5)
Common shares, no par value, unlimited shares authorized, 24,490,742 shares issued and outstanding as of September 30, 2019, 596,787 shares issued and outstanding as of December 31, 2018	226,211	2,039
Additional paid-in capital	3,466	2,655
Cumulative translation adjustment	(1,634)	(1,634)
Accumulated deficit	(95,211)	(58,270)
Total shareholders’ equity (deficit)	132,832	(55,210)
Total liabilities, convertible preferred shares and shareholders’ equity (deficit)	$ 141,892	88,081
Class A1 preferred shares
Convertible Preferred Shares (note 1 and 5)
Convertible preferred shares		2,027
Class A2 preferred shares
Convertible Preferred Shares (note 1 and 5)
Convertible preferred shares		12,643
Class B preferred shares
Convertible Preferred Shares (note 1 and 5)
Convertible preferred shares		17,198
Class C preferred shares
Convertible Preferred Shares (note 1 and 5)
Convertible preferred shares		27,236
Class D1 preferred shares
Convertible Preferred Shares (note 1 and 5)
Convertible preferred shares		64,719
Class D2 preferred shares
Convertible Preferred Shares (note 1 and 5)
Convertible preferred shares		$ 14,935

Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares	9 Months Ended	12 Months Ended
	Sep. 30, 2019	Dec. 31, 2018
Common shares, par value (in dollars per share)	$ 0	$ 0
Common shares, Shares authorized (in shares)	Unlimited	Unlimited
Common shares, Shares issued (in shares)	24,490,742	596,787
Common shares, Shares outstanding (in shares)	24,490,742	596,787
Class A1 preferred shares
Preferred shares, par value (in dollars per share)		$ 0
Preferred shares, Shares authorized (in shares)		Unlimited
Preferred shares, Shares issued (in shares)		372,211
Class A2 preferred shares
Preferred shares, par value (in dollars per share)		$ 0
Preferred shares, Shares authorized (in shares)		Unlimited
Preferred shares, Shares issued (in shares)		2,443,914
Class B preferred shares
Preferred shares, par value (in dollars per share)		$ 0
Preferred shares, Shares authorized (in shares)		Unlimited
Preferred shares, Shares issued (in shares)		2,830,907
Class C preferred shares
Preferred shares, par value (in dollars per share)		$ 0
Preferred shares, Shares authorized (in shares)		Unlimited
Preferred shares, Shares issued (in shares)		3,786,878
Class D1 preferred shares
Preferred shares, par value (in dollars per share)		$ 0
Preferred shares, Shares authorized (in shares)		Unlimited
Preferred shares, Shares issued (in shares)		6,893,236
Class D2 preferred shares
Preferred shares, par value (in dollars per share)		$ 0
Preferred shares, Shares authorized (in shares)		Unlimited
Preferred shares, Shares issued (in shares)		1,223,656

Condensed Consolidated Statements of Loss and Comprehensive Loss - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Operating expenses
Research and development, net of tax credits (note 7)	$ 9,545	$ 3,911	$ 27,836	$ 9,552
General and administrative	2,104	646	4,725	1,834
Commercial	2,076	1,228	6,428	2,329
Loss from operations	(13,725)	(5,785)	(38,989)	(13,715)
Interest income, net of bank charges	821	85	1,993	265
Loss and comprehensive loss before income taxes	(12,904)	(5,700)	(36,996)	(13,450)
Income tax (recovery) expense	(73)		(55)	18
Net loss and comprehensive loss for the period	$ (12,831)	$ (5,700)	$ (36,941)	$ (13,468)
Weighted average number of shares outstanding, basic and diluted (note 1)	24,490,742	282,771	12,848,974	277,917
Net loss per share, basic and diluted (note 6)	$ (0.52)	$ (20.16)	$ (2.87)	$ (48.46)

Condensed Consolidated Statements of Shareholders’ Equity (Deficit) and Convertible Preferred Shares - USD ($) $ in Thousands	Common shares	Class A1 preferred shares	Class A2 preferred shares	Class B preferred shares	Class C preferred shares	Class D1 preferred shares	Class D2 preferred shares	Additional paid-in capital	Cumulative translation adjustment	Accumulated deficit	Total
Balance at the beginning of period at Dec. 31, 2017	$ 1,228							$ 2,372	$ (1,634)	$ (35,085)
Balance at the beginning of period (in shares) at Dec. 31, 2017	239,990
Temporary equity, balance at the beginning of period at Dec. 31, 2017		$ 2,027	$ 12,643	$ 17,195	$ 27,236	$ 0	$ 0
Temporary equity, balance at the beginning of period (in shares) at Dec. 31, 2017		372,211	2,443,914	2,830,907	3,786,878	0	0
Total Equity, Balance at the beginning of period at Dec. 31, 2017											$ 25,985
Increase (Decrease) in Stockholders' Equity and Temporary Equity [Roll Forward]
Net loss and comprehensive loss										(4,181)	(4,181)
Exercise of stock options (note 5)	$ 55							(25)			30
Exercise of stock options (note 5) (in shares)	37,675
Share-based compensation (note 5)								125			125
Balance at the end of period at Mar. 31, 2018	$ 1,283							2,472	(1,634)	(39,266)
Balance at the end of period (in shares) at Mar. 31, 2018	277,665
Temporary equity, balance at the end of period at Mar. 31, 2018		$ 2,027	$ 12,643	$ 17,195	$ 27,236
Temporary equity, balance at the end of period (in shares) at Mar. 31, 2018		372,211	2,443,914	2,830,907	3,786,878
Total Equity, Balance at the end of period at Mar. 31, 2018											21,959
Balance at the beginning of period at Dec. 31, 2017	$ 1,228							2,372	(1,634)	(35,085)
Balance at the beginning of period (in shares) at Dec. 31, 2017	239,990
Temporary equity, balance at the beginning of period at Dec. 31, 2017		$ 2,027	$ 12,643	$ 17,195	$ 27,236	$ 0	$ 0
Temporary equity, balance at the beginning of period (in shares) at Dec. 31, 2017		372,211	2,443,914	2,830,907	3,786,878	0	0
Total Equity, Balance at the beginning of period at Dec. 31, 2017											25,985
Increase (Decrease) in Stockholders' Equity and Temporary Equity [Roll Forward]
Net loss and comprehensive loss											$ (13,468)
Exercise of stock options (note 5)								(32)
Exercise of stock options (note 5) (in shares)											42,781
Share-based compensation (note 5)								289
Balance at the end of period at Sep. 30, 2018	$ 1,297							2,629	(1,634)	(48,555)
Balance at the end of period (in shares) at Sep. 30, 2018	282,771
Temporary equity, balance at the end of period at Sep. 30, 2018		$ 2,027	$ 12,643	$ 17,195	$ 27,236
Temporary equity, balance at the end of period (in shares) at Sep. 30, 2018		372,211	2,443,914	2,830,907	3,786,878
Total Equity, Balance at the end of period at Sep. 30, 2018											$ 12,841
Balance at the beginning of period at Mar. 31, 2018	$ 1,283							2,472	(1,634)	(39,266)
Balance at the beginning of period (in shares) at Mar. 31, 2018	277,665
Temporary equity, balance at the beginning of period at Mar. 31, 2018		$ 2,027	$ 12,643	$ 17,195	$ 27,236
Temporary equity, balance at the beginning of period (in shares) at Mar. 31, 2018		372,211	2,443,914	2,830,907	3,786,878
Total Equity, Balance at the beginning of period at Mar. 31, 2018											21,959
Increase (Decrease) in Stockholders' Equity and Temporary Equity [Roll Forward]
Net loss and comprehensive loss										(3,589)	(3,589)
Exercise of stock options (note 5)	$ 14							(7)			7
Exercise of stock options (note 5) (in shares)	5,106
Share-based compensation (note 5)								79			79
Balance at the end of period at Jun. 30, 2018	$ 1,297							2,544	(1,634)	(42,855)
Balance at the end of period (in shares) at Jun. 30, 2018	282,771
Temporary equity, balance at the end of period at Jun. 30, 2018		$ 2,027	$ 12,643	$ 17,195	$ 27,236
Temporary equity, balance at the end of period (in shares) at Jun. 30, 2018		372,211	2,443,914	2,830,907	3,786,878
Total Equity, Balance at the end of period at Jun. 30, 2018											18,456
Increase (Decrease) in Stockholders' Equity and Temporary Equity [Roll Forward]
Net loss and comprehensive loss										(5,700)	(5,700)
Share-based compensation (note 5)								85			85
Balance at the end of period at Sep. 30, 2018	$ 1,297							2,629	(1,634)	(48,555)
Balance at the end of period (in shares) at Sep. 30, 2018	282,771
Temporary equity, balance at the end of period at Sep. 30, 2018		$ 2,027	$ 12,643	$ 17,195	$ 27,236
Temporary equity, balance at the end of period (in shares) at Sep. 30, 2018		372,211	2,443,914	2,830,907	3,786,878
Total Equity, Balance at the end of period at Sep. 30, 2018											12,841
Balance at the beginning of period at Dec. 31, 2018	$ 2,039							2,655	(1,634)	(58,270)	$ (55,210)
Balance at the beginning of period (in shares) at Dec. 31, 2018	596,787										596,787
Temporary equity, balance at the beginning of period at Dec. 31, 2018		$ 2,027	$ 12,643	$ 17,198	$ 27,236	$ 64,719	$ 14,935				$ 138,758
Temporary equity, balance at the beginning of period (in shares) at Dec. 31, 2018		372,211	2,443,914	2,830,907	3,786,878	6,893,236	1,223,656
Total Equity, Balance at the beginning of period at Dec. 31, 2018											83,548
Increase (Decrease) in Stockholders' Equity and Temporary Equity [Roll Forward]
Net loss and comprehensive loss										(10,452)	(10,452)
Exercise of stock options (note 5)	$ 51							(26)			25
Exercise of stock options (note 5) (in shares)	18,153
Share-based compensation (note 5)								211			211
Balance at the end of period at Mar. 31, 2019	$ 2,090							2,840	(1,634)	(68,722)
Balance at the end of period (in shares) at Mar. 31, 2019	614,940
Temporary equity, balance at the end of period at Mar. 31, 2019		$ 2,027	$ 12,643	$ 17,198	$ 27,236	$ 64,719	$ 14,935
Temporary equity, balance at the end of period (in shares) at Mar. 31, 2019		372,211	2,443,914	2,830,907	3,786,878	6,893,236	1,223,656
Total Equity, Balance at the end of period at Mar. 31, 2019											73,332
Balance at the beginning of period at Dec. 31, 2018	$ 2,039							2,655	(1,634)	(58,270)	$ (55,210)
Balance at the beginning of period (in shares) at Dec. 31, 2018	596,787										596,787
Temporary equity, balance at the beginning of period at Dec. 31, 2018		$ 2,027	$ 12,643	$ 17,198	$ 27,236	$ 64,719	$ 14,935				$ 138,758
Temporary equity, balance at the beginning of period (in shares) at Dec. 31, 2018		372,211	2,443,914	2,830,907	3,786,878	6,893,236	1,223,656
Total Equity, Balance at the beginning of period at Dec. 31, 2018											83,548
Increase (Decrease) in Stockholders' Equity and Temporary Equity [Roll Forward]
Net loss and comprehensive loss											$ (36,941)
Exercise of stock options (note 5)								(26)
Exercise of stock options (note 5) (in shares)											18,153
Share-based compensation (note 5)								837
Balance at the end of period at Sep. 30, 2019	$ 226,211							3,466	(1,634)	(95,211)	$ 132,832
Balance at the end of period (in shares) at Sep. 30, 2019	24,490,742										24,490,742
Temporary equity, balance at the end of period at Sep. 30, 2019		$ 0	$ 0	$ 0	$ 0	$ 0	$ 0
Temporary equity, balance at the end of period (in shares) at Sep. 30, 2019		0	0	0	0	0	0
Total Equity, Balance at the end of period at Sep. 30, 2019											$ 132,832
Balance at the beginning of period at Mar. 31, 2019	$ 2,090							2,840	(1,634)	(68,722)
Balance at the beginning of period (in shares) at Mar. 31, 2019	614,940
Temporary equity, balance at the beginning of period at Mar. 31, 2019		$ 2,027	$ 12,643	$ 17,198	$ 27,236	$ 64,719	$ 14,935
Temporary equity, balance at the beginning of period (in shares) at Mar. 31, 2019		372,211	2,443,914	2,830,907	3,786,878	6,893,236	1,223,656
Total Equity, Balance at the beginning of period at Mar. 31, 2019											73,332
Increase (Decrease) in Stockholders' Equity and Temporary Equity [Roll Forward]
Net loss and comprehensive loss										(13,658)	(13,658)
Share-based compensation (note 5)								276			276
Initial public offering (note 5)	$ 85,363										85,363
Initial public offering (note 5) (in shares)	6,325,000
Preferred share conversion (note 5)	$ 138,758
Preferred share conversion (note 5) (in shares)	17,550,802
Balance at the end of period at Jun. 30, 2019	$ 226,211							3,116	(1,634)	(82,380)
Balance at the end of period (in shares) at Jun. 30, 2019	24,490,742
Temporary equity, balance at the end of period at Jun. 30, 2019		$ (2,027)	$ (12,643)	$ (17,198)	$ (27,236)	$ (64,719)	$ (14,935)
Temporary equity, balance at the end of period (in shares) at Jun. 30, 2019		(372,211)	(2,443,914)	(2,830,907)	(3,786,878)	(6,893,236)	(1,223,656)
Total Equity, Balance at the end of period at Jun. 30, 2019											145,313
Increase (Decrease) in Stockholders' Equity and Temporary Equity [Roll Forward]
Net loss and comprehensive loss										(12,831)	(12,831)
Share-based compensation (note 5)								350			350
Balance at the end of period at Sep. 30, 2019	$ 226,211							$ 3,466	$ (1,634)	$ (95,211)	$ 132,832
Balance at the end of period (in shares) at Sep. 30, 2019	24,490,742										24,490,742
Temporary equity, balance at the end of period at Sep. 30, 2019		$ 0	$ 0	$ 0	$ 0	$ 0	$ 0
Temporary equity, balance at the end of period (in shares) at Sep. 30, 2019		0	0	0	0	0	0
Total Equity, Balance at the end of period at Sep. 30, 2019											$ 132,832

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
Operating activities
Net loss for the period	$ (36,940)	$ (13,469)
Adjustments to reconcile net loss to net cash used in operating activities:
Amortization of property and equipment	14	8
Share-based compensation expense (note 5)	837	289
Changes in operating assets and liabilities:
Other receivables	(110)	(14)
Research and development tax credits receivable	(166)	200
Prepaid expenses	(2,119)	(1,369)
Operating lease, net	(11)
Accounts payable and accrued liabilities	4,001	624
Income taxes payable	(55)	(4)
Net cash used in operating activities	(34,549)	(13,735)
Investing activities
Acquisition of property and equipment	(312)	(5)
Acquisition of short-term investments	(35,000)	(9,000)
Redemption of short-term investments	5,029	16,018
Net cash (used in) provided by investing activities	(30,283)	7,013
Financing activities
Net proceeds from issuance of common shares in Initial Public Offering (note 5)	85,361
Issuance of common shares on exercise of share options (note 5)	25	37
Net cash provided by financing activities	85,386	37
Net increase in cash and cash equivalents during the period	20,554	(6,685)
Cash and cash equivalents – Beginning of period	85,947	10,880
Cash and cash equivalents – End of period	$ 106,501	$ 4,195

Organization and nature of operations	9 Months Ended
Organization and nature of operations	Sep. 30, 2019
Organization and nature of operations
Organization and nature of operations	1 Organization and nature of operations Milestone Pharmaceuticals Inc. (Milestone or the Company) is a Phase 3 clinical-stage biopharmaceutical company incorporated under the Business Corporations Act of Quebec. Milestone is dedicated to developing and commercializing etripamil for the treatment of cardiovascular indications. Etripamil is a novel, potent short-acting calcium channel blocker that the Company designed and is developing as a rapid-onset nasal spray to be administered by the patient to terminate episodes of paroxysmal supraventricular tachycardia as they occur. Reverse stock split On April 26, 2019, the Company’s Board of Directors approved an amendment to the Company’s articles of incorporation to effect a 1-for-5.3193 reverse stock split of the Company’s common shares, convertible preferred shares and the share options of the Company. Accordingly, all common shares, convertible preferred shares, share options and per share amounts in these unaudited interim consolidated financial statements have been retroactively adjusted for all periods presented to give effect to the reverse stock split. The reverse stock split was effected on April 26, 2019. Initial Public Offering On May 13, 2019, the Company completed its initial public offering ("IPO"), whereby the Company issued 5,500,000 common shares at a public offering price of $15.00 per share. The shares began trading on The Nasdaq Global Select Market on May 9, 2019. On May 15, 2019, the underwriters fully exercised their option to purchase an additional 825,000 common shares at the public offering price of $15.00 per share. The gross proceeds received by the Company from the offering were $94.9 million, before deducting underwriting discounts and commissions and other estimated offering expenses payable by the Company. Upon the closing of the IPO, 24,490,742 common shares were outstanding, which included all outstanding shares of Class A1, A2, B, C, D1 and D2 preferred shares that converted into 17,550,802 common shares.

Summary of significant accounting policies

9 Months Ended

Sep. 30, 2019

Summary of significant accounting policies

Summary of significant accounting policies

2 Summary of significant accounting policies

a) Basis of consolidation

The unaudited interim condensed consolidated financial statements include the accounts of the Company and its wholly-owned subsidiary, Milestone Pharmaceuticals USA, Inc. Milestone Pharmaceuticals USA, Inc. began its operations on March 3, 2017. All intercompany transactions and balances have been eliminated.

b) Basis of presentation and use of accounting estimates

These unaudited interim condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America (US GAAP) and on a basis consistent with those accounting principles followed by the Company and disclosed in note 2 of its most recent annual consolidated financial statements, except for the adoption of ASC 842 “Leases” described in c) below. Certain information, in particular the accompanying notes normally included in the annual financial statements prepared in accordance with US GAAP have been omitted or condensed. Accordingly, the unaudited interim condensed consolidated financial statements do not include all the information required for full annual financial statements, and therefore, should be read in conjunction with the annual consolidated financial statements and the notes thereto for the year ended December 31, 2018.

In the opinion of the Company's management, the accompanying unaudited interim condensed consolidated financial statements contain all adjustments, consisting of only normal recurring adjustments, necessary for a fair statement of its financial position as of September 30, 2019, and its results of operations for the three and nine months ended September 30, 2019 and 2018.

The condensed consolidated balance sheet as of December 31, 2018, was derived from audited annual consolidated financial statements, but does not contain all of the footnote disclosures required by accounting principles generally accepted in the United States of America.

These unaudited interim condensed consolidated financial statements are presented in US dollars, which is the Company’s functional currency.

The preparation of unaudited interim condensed consolidated financial statements in conformity with US GAAP requires the Company to make estimates and judgments that affect certain reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the unaudited interim condensed consolidated financial statements and the reported amounts of revenue and expenses during the period. The Company bases its estimates and assumptions on current facts, historical experience and various other factors that it believes are reasonable under the circumstances, to determine the carrying values of assets and liabilities that are not readily apparent from other sources. Significant estimates and judgments include, but are not limited to, research and development tax credits recoverable, research and development expenses, and share-based compensation. Accordingly, actual results may differ from those estimates and such differences may be material.

c) Adoption of New Accounting Standards and New Lease Agreement

Effective January 1, 2019, the Company adopted Accounting Standards Update (ASU) No. 2016-02, “Leases”. This ASU requires substantially all leases to be recorded on the balance sheet as right-of-use asset and lease obligations. The Company elected the package of practical expedients permitted under the transition guidance and applied the modified retrospective approach which allowed the Company to carry forward the historical lease classification. Adoption of this standard resulted in the recording of an operating lease right-of-use asset and corresponding operating lease liabilities of $0.3 million. The Company’s condensed consolidated balance sheets for reporting periods beginning on January 1, 2019 are presented under the new guidance, while prior period amounts were not adjusted and continue to be reported in accordance with previous guidance. Operating lease right-of-use asset and operating lease liabilities are recognized upon the adoption date based on the present value of lease payments over the remaining lease term.

The Company did not record an operating lease right-of-use asset and corresponding lease liability for leases with an initial term of twelve months or less and recognizes lease expense for these leases as incurred over the lease term. Upon adoption date, the Company had only one operating lease with a remaining term of less than 12 months for its offices located in Charlotte, NC, which had a termination date of July 31, 2019, and for which the Company was not reasonably certain of renewing the lease. The lease was extended for two months and terminated in September 2019.

On June 3, 2019, the Company entered into a new lease arrangement for a three-year term for its office located in Charlotte, NC. The Company recognized the operating lease right-of-use asset and operating lease liabilities at the lease commencement date on September 10, 2019. The company was not reasonably certain of renewing the lease following the initial term and recognized the right-of-use asset and operating lease liabilities over the 36-month period ending September 30, 2022.

The Company does not have a public credit rating and carries no debt. As such, several factors were considered in the determination of its incremental borrowing rate used in determining the present value of lease payments. The Company examined the Bloomberg credit ratings for similar companies; assumed equivalency between the Canadian and US markets for collateralized debt; factored in the cumulative dividend rate on convertible preferred shares; and used short-term rates based on the remaining lease term of 23 months upon the standard adoption on January 1, 2019 and on 36 months for the new lease agreement entered into in September 2019. This resulted in an incremental borrowing rate of 8%. Lease expenses are recognized on a straight-line basis over the lease term, which is accomplished by increasing the amortization of the right-of-use asset as interest expense on the lease liability declines over the lease term. The Company’s lease arrangements do not have lease and non-lease components which are accounted for separately. The adoption of the accounting standard did not materially impact the Company’s consolidated statement of operations or its consolidated statement of cash flows for the nine months ended September 30, 2019.

The Company's two operating leases right-of-use assets are as follows as at September 30, 2019:


Right-of-use adoption date of January 1, 2019	$	321
New operating lease right-of-use asset		401
Amortization of right-of-use asset during the nine-month period ending September 30, 2019		(129)
	$	593

Operating lease expenses of $202 are included in general and administrative operating expenses in the consolidated statement loss and comprehensive loss, and within operating activities in the statement of cash flows for the nine-month period ended September 30, 2019, and are comprised of two operating lease right-of-use assets and one operating lease of less than 12 months.

The following table summarizes the future minimum lease payments of right-of-use assets operating lease as at September 30, 2019:


October 1, 2019 to September 30, 2020	$	389
October 1, 2020 to September 30, 2021		131
October 1, 2021 to September 30, 2022		109
		629
Less interest		(47)
	$	582

As at December 31, 2018, the Company had a lease commitment for its headquarters located in Ville Saint-Laurent, Quebec, expiring on November 30, 2020 with an option to renew for an additional three years and a commitment for its office located in Charlotte, North Carolina, which had a termination date of July 31, 2019. The minimum lease payments as at December 31, 2018 were as follows:


	Lease		Lease
	operating		base rent		Total lease
	expenses		expenses		commitment
2019	$	86	$	130	$	216
2020		79		85		164
	$	165	$	215	$	380

Total rental expense under operating leases for the year ended December 31, 2018 was $232.

Accounts payable and accrued liabilities

9 Months Ended

Sep. 30, 2019

Accounts payable and accrued liabilities

Accounts payable and accrued liabilities

4 Accounts payable and accrued liabilities

Accounts payable and accrued liabilities comprised the following:


	September 30, 2019		December 31, 2018
Trade accounts payable	$	3,324	$	2,603
Accrued research and development liabilities		3,580		1,012
Other accrued liabilities		560		164
Accrued compensation and benefits payable		1,014		698
	$	8,478	$	4,477

Shareholders’ equity (deficit)

9 Months Ended

Sep. 30, 2019

Shareholders’ equity (deficit)

Shareholders’ equity (deficit)

5 Shareholders’ equity (deficit)

Authorized share capital

An unlimited number of common shares, voting and participating, without par value.

In May 2019, the Company completed its initial public offering ("IPO"), whereby the Company issued in total 6,325,000 common shares at a public offering price of $15.00 per share (note 1). The gross proceeds received by the Company from the offering were $94.9 million. Upon the closing of the IPO, all outstanding shares of Class A1, A2, B, C, D1 and D2 preferred shares converted into 17,550,802 common shares.

The Company's board of directors adopted and its shareholders approved the 2019 Employee Share Purchase Plan ("ESPP") in April 2019, which became effective on May 8, 2019. The number of common shares initially reserved for issuance under the ESPP was 278,734 common shares. The number of shares reserved for issuance will automatically increase on January 1 of each calendar year, beginning on January 1, 2020 through January 1, 2029, by the lesser of (1) 1% of the total number of shares of the Company's share capital outstanding on the last day of the calendar month before the date of the automatic increase and (2) 487,837 shares; provided that before the date of any such increase, the Company's board of directors may determine that such increase will be less than the amount set forth in clauses (1) and (2). As of September 30, 2019, no common shares have been issued under the ESPP. The first offering period has not yet been decided by the Company's board of directors.

During the nine-month period ended September 30, 2019, the Company issued a total of 18,153 common shares [2018 – 42,781]for a total cash consideration of $25 [2018 - $37] pursuant to the exercise of 18,153 stock options [2018 – 42,781] at an average exercise price of US$1.3225 per option [2018 – US$0.8298]. As a result, an amount of $26 [2018 - $32] previously included in additional paid-in capital related to the exercised options has been credited to share capital and deducted from additional paid-in capital.

Additional paid-in capital


	Three months ended September 30,				Nine months ended September 30,
	2019		2018		2019		2018
Opening balance	$	3,116	$	2,544	$	2,655	$	2,372
Share-based compensation expense		350		85		837		289
Exercise of stock options		—		—		(26)		(32)
Closing balance	$	3,466	$	2,629	$	3,466	$	2,629

Share-based compensation

The Company's board of directors adopted and its shareholders approved the 2019 Equity Incentive Plan (the "2019 Plan") in April 2019, which became effective on May 8, 2019 in connection with the IPO. Initially, the maximum number of the Company's common shares that may be issued under the 2019 Plan is 4,710,564 shares, which is the sum of (1) 1,923,501 new shares, plus (2) the number of shares (not to exceed 2,787,063 shares) (i) that remained available for the issuance of awards under the Company's Stock Option Plan (the "2011 Plan") at the time the 2019 Plan became effective, and (ii) any shares subject to outstanding options or other share awards that were granted under the 2011 Plan that terminate, expire or are otherwise forfeited, reacquired or withheld. In addition, the number of the Company's common shares reserved for issuance under the 2019 Plan will automatically increase on January 1 of each calendar year, starting on January 1, 2020 through January 1, 2029, in an amount equal to 4% of the total number of the Company's capital shares outstanding on the last day of the calendar month before the date of each automatic increase, or a lesser number of shares determined by the Company's board of directors. As of May 8, 2019, the Company's 2011 Plan was terminated and no further option grants will be made under the 2011 Plan.

On October 15, 2018, the Company amended for a third time and restated the 2011 Plan whereby options to purchase common shares of the Company’s shares may be granted to directors, officers, employees, consultants and members of the scientific advisory board. The 2011 Plan was administered by the Board of Directors. The Board of Directors determined the number of options to be granted, the vesting period and the exercise price of new options. It was the Company’s policy to establish the exercise price at an amount that approximated the fair value of the underlying shares on the date of grant as determined by the Board of Directors.

Under the 2011 Plan, unless otherwise decided by the Board of Directors, options vest and are exercisable as follows: 25% are exercisable from the first anniversary of grant date and 2.0833% become available at the end of each month after the first anniversary of grant date.

The 2011 Plan was terminated as of May 8, 2019 and a total of 2,393,631 options are still outstanding at September 30, 2019.

As of September 30, 2019, there were 2,316,933 options available for awards under the 2019 Plan, of which 241,378 were granted, leaving 2,075,555 available for future grants.

The total outstanding and exercisable options from the 2011 Plan and 2019 Plan as at September 30 were as follows:


	2019			2018
		Weighted			Weighted
		average			average
	Number	exercise		Number	exercise
	of shares	price		of shares	price
Outstanding at beginning of period	2,295,045	$	1.7714	968,782	$	1.1330
Forfeited/expired	—		—	(12,198)		1.0958
Granted – 2011 Plan	116,739		9.4152	970,225		1.5745
Granted – 2019 Plan	241,378		20.3400	—		—
Exercised	(18,153)		1.3225	(42,781)		0.8298
Outstanding at end of period	2,635,009	$	3.8141	1,884,028	$	1.3671
Exercisable at end of period	906,994	$	1.4851	691,983	$	1.1064

As of September 30, 2019, the weighted average remaining contractual life was 6.25 [2018 – 6.25 years]. The weighted average remaining contractual life was 6.7 years for vested options [2018 – 7.0 years]. There were no options forfeited for the nine-month period ended September 30, 2019 (2018 –12,198).

Options granted are valued using the Black-Scholes option pricing model. Amortization of the fair value of the options over vesting years has been expensed and credited to additional paid-in capital in shareholders’ equity (deficit). The weighted average fair values of options granted in the nine-month period ended September 30, 2019 was $11.76 per share [2018 - $1.13]. Share-based compensation expense recognized for the nine-month period ended September 30, 2019 was $837 [2018 - $289].

As of September 30, 2019, there was $6,193 [2018 – $1,336] of total unrecognized compensation cost, related to non-vested share options, which is expected to be recognized over a remaining weighted average vesting period of 2.8 years [2018 – 3.1 years].

The non-vested options as at September 30 were as follows:


	2019			2018
		Weighted			Weighted
	Number	average		Number	average
	of options	fair value		of options	fair value
Non-vested share options at beginning of period	1,706,303	$	1.3458	451,113	$	1.0266
Forfeited/expired	—		—	(12,198)		1.0639
Granted – 2011 Plan	116,739		6.6491	970,225		1.1343
Granted – 2019 Plan	241,378		14.2264	—		—
Vested, outstanding	(336,405)	$	1.2104	(217,018)	$	1.0851
Non-vested share options at end of period	1,728,015	$	3.5297	1,192,122	$	1.1011

The fair value of share-based payment transaction is measured using Black-Scholes valuation model. This model also requires assumptions, including expected option life, volatility, risk-free interest rate and dividend yield, which greatly affect the calculated values.

The fair value of options granted was estimated using the Black-Scholes option pricing model, resulting in the following weighted average assumptions for the options granted for the three-month and nine-month periods ended September 30:


	Three months ended September 30,						Nine months ended September 30,
	2019			2018			2019			2018
Exercise price	$	21.63		$	1.91		$	16.78		$	1.57
Share price	$	21.63		$	1.91		$	16.78		$	1.57
Volatility		80	%		82	%		80	%		82	%
Risk-free interest rate		1.54	%		2.77	%		1.94	%		2.77	%
Expected life		6.25			6.25			6.25			6.25
Dividend		0	%		0	%		0	%		0	%

Expected volatility is determined using comparable companies for which the information is publicly available. The risk-free interest rate is determined based on the US sovereign rates benchmark in effect at the time of grant with a remaining term equal to the expected life of the option. Expected option life is determined based on the simplified method as the Company does not have sufficient historical exercise data to provide a reasonable basis upon which to estimate expected term. The simplified method is an average of the contractual term of the options and its ordinary vesting period. Dividend yield is based on the share option’s exercise price and expected annual dividend rate at the time of grant.

The Company recognized share-based compensation expense as follows for the three and nine months ended September 30:


	Three months ended September 30,				Nine months ended September 30,
	2019		2018		2019		2018
Administration	$	194	$	22	$	396	$	72
Research and development		124		53		358		178
Commercial activities		32		10		83		39
	$	350	$	85	$	837	$	289

Net loss per share

9 Months Ended

Sep. 30, 2019

Net loss per share

Net loss per share

6 Net loss per share

Basic and diluted net loss per common share is determined by dividing net loss applicable to common shareholders by the weighted average number of common shares outstanding during the period. The outstanding convertible preferred shares and share-based compensation have been excluded from the calculation because their effects would be anti-dilutive. Therefore, the weighted average number of shares used to calculate both basic and diluted loss per share are the same.

The following potentially dilutive securities have been excluded from the computation of diluted weighted average shares outstanding as of September 30 as they would be anti-dilutive:


	2019	2018
Redeemable convertible preferred shares	—	9,433,910
Share options and unvested restricted share awards	2,635,009	1,884,028
	2,635,009	11,317,938

Amounts in the table above reflect the common share equivalents of the noted instruments.

Fair value of financial instruments	9 Months Ended
Fair value of financial instruments	Sep. 30, 2019
Fair value of financial instruments
Fair value of financial instruments	8 Fair value of financial instruments Pursuant to the accounting guidance for fair value measurement and its subsequent updates, fair value is defined as the price that would be received to sell an asset or paid to transfer a liability (i.e. the exit price) in an orderly transaction between market participants at the measurement date. The accounting guidance establishes a hierarchy for inputs used in measuring fair value that minimizes the use of unobservable inputs by requiring the use of observable market data when available. Observable inputs are inputs that market participants would use in pricing the asset or liability based on active market data. Unobservable inputs are inputs that reflect the assumptions market participants would use in pricing the asset or liability based on the best information available in the circumstances. The fair value hierarchy is broken down into the three input levels summarized below: Level 1 – Valuations are based on quoted prices in active markets for identical assets or liabilities and readily accessible by the Company at the reporting date. Level 2 – Valuations based on inputs other than the quoted prices in active markets that are observable either directly or indirectly in active markets. Level 3 – Valuations based on unobservable inputs in which there is little or no market data, which requires the Company to develop its own assumptions. The Company has determined that the carrying values of its short-term financial assets and liabilities approximate their fair value given the short-term nature of these instruments.

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References + Details

Summary of significant accounting policies (Policies)	9 Months Ended
Summary of significant accounting policies (Policies)	Sep. 30, 2019
Summary of significant accounting policies
Basis of consolidation	a) Basis of consolidation The unaudited interim condensed consolidated financial statements include the accounts of the Company and its wholly-owned subsidiary, Milestone Pharmaceuticals USA, Inc. Milestone Pharmaceuticals USA, Inc. began its operations on March 3, 2017. All intercompany transactions and balances have been eliminated.
Basis of presentation and use of accounting estimates	b) Basis of presentation and use of accounting estimates These unaudited interim condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America (US GAAP) and on a basis consistent with those accounting principles followed by the Company and disclosed in note 2 of its most recent annual consolidated financial statements, except for the adoption of ASC 842 “Leases” described in c) below. Certain information, in particular the accompanying notes normally included in the annual financial statements prepared in accordance with US GAAP have been omitted or condensed. Accordingly, the unaudited interim condensed consolidated financial statements do not include all the information required for full annual financial statements, and therefore, should be read in conjunction with the annual consolidated financial statements and the notes thereto for the year ended December 31, 2018. In the opinion of the Company's management, the accompanying unaudited interim condensed consolidated financial statements contain all adjustments, consisting of only normal recurring adjustments, necessary for a fair statement of its financial position as of September 30, 2019, and its results of operations for the three and nine months ended September 30, 2019 and 2018. The condensed consolidated balance sheet as of December 31, 2018, was derived from audited annual consolidated financial statements, but does not contain all of the footnote disclosures required by accounting principles generally accepted in the United States of America. These unaudited interim condensed consolidated financial statements are presented in US dollars, which is the Company’s functional currency. The preparation of unaudited interim condensed consolidated financial statements in conformity with US GAAP requires the Company to make estimates and judgments that affect certain reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the unaudited interim condensed consolidated financial statements and the reported amounts of revenue and expenses during the period. The Company bases its estimates and assumptions on current facts, historical experience and various other factors that it believes are reasonable under the circumstances, to determine the carrying values of assets and liabilities that are not readily apparent from other sources. Significant estimates and judgments include, but are not limited to, research and development tax credits recoverable, research and development expenses, and share-based compensation. Accordingly, actual results may differ from those estimates and such differences may be material.

Summary of significant accounting policies (Tables)

9 Months Ended

Sep. 30, 2019

Summary of significant accounting policies

Schedule of operating lease right-of-use asset

The Company's two operating leases right-of-use assets are as follows as at September 30, 2019:


Right-of-use adoption date of January 1, 2019	$	321
New operating lease right-of-use asset		401
Amortization of right-of-use asset during the nine-month period ending September 30, 2019		(129)
	$	593

Schedule of minimum lease payments

The following table summarizes the future minimum lease payments of right-of-use assets operating lease as at September 30, 2019:


October 1, 2019 to September 30, 2020	$	389
October 1, 2020 to September 30, 2021		131
October 1, 2021 to September 30, 2022		109
		629
Less interest		(47)
	$	582

Schedule of minimum lease payments

The minimum lease payments as at December 31, 2018 were as follows:


	Lease		Lease
	operating		base rent		Total lease
	expenses		expenses		commitment
2019	$	86	$	130	$	216
2020		79		85		164
	$	165	$	215	$	380

Accounts payable and accrued liabilities (Tables)

9 Months Ended

Sep. 30, 2019

Accounts payable and accrued liabilities

Schedule of accounts payable and accrued liabilities


	September 30, 2019		December 31, 2018
Trade accounts payable	$	3,324	$	2,603
Accrued research and development liabilities		3,580		1,012
Other accrued liabilities		560		164
Accrued compensation and benefits payable		1,014		698
	$	8,478	$	4,477

Shareholders’ equity (deficit) (Tables)

9 Months Ended

Sep. 30, 2019

Shareholders’ equity (deficit)

Schedule of additional paid-in capital


	Three months ended September 30,				Nine months ended September 30,
	2019		2018		2019		2018
Opening balance	$	3,116	$	2,544	$	2,655	$	2,372
Share-based compensation expense		350		85		837		289
Exercise of stock options		—		—		(26)		(32)
Closing balance	$	3,466	$	2,629	$	3,466	$	2,629

Schedule of outstanding and exercisable options

The total outstanding and exercisable options from the 2011 Plan and 2019 Plan as at September 30 were as follows:


	2019			2018
		Weighted			Weighted
		average			average
	Number	exercise		Number	exercise
	of shares	price		of shares	price
Outstanding at beginning of period	2,295,045	$	1.7714	968,782	$	1.1330
Forfeited/expired	—		—	(12,198)		1.0958
Granted – 2011 Plan	116,739		9.4152	970,225		1.5745
Granted – 2019 Plan	241,378		20.3400	—		—
Exercised	(18,153)		1.3225	(42,781)		0.8298
Outstanding at end of period	2,635,009	$	3.8141	1,884,028	$	1.3671
Exercisable at end of period	906,994	$	1.4851	691,983	$	1.1064

Schedule of non-vested share options activity

The non-vested options as at September 30 were as follows:


	2019			2018
		Weighted			Weighted
	Number	average		Number	average
	of options	fair value		of options	fair value
Non-vested share options at beginning of period	1,706,303	$	1.3458	451,113	$	1.0266
Forfeited/expired	—		—	(12,198)		1.0639
Granted – 2011 Plan	116,739		6.6491	970,225		1.1343
Granted – 2019 Plan	241,378		14.2264	—		—
Vested, outstanding	(336,405)	$	1.2104	(217,018)	$	1.0851
Non-vested share options at end of period	1,728,015	$	3.5297	1,192,122	$	1.1011

Schedule of weighted average assumptions for the options granted


	Three months ended September 30,						Nine months ended September 30,
	2019			2018			2019			2018
Exercise price	$	21.63		$	1.91		$	16.78		$	1.57
Share price	$	21.63		$	1.91		$	16.78		$	1.57
Volatility		80	%		82	%		80	%		82	%
Risk-free interest rate		1.54	%		2.77	%		1.94	%		2.77	%
Expected life		6.25			6.25			6.25			6.25
Dividend		0	%		0	%		0	%		0	%

Schedule of share-based compensation expense

The Company recognized share-based compensation expense as follows for the three and nine months ended September 30:


	Three months ended September 30,				Nine months ended September 30,
	2019		2018		2019		2018
Administration	$	194	$	22	$	396	$	72
Research and development		124		53		358		178
Commercial activities		32		10		83		39
	$	350	$	85	$	837	$	289

Net loss per share (Tables)

9 Months Ended

Sep. 30, 2019

Net loss per share

Schedule of potentially dilutive securities excluded from the computation of diluted weighted average shares

The following potentially dilutive securities have been excluded from the computation of diluted weighted average shares outstanding as of September 30 as they would be anti-dilutive:


	2019	2018
Redeemable convertible preferred shares	—	9,433,910
Share options and unvested restricted share awards	2,635,009	1,884,028
	2,635,009	11,317,938

Organization and nature of operations (Details) $ / shares in Units, $ in Millions				1 Months Ended
	May 15, 2019 $ / shares shares	May 13, 2019 $ / shares shares	Apr. 26, 2019	May 31, 2019 USD ($) $ / shares shares	Sep. 30, 2019 shares	Dec. 31, 2018 shares
Organization and nature of operations
Reverse stock split			0.1880
Common shares, Shares outstanding (in shares)					24,490,742	596,787
Initial public offering
Organization and nature of operations
Common shares, Shares outstanding (in shares)		24,490,742
Initial public offering \| Common shares
Organization and nature of operations
Number of shares issued during the period		5,500,000		6,325,000
Share Price \| $ / shares		$ 15.00		$ 15.00
Gross proceeds of initial public offering \| $				$ 94.9
Number of preferred shares converted in to common shares				17,550,802
Underwriters option \| Common shares
Organization and nature of operations
Number of shares issued during the period	825,000
Share Price \| $ / shares	$ 15.00

Summary of significant accounting policies - Adoption of ASU 2016-02 (Details) $ in Thousands	Jan. 01, 2019 USD ($) lease	Sep. 30, 2019 USD ($) lease	Sep. 10, 2019
Adoption of New Accounting Standards
Operating lease right-of use asset	$ 321	$ 593
Operating lease liabilities		582
Lease extended term	2 months
Carrying value of debt		$ 0
Remaining lease term	23 months		36 months
Incremental borrowing rate		8.00%
Charlotte, NC
Adoption of New Accounting Standards
Operating lease, term		3 years
ASU 2016-02, Leases
Adoption of New Accounting Standards
Election of practical expedients package	true
Number of short-term operating leases \| lease		2
ASU 2016-02, Leases \| Charlotte, NC
Adoption of New Accounting Standards
Short-term lease commitment	true
Number of short-term operating leases \| lease	1
ASU 2016-02, Leases \| Adjustment
Adoption of New Accounting Standards
Operating lease right-of use asset	$ 300
Operating lease liabilities	$ 300

Summary of significant accounting policies - Changes in ROU assets (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2019	Jan. 01, 2019
Changes in operating lease right-of-use asset
New operating lease right-of-use asset	$ 401
Amortization of right-of-use asset during the nine-month period ending September 30, 2019	(129)
Operating lease right-of use asset	593	$ 321
Operating lease expenses	$ 202

Summary of significant accounting policies - Future minimum lease payments (Details) $ in Thousands	Sep. 30, 2019 USD ($)
Future minimum lease payments
October 1, 2019 to September 30, 2020	$ 389
October 1, 2020 to September 30, 2021	131
October 1, 2021 to September 30, 2022	109
Total future minimum lease payments	629
Less interest	(47)
Operating lease liability	$ 582

Summary of significant accounting policies - Minimum lease payments under ASU 840 (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Jan. 01, 2019
Operating leases
Renewal of Lease		2 months
Lease operating expenses
2019	$ 86
2020	79
Total	165
Lease base rent expenses
2019	130
2020	85
Total	215
Total lease commitment
2019	216
2020	164
Total	380
Rental expense under operating leases	$ 232
Ville Saint-Laurent, Quebec
Operating leases
Renewal of Lease	3 years

Accounts payable and accrued liabilities (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Accounts payable and accrued liabilities
Trade accounts payable	$ 3,324	$ 2,603
Accrued research and development liabilities	3,580	1,012
Other accrued liabilities	560	164
Accrued compensation and benefits payable	1,014	698
Accounts payable and accrued liabilities	$ 8,478	$ 4,477

Shareholders’ equity (deficit) - Authorized share capital (Details) - USD ($) $ / shares in Units, $ in Thousands		1 Months Ended	9 Months Ended
	May 13, 2019	May 31, 2019	Sep. 30, 2019	Sep. 30, 2018	May 08, 2019
Authorized share capital
Number of shares options exercised			18,153	42,781
Average exercise price (in dollar per share)			$ 1.3225	$ 0.8298
Amount reclassified from APIC to share capital			$ (26)	$ (32)
Initial public offering \| Common shares
Authorized share capital
Number of shares issued during the period	5,500,000	6,325,000
Share Price	$ 15.00	$ 15.00
Gross proceeds of initial public offering		$ 94,900
Number of preferred shares converted in to common shares		17,550,802
Options \| Common shares
Authorized share capital
Number of shares issued upon exercise of options			18,153	42,781
Cash consideration			$ 25	$ 37
Number of shares options exercised			18,153	42,781
Employee Share Purchase Plan 2019 \| Common shares
Authorized share capital
Number of common shares initially reserved for issuance					278,734
Percentage of shares reserved for future issuance			1.00%
Additional shares reserved for issuance			487,837
Number of shares issued under the ESPP			0

Shareholders’ equity (deficit) - Additional paid-in capital (Details) - USD ($) $ in Thousands	3 Months Ended						9 Months Ended
	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Sep. 30, 2019	Sep. 30, 2018
Additional paid-in capital
Balance at the beginning of period			$ (55,210)				$ (55,210)
Share-based compensation expense	$ 350	$ 276	211	$ 85	$ 79	$ 125
Exercise of stock options			25		7	30
Balance at the end of period	132,832						132,832
Additional paid-in capital
Additional paid-in capital
Balance at the beginning of period	3,116	2,840	2,655	2,544	2,472	2,372	2,655	$ 2,372
Share-based compensation expense	350	276	211	85	79	125	837	289
Exercise of stock options			(26)		(7)	(25)	(26)	(32)
Balance at the end of period	$ 3,466	$ 3,116	$ 2,840	$ 2,629	$ 2,544	$ 2,472	$ 3,466	$ 2,629

Shareholders’ equity (deficit) - Share-based compensation (Details) - shares	9 Months Ended
	Sep. 30, 2019	May 08, 2019	May 07, 2019
2011 Plan
Share-based compensation
Total number of shares available for awards under the plan			2,787,063
2011 Plan \| Options \| Share-based Compensation Award, Tranche One
Share-based compensation
Percentage of shares to vest	25.00%
2011 Plan \| Options \| Share-based Compensation Award, Tranche Two
Share-based compensation
Percentage of shares to vest	2.0833%
2019 Plan
Share-based compensation
Total number of shares available for awards under the plan		4,710,564
Number of new shares available for awards under the plan		1,923,501
Percentage of shares reserved for future issuance		4.00%
2019 Plan \| Options
Share-based compensation
Total number of shares available for awards under the plan	2,316,933
Aggregate number of shares granted	241,378
Available for future grants	2,075,555

Shareholders’ equity (deficit) - Share-based compensation - Outstanding and exercisable options (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Outstanding and exercisable options, number of shares
Outstanding at beginning of period			2,295,045	968,782
Forfeited/cancelled				(12,198)
Exercised			(18,153)	(42,781)
Outstanding at end of period	2,635,009	1,884,028	2,635,009	1,884,028
Exercisable at end of period	906,994	691,983	906,994	691,983
Outstanding and exercisable options, weighted average exercise price
Outstanding at beginning of period			$ 1.7714	$ 1.1330
Forfeited/expired				1.0958
Granted			11.76	1.13
Exercised			1.3225	0.8298
Outstanding at end of period	$ 3.8141	$ 1.3671	3.8141	1.3671
Exercisable at end of period	$ 1.4851	$ 1.1064	$ 1.4851	$ 1.1064
Weighted average remaining contractual life (in years)			6 years 3 months	6 years 3 months
Weighted average remaining contractual life for vested options (in years)			6 years 8 months 12 days	7 years
Options forfeited			0	12,198
Share-based compensation expense	$ 350	$ 85	$ 837	$ 289
Unrecognized compensation cost	$ 6,193	$ 1,336	$ 6,193	$ 1,336
Expected period for recognition			2 years 9 months 18 days	3 years 1 month 6 days
2011 Plan
Outstanding and exercisable options, number of shares
Granted			116,739	970,225
Outstanding at end of period	2,393,631		2,393,631
Outstanding and exercisable options, weighted average exercise price
Granted			$ 9.4152	$ 1.5745
Weighted average fair values of options granted			$ 6.6491	$ 1.1343
2019 Plan
Outstanding and exercisable options, number of shares
Granted			241,378
Outstanding and exercisable options, weighted average exercise price
Granted			$ 20.3400
Weighted average fair values of options granted			$ 14.2264

Shareholders’ equity (deficit) - Share-based compensation - Non-vested share options (Details) - $ / shares	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
Number of options
Non-vested at beginning of period	1,706,303	451,113
Forfeited/expired		(12,198)
Vested, outstanding	(336,405)	(217,018)
Non-vested share options at end of period	1,728,015	1,192,122
Weighted average fair value
Non-vested at beginning of period	$ 1.3458	$ 1.0266
Forfeited/expired		1.0639
Vested, outstanding	1.2104	1.0851
Non-vested at end of period	$ 3.5297	$ 1.1011
2011 Plan
Number of options
Granted	116,739	970,225
Weighted average fair value
Granted	$ 6.6491	$ 1.1343
2019 Plan
Number of options
Granted	241,378
Weighted average fair value
Granted	$ 14.2264

Shareholders’ equity (deficit) - Share-based compensation - Weighted average assumptions for the options granted (Details) - Options - $ / shares	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Share-based compensation
Exercise price (in dollars per share)	$ 21.63	$ 1.91	$ 16.78	$ 1.57
Share price (in dollars per share)	$ 21.63	$ 1.91	$ 16.78	$ 1.57
Volatility (as a percent)	80.00%	82.00%	80.00%	82.00%
Risk-free interest rate (as a percent)	1.54%	2.77%	1.94%	2.77%
Expected life (in years)	6 years 3 months	6 years 3 months	6 years 3 months	6 years 3 months
Dividend (as a percent)	0.00%	0.00%	0.00%	0.00%

Shareholders’ equity (deficit) - Share-based compensation - Recognized share-based compensation expense (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Share-based compensation
Share-based compensation expense	$ 350	$ 85	$ 837	$ 289
Administration
Share-based compensation
Share-based compensation expense	194	22	396	72
Research and development
Share-based compensation
Share-based compensation expense	124	53	358	178
Commercial activities
Share-based compensation
Share-based compensation expense	$ 32	$ 10	$ 83	$ 39

Net loss per share (Details) - shares	9 Months Ended
Net loss per share (Details) - shares	Sep. 30, 2019	Sep. 30, 2018
Net loss per share
Potentially dilutive securities excluded from the computation of diluted weighted average shares outstanding	2,635,009	11,317,938
Redeemable convertible preferred shares
Net loss per share
Potentially dilutive securities excluded from the computation of diluted weighted average shares outstanding		9,433,910
Share options and unvested restricted share awards
Net loss per share
Potentially dilutive securities excluded from the computation of diluted weighted average shares outstanding	2,635,009	1,884,028

Short-term investments	9 Months Ended
Short-term investments	Sep. 30, 2019
Short-term investments
Short-term investments	3 Short-term investments Short-term investments are comprised of term deposits issued in US currency, earning interest at 2.47%, maturing between October 1, 2019 and October 25, 2019.

Government assistance	9 Months Ended
Government assistance	Sep. 30, 2019
Government assistance
Government assistance	7 Government assistance The Company incurred research and development expenditures that are eligible for investment tax credits. The investment tax credits recorded are based on management’s estimates of amounts expected to be recovered and are subject to audit by the taxation authorities. These amounts have been recorded as a reduction of research and development expenditures for an amount of $270 for the nine-month period ended September 30, 2019 [2018 - $195].

Short-term investments (Details)	Sep. 30, 2019
Term Deposits \| Minimum
Net Investment Income
Earning interest rate	0.0247%

Government assistance (Details) - USD ($) $ in Thousands	9 Months Ended
Government assistance (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Sep. 30, 2018
Government assistance
Research and development expenditures eligible for investment tax credits	$ 270	$ 195