Exagen Inc. Reports First Quarter 2026 Results
Rhea-AI Summary
Exagen (Nasdaq:XGN) reported record Q1 2026 revenue of $17.3 million, up 12% year over year, with gross margin of 59.0% and AVISE CTD test volume up 10%.
Trailing-twelve-month AVISE CTD ASP rose 6% to $444. Net loss was $4.0 million and adjusted EBITDA loss improved to $2.2 million. Cash and equivalents were about $22 million. Full-year 2026 revenue guidance remains $70–$73 million.
AI-generated analysis. Not financial advice.
Positive
- Record Q1 2026 revenue of $17.3 million, up 12% year over year
- AVISE CTD test volume grew 10% versus Q1 2025
- Trailing-twelve-month AVISE CTD ASP increased 6% to $444
- Adjusted EBITDA loss improved to $2.2 million from $2.5 million
- Cash and equivalents increased to about $22 million from $11.2 million
- Full-year 2026 revenue guidance maintained at $70–$73 million
Negative
- Q1 2026 operating loss widened slightly to $3.4 million
- Q1 2026 net loss increased to $4.0 million
- Operating expenses rose to $13.6 million from $12.5 million
Market Reaction – XGN
Following this news, XGN has gained 4.41%, reflecting a moderate positive market reaction. Argus tracked a peak move of +14.7% during the session. Our momentum scanner has triggered 20 alerts so far, indicating elevated trading interest and price volatility. The stock is currently trading at $3.08. This price movement has added approximately $3M to the company's valuation. Trading volume is very high at 4.9x the average, suggesting strong buying interest.
Data tracked by StockTitan Argus (15 min delayed). Upgrade to Gold for real-time data.
Key Figures
Market Reality Check
Peers on Argus
XGN was up 0.34% pre-news context while momentum peers were mixed: PRE up 3.16% and PSNL down 3.18%. Broader diagnostics peers in the affinity list also showed both gains and losses, pointing to company-specific rather than sector-driven moves.
Previous Earnings Reports
| Date | Event | Sentiment | Move | Catalyst |
|---|---|---|---|---|
| Jan 11 | Prelim 2025 results | Positive | -6.2% | Preliminary 2025 revenue, volume, ASP and cash all up versus 2024. |
| Nov 04 | Q3 2025 earnings | Positive | -9.0% | Strong Q3 2025 revenue growth, higher ASP and reduced EBITDA loss. |
| Jul 29 | Q2 2025 earnings | Positive | +14.3% | Record Q2 2025 revenue, higher CTD volume and improved gross margin. |
| May 05 | Q1 2025 earnings | Positive | +3.8% | Record Q1 2025 revenue, rising ASP and new credit facility support. |
| Mar 11 | FY 2024 earnings | Positive | +18.3% | Record 2024 revenue with higher gross margin and reduced net loss. |
Earnings releases have often been positive on fundamentals, with three past reports seeing aligned price gains and two showing selloffs despite strong growth metrics.
Over the past year, Exagen has repeatedly reported record or strong results, with revenue climbing from $55.6M in full-year 2024 to $66.6M in 2025 and a trailing ASP rising into the $441 range. Prior earnings in Q1–Q3 2025 highlighted growing AVISE CTD volume, margin expansion, and improving adjusted EBITDA. The current Q1 2026 update, with record quarterly revenue and higher ASP, extends this trajectory and ties back to earlier guidance for 2026 revenue of $70M–$73M.
Historical Comparison
Across five prior earnings-related releases, XGN moved an average of 4.26%. Today’s pre-context move of 0.34% was modest versus typical earnings volatility.
Earnings updates show a progression of rising revenue and AVISE CTD ASP from 2024 through 2025, with guidance pointing to further topline growth into 2026.
Regulatory & Risk Context
An effective Form S-3 shelf dated 2025-06-20 registers up to 1,150,000 warrant shares for resale, tied to a $75 million Perceptive term loan. The company receives no proceeds from resales, only potential cash on warrant exercise, so investors face both potential dilution and high-cost leverage through 2030.
Market Pulse Summary
This announcement reports record Q1 2026 revenue of $17.3M, improved AVISE CTD metrics, and continued guidance for $70M–$73M in 2026 revenue, while losses and adjusted EBITDA remain negative. Historically, earnings releases have produced mixed stock reactions despite growth. Investors may watch how revenue growth, ASP expansion, and cash of $21.5M balance against ongoing losses and the overhang from 1,150,000 registered warrant shares tied to a $75M term loan.
Key Terms
adjusted EBITDA financial
non-GAAP financial measure financial
warrant liability financial
AI-generated analysis. Not financial advice.
Delivers record total revenue and AVISE(R) CTD average selling price
CARLSBAD, Calif., May 11, 2026 (GLOBE NEWSWIRE) -- Exagen Inc. (Nasdaq: XGN), a leading provider of autoimmune testing solutions, today reported financial results for the quarter ended March 31, 2026, and recent corporate updates.
| Three Months Ended March 31, | ||||||||
| 2026 | 2025 | |||||||
| Unaudited. In thousands, except ASP data. | ||||||||
| Revenue | $ | 17,306 | $ | 15,498 | ||||
| Gross margin | 59.0 | % | 58.9 | % | ||||
| Operating expenses | $ | 13,619 | $ | 12,488 | ||||
| Operating loss | $ | (3,414 | ) | $ | (3,365 | ) | ||
| Net loss | $ | (3,967 | ) | $ | (3,752 | ) | ||
| Adjusted EBITDA | $ | (2,160 | ) | $ | (2,508 | ) | ||
| Trailing-twelve-month average selling price (ASP) | $ | 444 | $ | 419 | ||||
| Cash and cash equivalents | $ | 21,513 | $ | 11,194 | ||||
First Quarter 2026 Highlights:
- Achieved record total revenue of
$17.3 million , an increase of12% compared to first quarter 2025. - Grew AVISE CTD test volume
10% compared to first quarter 2025. - Expanded AVISE CTD trailing-twelve-month ASP to
$444 per test, an increase of$25 per test, or6% compared to first quarter 2025. - Delivered an adjusted EBITDA loss of
$2.2 million , an improvement of14% compared to first quarter 2025. - Ended the quarter with approximately
$22 million in cash and cash equivalents, ahead of expectations and consistent with long-standing strategy to hold claims in the first quarter.
“First quarter results establish a solid start to 2026, reflecting our team’s disciplined execution and effective revenue cycle management,” said John Aballi, President and CEO. “Exagen is uniquely committed to providing clarity for autoimmune patients and confidence for clinicians. We have built a foundation to expand our reach and advance innovation in a market with significant unmet need.”
2026 Guidance
The Company continues to expect full-year 2026 revenue of
Conference Call
A conference call to review first quarter financial results is scheduled for today, May 11, 2026, at 8:30 a.m. ET (5:30 a.m. PT). Interested parties may access the conference call by dialing (877) 407-0890 (U.S.), or +1 (201) 389-0918 (international). Additionally, a link to a live webcast of the call will be available in the Investor Relations section of Exagen's website at investors.exagen.com. Participants are asked to join a few minutes prior to the call to register for the event.
A replay of the conference call will be available until May 25, 2026. Interested parties may access the replay by dialing (877) 660-6853 (U.S.) or +1 (201) 612-7415 (international) using passcode 13759736. A link to the replay of the webcast will also be available in the Investor Relations section of Exagen's website.
Use of Non-GAAP Financial Measures (UNAUDITED)
In addition to the financial results prepared in accordance with generally accepted accounting principles in the United States (GAAP), this press release contains the metric adjusted EBITDA, which is not calculated in accordance with GAAP and is a non-GAAP financial measure. Adjusted EBITDA is defined as net loss adjusted for interest income (expense), income tax expense (benefit), depreciation and amortization expense, stock‑based compensation expense, change in fair value of warrant liability, and certain other non‑cash, unusual or non‑recurring items, including, for example, losses on extinguishment of debt and changes in the fair value of warrant liabilities; we do not exclude normal, recurring, cash operating expenses from this measure. Such items could have a significant impact on the calculation of GAAP net loss.
Exagen uses adjusted EBITDA internally because the company believes these metrics provide useful supplemental information in assessing its operating performance reported in accordance with GAAP. Exagen believes adjusted EBITDA may enhance an evaluation of the operating performance because it excludes the impact of prior decisions made about capital investment, financing, investing and certain expenses the company believes are not indicative of the ongoing performance. However, this non-GAAP financial measure may be different from non-GAAP financial measures used by other companies, even when the same or similarly titled terms are used to identify such measures, limiting their usefulness for comparative purposes.
This non-GAAP financial measure is not meant to be considered in isolation or used as a substitute for net loss reported in accordance with GAAP, should be considered in conjunction with the financial information presented in accordance with GAAP, has no standardized meaning prescribed by GAAP, is unaudited, and is not prepared under any comprehensive set of accounting rules or principles. In addition, from time to time in the future, there may be other items that Exagen may exclude for purposes of these non-GAAP financial measures, and the company may in the future cease to exclude items that it has historically excluded for purposes of these non-GAAP financial measures. Likewise, Exagen may determine to modify the nature of adjustments to arrive at these non-GAAP financial measures. Because of the non-standardized definitions of non-GAAP financial measures, the non-GAAP financial measure as used by the company in this press release and the accompanying reconciliation table have limits in their usefulness to investors and may be calculated differently from, and therefore may not be directly comparable to, similarly titled measures used by other companies. Accordingly, investors should not place undue reliance on non-GAAP financial measures.
A reconciliation of net loss to non-GAAP adjusted EBITDA is provided in the financial schedules that are part of this press release.
About Exagen
Exagen Inc. (Nasdaq: XGN) is a leading provider of autoimmune diagnostics, committed to transforming care for patients with chronic and debilitating autoimmune conditions. Based in San Diego County, California, Exagen’s mission is to provide clarity in autoimmune disease decision-making and improve clinical outcomes through its innovative testing portfolio. The company’s flagship product, AVISE® CTD, enables clinicians to more effectively diagnose complex autoimmune conditions such as lupus, rheumatoid arthritis, and Sjögren’s disease earlier and with greater accuracy. Exagen’s CLIA-certified, CAP-accredited laboratory specializes in the testing of rheumatic diseases, delivering precise and timely results, supported by a suite of AVISE-branded tests for disease diagnosis, prognosis, and monitoring. With a focus on research, innovation, education, and patient-centered care, Exagen is dedicated to addressing the ongoing challenges of autoimmune disease management.
For more information, visit Exagen.com or follow Exagen on LinkedIn.
Forward Looking Statements
Exagen cautions you that statements contained in this press release regarding matters that are not historical facts are forward-looking statements. These statements are based on Exagen’s current beliefs and expectations. Such forward-looking statements include, but are not limited to, statements regarding: Exagen’s goals, strategies, positioning, and ambitions; evaluations and judgments regarding financial results and the potential implications of those results, potential future financial and business performance, including any improvements to adjusted EBITDA, ASP, net loss and potential profitability; the potential utility and effectiveness of Exagen’s services and testing solutions; the anticipated benefits of and adoption trajectory for Exagen's recently launched biomarkers; the impact of Exagen's revenue cycle management strategy on the timing of collections and cash burn; potential stockholder value and growth and full-year 2026 guidance. The inclusion of forward-looking statements should not be regarded as a representation by Exagen that any of its plans will be achieved. Actual results may differ from those set forth in this press release due to the risks and uncertainties inherent in Exagen’s business, including, without limitation: delays in reimbursement and coverage decisions from Medicare and third-party payors and interactions with regulatory authorities, and delays in ongoing and planned clinical trials involving its tests; the potential effects of inflation and tariffs on Exagen’s margins; and changes in laws and regulations related to Exagen’s regulatory requirements. Exagen’s commercial success depends upon attaining and maintaining significant market acceptance of its testing products among rheumatologists, patients, third-party payors and others in the medical community; Exagen’s ability to successfully execute on its business strategies; and ability to obtain additional funding; third-party payors not providing coverage and adequate reimbursement for Exagen’s testing products, including Exagen’s ability to collect on funds due; Exagen’s ability to obtain and maintain intellectual property protection for its testing products; regulatory developments affecting Exagen’s business; and other risks described in Exagen’s prior press releases and Exagen’s filings with the Securities and Exchange Commission (SEC), including under the heading “Risk Factors” in Exagen’s Annual Report on Form 10-K for the year ended December 31, 2025, filed with the SEC on March 10, 2026, and any subsequent filings with the SEC. You are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date hereof, and Exagen undertakes no obligation to update such statements to reflect events that occur or circumstances that exist after the date hereof. All forward-looking statements are qualified in their entirety by this cautionary statement, which is made under the safe harbor provisions of the Private Securities Litigation Reform Act of 1995.
Investors:
Tina Jacobsen, CFA
Exagen Inc.
ir@exagen.com
| Exagen Inc. | ||||||||
| Unaudited Condensed Statements of Operations | ||||||||
| (in thousands, except share and per share amounts) | ||||||||
| Three Months Ended March 31, | ||||||||
| 2026 | 2025 | |||||||
| Revenue | $ | 17,306 | $ | 15,498 | ||||
| Cost of revenue | 7,101 | 6,375 | ||||||
| Gross margin | 10,205 | 9,123 | ||||||
| Operating expenses: | ||||||||
| Selling, general and administrative expenses | 12,066 | 11,204 | ||||||
| Research and development expenses | 1,553 | 1,284 | ||||||
| Total operating expenses | 13,619 | 12,488 | ||||||
| Loss from operations | (3,414 | ) | (3,365 | ) | ||||
| Interest expense | (1,267 | ) | (545 | ) | ||||
| Change in fair value of warrant liability | 882 | — | ||||||
| Other income (expense), net | (132 | ) | 158 | |||||
| Loss before income taxes | (3,931 | ) | (3,752 | ) | ||||
| Income tax benefit | (36 | ) | — | |||||
| Net loss | $ | (3,967 | ) | $ | (3,752 | ) | ||
| Net loss per share, basic and diluted | $ | (0.17 | ) | $ | (0.20 | ) | ||
| Weighted-average number of shares used to compute net loss per share, basic and diluted | 23,854,997 | 18,557,390 | ||||||
| Exagen Inc. | ||||||||
| Unaudited Condensed Balance Sheets | ||||||||
| (in thousands, except share and per share amounts) | ||||||||
| March 31, 2026 | December 31, 2025 | |||||||
| Assets | ||||||||
| Current assets: | ||||||||
| Cash and cash equivalents | $ | 21,513 | $ | 32,220 | ||||
| Accounts receivable, net | 15,773 | 10,855 | ||||||
| Prepaid expenses and other current assets | 6,297 | 5,818 | ||||||
| Total current assets | 43,583 | 48,893 | ||||||
| Property and equipment, net | 6,611 | 6,938 | ||||||
| Operating lease right-of-use assets | 1,179 | 1,435 | ||||||
| Other assets | 584 | 756 | ||||||
| Total assets | $ | 51,957 | $ | 58,022 | ||||
| Liabilities and Stockholders' Equity | ||||||||
| Current liabilities: | ||||||||
| Accounts payable | $ | 4,159 | $ | 4,153 | ||||
| Accrued and other current liabilities | 4,772 | 6,327 | ||||||
| Deferred revenue | 681 | 675 | ||||||
| Finance lease liabilities, current | 1,113 | 1,135 | ||||||
| Operating lease liabilities, current | 1,259 | 1,226 | ||||||
| Borrowings, current | 580 | 643 | ||||||
| Total current liabilities | 12,564 | 14,159 | ||||||
| Borrowings, non-current, net of discounts and debt issuance costs | 22,291 | 22,264 | ||||||
| Finance lease liabilities, non-current | 1,792 | 1,960 | ||||||
| Operating lease liabilities, non-current | 111 | 438 | ||||||
| Warrant liability | 767 | 1,752 | ||||||
| Total liabilities | 37,525 | 40,573 | ||||||
| Commitments and contingencies (Note 5) | ||||||||
| Stockholders' equity: | ||||||||
| Preferred stock, | — | — | ||||||
| Common stock, | 24 | 23 | ||||||
| Additional paid-in capital | 332,657 | 331,708 | ||||||
| Accumulated deficit | (318,249 | ) | (314,282 | ) | ||||
| Total stockholders' equity | 14,432 | 17,449 | ||||||
| Total liabilities and stockholders' equity | $ | 51,957 | $ | 58,022 | ||||
Exagen Inc.
Reconciliation of Non-GAAP Financial Measures (UNAUDITED)
The table below presents the reconciliation of adjusted EBITDA, which is a non-GAAP financial measure. See "Use of Non-GAAP Financial Measures (UNAUDITED)" above for further information regarding Exagen's use of non-GAAP financial measures.
| Three Months Ended March 31, | ||||||||
| 2026 | 2025 | |||||||
| (in thousands) | ||||||||
| Adjusted EBITDA | ||||||||
| Net loss | $ | (3,967 | ) | $ | (3,752 | ) | ||
| Other (income) expense | 132 | (158 | ) | |||||
| Interest expense | 1,267 | 545 | ||||||
| Change in fair value of warrant liability | (882 | ) | — | |||||
| Income tax expense (benefit) | 36 | — | ||||||
| Depreciation and amortization expense | 599 | 440 | ||||||
| Stock-based compensation expense | 655 | 417 | ||||||
| Adjusted EBITDA (Non-GAAP) | $ | (2,160 | ) | $ | (2,508 | ) | ||
