Exagen (XGN) posts record Q1 2026 revenue and higher AVISE CTD pricing

Rhea-AI Filing Summary

Exagen Inc. reported first quarter 2026 results showing record revenue and higher test pricing but continued losses. Revenue rose to $17.3 million, up 12% from 2025, with gross margin at 59.0%. AVISE CTD test volume grew 10% and trailing-twelve-month average selling price increased to $444 per test.

Net loss was $4.0 million, or $0.17 per share, slightly wider than a year ago, while adjusted EBITDA loss improved to $2.2 million. The company ended the quarter with $21.5 million in cash and cash equivalents and reaffirmed full-year 2026 revenue guidance of $70–73 million.

Insights

Life sciences equity analyst

Exagen posted double-digit revenue growth and better EBITDA, but remains unprofitable.

Exagen delivered Q1 2026 revenue of $17.3 million, up 12% year over year, driven by a 10% increase in AVISE CTD test volume and a higher trailing-twelve-month average selling price of $444 per test.

Profitability remains a challenge. Net loss widened modestly to $3.97 million, though adjusted EBITDA loss improved to $2.16 million from $2.51 million, reflecting operating leverage despite higher operating expenses of $13.6 million. Interest expense also increased to $1.27 million, partially offset by a positive warrant liability revaluation.

The balance sheet shows $21.5 million in cash and cash equivalents and total liabilities of $37.5 million as of March 31, 2026. Management reiterated full-year 2026 revenue guidance of $70–73 million, so upcoming quarters will indicate whether current volume and pricing trends are sufficient to sustain that range.

8-K Event Classification

2 items: 2.02, 9.01

2 items

Item 2.02 Results of Operations and Financial Condition Financial

Disclosure of earnings results, typically an earnings press release or preliminary financials.

Item 9.01 Financial Statements and Exhibits Exhibits

Financial statements, pro forma financial information, and exhibit attachments filed with this report.

Key Figures

Q1 2026 revenue: $17.3 million Revenue growth: 12% year over year Net loss: $3.97 million +5 more

8 metrics

Q1 2026 revenue $17.3 million Revenue for the three months ended March 31, 2026

Revenue growth 12% year over year Increase vs. Q1 2025 revenue of $15.5 million

Net loss $3.97 million Net loss for Q1 2026

Net loss per share $0.17 per share Basic and diluted, Q1 2026

Adjusted EBITDA -$2.16 million Non-GAAP adjusted EBITDA for Q1 2026

Gross margin 59.0% Gross margin in Q1 2026 vs. 58.9% in Q1 2025

Cash and cash equivalents $21.5 million Cash position as of March 31, 2026

2026 revenue guidance $70–73 million Full-year 2026 revenue outlook

Key Terms

adjusted EBITDA, trailing-twelve-month average selling price, warrant liability, CLIA-certified, +1 more

5 terms

adjusted EBITDA financial

"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"

Adjusted EBITDA is a way companies measure how much money they make from their core operations, like running a business, by removing certain costs or income that aren’t part of regular business activities. It helps investors see how well a company is doing without distractions from unusual expenses or gains, making it easier to compare companies or track performance over time.

trailing-twelve-month average selling price financial

"Trailing-twelve-month average selling price (ASP) | | $ | 444 | | | $ | 419"

warrant liability financial

"Change in fair value of warrant liability | | 882 | | | —"

Warrant liability is the financial obligation a company records when it grants warrants—special options giving the holder the right to buy company shares at a set price in the future. It matters to investors because changes in this liability can affect a company's reported earnings and overall financial health, similar to how a pending contract can influence a company's future value.

CLIA-certified technical

"Exagen’s CLIA-certified, CAP-accredited laboratory specializes in the testing of rheumatic diseases"

CLIA-certified means a laboratory has passed U.S. federal standards for performing tests on human samples, showing its results are accurate, reliable and timely. For investors this matters because certification is often required to sell clinical test services, bill insurers, win hospital or physician partnerships and avoid regulatory penalties — much like a restaurant passing a health inspection or a car getting a safety sticker before it can be sold.

CAP-accredited technical

"Exagen’s CLIA-certified, CAP-accredited laboratory specializes in the testing of rheumatic diseases"

Cap-accredited means a laboratory or diagnostic service has been inspected and certified by the College of American Pathologists (CAP) for meeting rigorous standards in testing accuracy, quality control, staff qualifications and reporting. For investors, CAP accreditation signals that the lab’s results are more reliable and that the operation meets a well-recognized regulatory benchmark, which can reduce clinical and regulatory risk and support market trust and reimbursement; think of it like a high-score health inspection for a restaurant.

Earnings Snapshot

Revenue: $17.3 million · Guidance included

Q1 2026

Revenue $17.3 million +12% YoY

Net loss $3.97 million vs. $3.75 million prior year

Adjusted EBITDA -$2.16 million improved from -$2.51 million

AVISE CTD ASP $444 per test +6% vs. prior year

Guidance

Full-year 2026 revenue expected to be between $70 million and $73 million.

Understanding 8-K Material Events →

0001274737FALSE00012747372026-05-112026-05-11

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

FORM 8-K

CURRENT REPORT

Pursuant to Section 13 or 15(d)

of the Securities Exchange Act of 1934

Date of Report (Date of earliest event reported): May 11, 2026

EXAGEN INC.

(Exact name of registrant as specified in its charter)

Delaware

001-39049

20-0434866

(State or other jurisdiction of incorporation)

(Commission File Number)

(IRS Employer Identification No.)

1261 Liberty Way

Vista, CA 92081

(Address of principal executive offices) (Zip Code)

(760) 560-1501

(Registrant’s telephone number, including area code)

N/A

(Former Name or Former Address, if Changed Since Last Report)

Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions:

☐			Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)
☐			Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)
☐			Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))
☐			Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))

Securities registered pursuant to Section 12(b) of the Act:

Title of each class

Trading Symbol(s)

Name of each exchange on which registered

Common Stock, par value $0.001 per share

XGN

The Nasdaq Global Market

Indicate by check mark whether the registrant is an emerging growth company as defined in Rule 405 of the Securities Act of 1933 (§230.405 of this chapter) or Rule 12b-2 of the Securities Exchange Act of 1934 (§240.12b-2 of this chapter). Emerging growth company ☐

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐

Item 2.02. Results of Operations and Financial Condition.

On May 11, 2026, the Company reported its financial results for the three months ended March 31, 2026. A copy of the press release issued by the Company is furnished as Exhibit 99.1 to this report.

The information furnished with Item 2.02 of this report, including Exhibit 99.1, is being furnished and shall not be deemed “filed” for purposes of Section 18 of the Securities Exchange Act of 1934, as amended (the “Exchange Act”), or otherwise subject to the liabilities of that section, nor shall it be deemed incorporated by reference into any other filings under the Exchange Act or under the Securities Act of 1933, as amended, whether made before or after the date hereof, regardless of any general incorporation language in such filing, except as shall be expressly set forth by specific reference in such a filing.

Item 9.01. Financial Statements and Exhibits.

(d) Exhibits

Exhibit No.						Description
99.1						Press Release dated May 11, 2026
104						Cover Page Interactive Data File (embedded within the Inline XBRL document)

SIGNATURES

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.

EXAGEN INC.

Date: May 11, 2026

By:

/s/ Jeffrey G. Black

Jeffrey G. Black

Chief Financial Officer

Exagen Inc. Reports First Quarter 2026 Results

Delivers record total revenue and AVISE(R) CTD average selling price

May 11, 2026

Carlsbad, Calif., – 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 of 12% 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, or 6% compared to first quarter 2025.

•Delivered an adjusted EBITDA loss of $2.2 million, an improvement of 14% 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 $70 million to $73 million.

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, $0.001 par value; 10,000,000 shares authorized, no shares issued or outstanding as of March 31, 2026 and December 31, 2025						—						—
Common stock, $0.001 par value; 200,000,000 shares authorized as of March 31, 2026 and December 31, 2025; 24,088,057 and 22,911,575 shares issued and outstanding as of March 31, 2026 and December 31, 2025, respectively						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)

FAQ

How did Exagen (XGN) perform financially in Q1 2026?

Exagen generated $17.3 million in revenue in Q1 2026, up 12% year over year, with a 59.0% gross margin. The company reported a net loss of $3.97 million and an adjusted EBITDA loss of $2.16 million, showing some operating improvement.

What were Exagen (XGN)’s key operating highlights for Q1 2026?

Exagen achieved record total revenue, grew AVISE CTD test volume by 10%, and increased AVISE CTD trailing-twelve-month ASP to $444 per test. Adjusted EBITDA loss improved by 14% versus Q1 2025, reflecting better operating efficiency despite higher expenses.

What guidance did Exagen (XGN) provide for full-year 2026 revenue?

Exagen continues to expect full-year 2026 revenue of $70 million to $73 million. This range reflects management’s outlook based on current volume, pricing, and reimbursement trends across its autoimmune testing portfolio, including its flagship AVISE CTD test and recently launched biomarkers.

How did Exagen’s profitability and margins trend in Q1 2026?

Exagen posted a net loss of $3.97 million and an adjusted EBITDA loss of $2.16 million in Q1 2026. Gross margin was 59.0%, slightly above 58.9% a year earlier, while operating expenses rose to $13.6 million, keeping the company in loss-making territory.

What is Exagen (XGN)’s cash position and balance sheet profile after Q1 2026?

As of March 31, 2026, Exagen held $21.5 million in cash and cash equivalents and total assets of $52.0 million. Total liabilities were $37.5 million, including $22.9 million of borrowings, resulting in $14.4 million of stockholders’ equity.

How does Exagen (XGN) define and use adjusted EBITDA?

Exagen’s adjusted EBITDA starts from net loss and adds back interest, taxes, depreciation, amortization, stock-based compensation, warrant liability changes, and certain non-recurring or non-cash items. Management uses it internally to assess operating performance alongside GAAP results, while cautioning investors about its limitations.

Filing Exhibits & Attachments

4 documents

Press Releases

• EX-99.1 EX-99.1 116.0 KB

Other Documents

• EX-101 XBRL TAXONOMY EXTENSION SCHEMA DOCUMENT 1.7 KB
• EX-101 XBRL TAXONOMY EXTENSION LABEL LINKBASE DOCUMENT 21.1 KB
• EX-101 XBRL TAXONOMY EXTENSION PRESENTATION LINKBASE DOCUMENT 12.2 KB