Exagen Inc. — Third Quarter 2026 Earnings Summary

Financial Performance:

• Third quarter 2026 revenue was $18.4 million, a 7% increase compared to $17.2 million in the same period in 2025.
• Year-to-date revenue for the nine months ended September 30, 2026, was $55.7 million, an 11% increase compared to $49.9 million in 2025.
• Gross margin was 58.8% for the quarter, compared to 58.4% in the prior year period; year-to-date gross margin was 59.7% compared to 59.3% in 2025.
• Net loss for the quarter was $6.3 million, a 12% reduction from $7.1 million in the prior year period; year-to-date net loss was $13.5 million, reduced from $15.3 million in 2025.
• Adjusted EBITDA loss for the quarter was $1.9 million, an improvement of over 30% compared to $1.9 million in the prior year period; year-to-date Adjusted EBITDA loss was $4.2 million, improved from $6.1 million in 2025.
• Operating expenses were $15.2 million for the quarter compared to $13.2 million in 2025; year-to-date operating expenses were $42.8 million compared to $38.7 million in 2025.
• Cash and cash equivalents as of September 30, 2026, were $28.1 million, down from $35.7 million as of September 30, 2025.
• Total liabilities were $41.6 million as of September 30, 2026, compared to $40.6 million as of December 31, 2025.
• Borrowings were $22.8 million total ($0.5 million current, $22.4 million non-current) as of September 30, 2026.
• Deferred revenue was $1.4 million as of September 30, 2026, compared to $0.7 million as of December 31, 2025.

Guidance and Future Outlook:

• The company reiterated full-year 2026 revenue guidance of $72 million to $75 million.
• Exagen expects to launch its myositis offering early in 2027.
• An educational webcast regarding the unmet clinical need in myositis and pipeline development is scheduled for December 15, 2026.

Business Segments and Product Lines:

• AVISE CTD trailing twelve-month average selling price (ASP) expanded to $451 per test, an increase of $10 per test compared to the prior year period, marking the 14th consecutive quarter of ASP growth.
• On July 16, 2026, the company acquired assets including rights to technology, software, source code, know-how, and patents for an AI-enabled rheumatology practice workflow-optimization software platform.
• The acquisition resulted in an in-process research and development (IPR&D) charge of $587,000 recognized in the quarter.
• The company presented nine abstracts at the 2026 American College of Rheumatology (ACR) Convergence Conference, including two podium presentations on proprietary T-cell marker disease associations and an analysis of phenotypic patterns across more than 375,000 AVISE CTD tests.

Market and Competitive Landscape:

• The company operates a CLIA-certified, CAP-accredited rheumatology laboratory delivering results to physicians and partners across healthcare and biopharma.
• The AVISE CTD test provides diagnostic clarity for complex autoimmune conditions such as lupus, rheumatoid arthritis, and Sjögren's disease.
• Management highlighted the company's ability to execute against its vision and push the boundaries of traditional autoimmune care.

Risks and Challenges:

• Potential risks include delays in reimbursement and coverage decisions from Medicare and third-party payors, as well as interactions with regulatory authorities.
• Risks include delays in ongoing and planned clinical trials, the potential effects of inflation and tariffs on margins, and changes in laws and regulations.
• Fluctuations in the fair value of warrant liability and the company's ability to obtain additional funding are cited as risks.
• Success depends on attaining and maintaining market acceptance among rheumatologists, patients, and payors, as well as obtaining and maintaining intellectual property protection.

Management Commentary and Tone:

• John Aballi, President and CEO, stated that the third quarter extends a record year for Exagen, with test volume and ASP both ahead of the same period last year.
• Management expressed confidence that the team grew the business and that their science continues to push boundaries in autoimmune care.
• The tone indicates strong execution and a belief that the company is on track to launch new offerings to address significant clinical needs.

Other Key Points:

• The company hosts a webcast on December 15, 2026, to discuss myositis and pipeline development.
• A reconciliation of net loss to non-GAAP adjusted EBITDA is provided, adjusting for items such as stock-based compensation, depreciation, amortization, and changes in fair value of warrant liability.
• The company has 25,420,340 shares of common stock issued and outstanding as of September 30, 2026.
• The company operates under the Nasdaq ticker symbol XGN.