Exagen Inc.: Q4 FY2025 earnings call

What management said about Q4 FY2025, from the documents filed with the SEC on 10 March 2026: press release. The quarter’s numbers.

Key takeaways

Record full-year revenue reported: The company reported record full-year 2025 revenue of $66.6 million, up 20% from 2024. Source
Net loss and operating loss widened: Full-year net loss was $20.0 million, or $0.93 per share, against $15.1 million in 2024. Loss from operations was $14.1 million, against $13.6 million. Source
AVISE CTD volume grew over 11%: AVISE CTD test volume grew over 11% compared with 2024. Source
ASP rose to $441 per test: Trailing-twelve-month AVISE CTD average selling price reached $441 per test, up $30 or 7% from 2024. Source
Adjusted EBITDA loss narrowed for year: Adjusted EBITDA, a non-GAAP measure, was a loss of $9.8 million for the year, against $10.1 million in 2024. The fourth-quarter loss was $3.7 million, against $2.5 million. Source
Year-end cash of $32 million: Year-end cash and cash equivalents were $32 million, up from $22.0 million at year-end 2024. Source
Plan to widen autoimmune reach: Management said it plans to expand Exagen's reach across autoimmune disease, addressing multiple high-impact clinical dilemmas in a large, underserved market. Source

“Their disciplined execution advanced our operational turnaround and delivered record revenue performance, driven by both test volume growth and gains to ASP.”
John Aballi, President and CEO

Guidance

Area	Period	Figure	Against last quarter
Revenue Source	full-year 2026	$70 million to $73 million

What changed from last quarter

New: Michael Mahler, PhD, was appointed Chief Scientific Officer. Source
New: Chas McKhann was appointed to the Board of Directors. Source
New: The company reported a $20 million public offering of common stock and a $25 million credit facility during 2025. Source
New: The AVISE CTD platform gained a commercial launch of T-Cell and seronegative RA biomarkers, including anti-RA33 and anti-PAD4. Source

Full-year and fourth-quarter results

Record full-year revenue reported: The company reported record full-year 2025 revenue of $66.6 million, up 20% from 2024. Source
Fourth-quarter revenue rose: Fourth-quarter 2025 revenue was $16.6 million, against $13.7 million in the fourth quarter of 2024. Source
Net loss and operating loss widened: Full-year net loss was $20.0 million, or $0.93 per share, against $15.1 million in 2024. Loss from operations was $14.1 million, against $13.6 million. Source

Test volume and pricing

AVISE CTD volume grew over 11%: AVISE CTD test volume grew over 11% compared with 2024. Source
Biomarkers and sales force cited: The release headline credits new biomarkers and sales force expansion for the over 11% full-year test volume growth. Source
ASP rose to $441 per test: Trailing-twelve-month AVISE CTD average selling price reached $441 per test, up $30 or 7% from 2024. Source

“We are clearly building a stronger foundation for long-term, profitable growth and value creation.”
John Aballi, President and CEO

Margins and operating costs

Gross margin 58.3% for the year: Gross margin was 58.3% for full-year 2025 and 55.4% for the fourth quarter. Source
Operating expenses rose on selling costs: Total operating expenses were $52.9 million for the year, against $46.7 million in 2024. Selling, general and administrative expenses were $46.6 million and research and development $6.3 million. Source
Adjusted EBITDA loss narrowed for year: Adjusted EBITDA, a non-GAAP measure, was a loss of $9.8 million for the year, against $10.1 million in 2024. The fourth-quarter loss was $3.7 million, against $2.5 million. Source
Interest and warrant items rose: Interest expense was $4.3 million for the year, up from $2.2 million. A $1.5 million loss on the change in fair value of the warrant liability and a $0.3 million loss on debt extinguishment were also recorded. Source

Cash and balance sheet

Year-end cash of $32 million: Year-end cash and cash equivalents were $32 million, up from $22.0 million at year-end 2024. Source
Non-current borrowings rose: Non-current borrowings, net of discounts and debt issuance costs, were $22.3 million at year-end, up from $19.8 million. Finance lease liabilities totaled $3.1 million including the current portion. Source
Shares outstanding increased: Shares issued and outstanding rose to 22.9 million at year-end 2025 from 17.6 million a year earlier. Source
Accumulated deficit deepened: The accumulated deficit was $314.3 million at year-end 2025, against $294.3 million. Total stockholders' equity was $17.4 million, up from $9.5 million. Source

“Exagen is committed to improving care for autoimmune disease, delivering clarity for patients and confidence for clinicians”
John Aballi, President and CEO

Strategy and platform plans

Plan to widen autoimmune reach: Management said it plans to expand Exagen's reach across autoimmune disease, addressing multiple high-impact clinical dilemmas in a large, underserved market. Source
Cash position supports investment: The January preliminary release said the cash position and disciplined approach give flexibility to keep investing in innovation and in the goal to change the standard of care.
Scientific and commercial teams strengthened: The January preliminary release said the scientific and commercial teams were strengthened during 2025.

Preliminary versus final results

Revenue within preliminary ranges: Final fourth-quarter and full-year revenue fall within the ranges in the January 11, 2026 preliminary release, which gave $16M to $17M for the quarter and $66M to $67M for the year.
ASP at low end of preliminary range: Final trailing-twelve-month ASP of $441 is at the low end of the $441 to $445 range in the preliminary release.
Patient count against preliminary volume: The preliminary release gave AVISE CTD volume of 136,000 to 137,000. The final release cites over 137,000 patients tested by AVISE CTD.

Coming up, as management said on 10 March 2026

Form 10-K expected March 10: The Form 10-K for the year ended December 31, 2025 was expected to be filed with the SEC on March 10, 2026. Source

Figures management reported

Figure	Reported
Patient volumes Source	over 137,000 patients tested by AVISE CTD

Risks management discussed

External: Management cited unexpected ASP headwinds in the second half of 2025 in its January 11, 2026 preliminary release.

Earlier plans management reported on

Met: The January 11, 2026 preliminary results were described as in line with prior financial guidance.
Not stated: The balance sheet was described as positioned to support the company's path to cash flow positivity. Source

Other quarters

Summarised with AI from the documents the company filed with the SEC. Every point is checked against the filing before it is shown: management’s own words word for word, figures against the line or table row they come from. A point that fails the check is left out. Source opens the filing at that line.

As filed with the SEC

Open the filing on EDGAR

Exagen Inc. Reports Strong Fourth Quarter and Full-Year 2025 Results

Record full-year total revenue and AVISE® CTD average selling price

New biomarkers and sales force expansion drove over 11% full-year test volume growth

Carlsbad, Calif., - Exagen Inc. (Nasdaq: XGN), a leading provider of autoimmune testing, today reported financial results for the fourth quarter and full year ended December 31, 2025, and recent business highlights.

	Three Months Ended December 31,	Year Ended December 31,
	2025	2025
(in thousands, except ASP data)
Revenue	$16,631	$66,575
Gross margin	55.4%	58.3%
Operating expenses	$14,181	$52,869
Loss from operations	$(4,975)	$(14,070)
Net loss	$(4,673)	$(19,951)
Adjusted EBITDA	$(3,670)	$(9,794)
Cash, cash equivalents and restricted cash			$32,420
Trailing-twelve-month average selling price (ASP)			$441

2025 Highlights:

Supported the diagnosis and management of care for over 137,000 patients tested by AVISE CTD.
Delivered record total revenue of $66.6 million, an increase of 20% compared to 2024.
Grew AVISE CTD test volume over 11% compared to 2024.
Expanded AVISE CTD trailing twelve-month ASP to $441 per test, an increase of $30 per test, or 7% compared to 2024.
Enhanced the AVISE CTD platform with commercial launch of novel T-Cell and seronegative RA biomarkers, including anti-RA33 and anti-PAD4.
Enriched leadership team through appointment of Michael Mahler, PhD, as Chief Scientific Officer and expanded the Board of Directors with appointment of Chas McKhann.
Positioned balance sheet to support Company's path to cash flow positivity through $20 million public offering of common stock and $25 million credit facility, ending the year with $32 million in cash and cash equivalents.

“Exagen is committed to improving care for autoimmune disease, delivering clarity for patients and confidence for clinicians,” said John Aballi, President and CEO. “I’m incredibly proud of our team’s accomplishments throughout 2025. Their disciplined execution advanced our operational turnaround and delivered record revenue performance, driven by both test volume growth and gains to ASP. We are clearly building a stronger foundation for long-term, profitable growth and value creation. Looking ahead, we plan to expand Exagen’s reach across autoimmune disease, addressing multiple, high-impact clinical dilemmas in one of the largest and most underserved markets in healthcare.”

Financial Outlook

The Company expects full-year 2026 revenue of $70 million to $73 million.

Conference Call

A conference call to review fourth quarter and full-year 2025 financial results is scheduled for today, March 10, 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 March 24, 2026. Interested parties may access the replay by dialing (877) 660-6853 (U.S.) or +1 (201) 612-7415 (international) using passcode 13757484. 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, 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 our 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 our 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 our 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

Forward-looking statements notice

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; 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, expected to be 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.

Statements of Operations

(in thousands, except share and per share amounts)

	Three Months Ended December 31,		Year Ended December 31,
	2025	2024	2025	2024
	(Unaudited)
Revenue	$16,631	$13,655	$66,575	$55,641
Costs of revenue	7,425	5,178	27,776	22,529
Gross profit	9,206	8,477	38,799	33,112
Operating expenses:
Selling, general and administrative expenses	12,424	10,204	46,615	41,373
Research and development expenses	1,757	1,656	6,254	5,375
Total operating expenses	14,181	11,860	52,869	46,748
Loss from operations	(4,975)	(3,383)	(14,070)	(13,636)
Interest expense	(1,330)	(563)	(4,318)	(2,234)
Loss on extinguishment of debt	-	-	(295)	-
Change in fair value of warrant liability	1,602	-	(1,506)	-
Interest income	43	185	289	767
Loss before income taxes	(4,660)	(3,761)	(19,900)	(15,103)
Income tax expense	(13)	-	(51)	(12)
Net loss	$(4,673)	$(3,761)	$(19,951)	$(15,115)
Net loss per share, basic and diluted	$(0.20)	$(0.20)	$(0.93)	$(0.83)
Weighted-average number of shares used to compute net loss per share, basic and diluted	23,575,693	18,427,887	21,558,245	18,203,044

Balance Sheets

(in thousands, except share and per share amounts)

	December 31,
	2025	2024
Assets
Current assets:
Cash and cash equivalents	$32,220	$22,036
Accounts receivable, net	10,855	7,835
Prepaid expenses and other current assets	5,818	6,584
Total current assets	48,893	36,455
Property and equipment, net	6,938	5,283
Operating lease right-of-use assets	1,435	2,401
Other assets	756	550
Total assets	$58,022	$44,689
Liabilities and Stockholders' Equity
Current liabilities:
Accounts payable	$4,153	$4,137
Accrued and other current liabilities	6,327	6,916
Deferred revenue	675	733
Finance lease liabilities, current	1,135	201
Operating lease liabilities, current	1,226	1,096
Borrowings, current	643	423
Total current liabilities	14,159	13,506
Borrowings, non-current, net of discounts and debt issuance costs	22,264	19,822
Finance lease liabilities, non-current	1,960	157
Operating lease liabilities, non-current	438	1,664
Warrant liability	1,752	-
Total liabilities	40,573	35,149
Commitments and contingencies
Stockholders' equity:
Preferred stock, $0.001 par value per share; 10,000,000 share authorized, no shares issued or outstanding at December 31, 2025 and December 31, 2024	-	-
Common stock, $0.001 par value; 200,000,000 shares authorized at December 31, 2025 and December 31, 2024; 22,911,575 and 17,640,328 shares issued and outstanding at December 31, 2025 and December 31, 2024, respectively	23	18
Additional paid-in capital	331,708	303,853
Accumulated deficit	(314,282)	(294,331)
Total stockholders' equity	17,449	9,540
Total liabilities and stockholders' equity	$58,022	$44,689

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 the Company's use of non-GAAP financial measures.

	Three Months Ended December 31,		Twelve Months Ended December 31,
	2025	2024	2025	2024
(in thousands)
Adjusted EBITDA
Net loss	$(4,673)	$(3,761)	$(19,951)	$(15,115)
Interest income	(43)	(185)	(289)	(767)
Interest expense	1,330	563	4,318	2,234
Loss on extinguishment of debt	-	-	295	-
Change in fair value of warrant liability	(1,602)	-	1,506	-
Income tax expense	13	-	51	12
Depreciation and amortization expense	600	415	2,118	1,724
Stock-based compensation expense	705	433	2,158	1,763
Adjusted EBITDA (Non-GAAP)	$(3,670)	$(2,535)	$(9,794)	$(10,149)

Contacts
Tina Jacobsen, CFA ir@exagen.com