Exagen Inc. 2026 Q1 – Results – Earnings Call Presentation – Image for illustrative purposes only (Image credits: Unsplash)
Exagen Inc. reported its strongest first-quarter results to date on May 11, 2026, with total revenue reaching $17.3 million. The figure represents a 12 percent increase from the same period last year and reflects continued adoption of the company’s autoimmune diagnostic tests. Executives highlighted steady gross margins and an improved path toward profitability during the earnings call.
Revenue and Margin Performance
The company achieved the revenue milestone primarily through higher test volumes and better pricing discipline. Gross margin held steady at 59 percent, matching the prior year’s level and indicating effective cost control in laboratory operations.
Operating expenses rose modestly to $13.6 million, yet the adjusted EBITDA loss narrowed to $2.2 million, a 14 percent improvement year over year. Net loss for the quarter came in at approximately $4.0 million, slightly wider than the $3.8 million reported in Q1 2025 due to higher interest costs.
Operational Metrics and Growth Drivers
AVISE CTD test volume increased 10 percent compared with the first quarter of 2025. The trailing twelve-month average selling price for the test rose to $444, up $25 or 6 percent from the prior year. Ordering clinicians grew 15 percent to more than 2,700, expanding the company’s reach among rheumatologists and other specialists.
Cash and cash equivalents stood at $21.5 million at quarter end, ahead of internal expectations. Management attributed the stronger cash position to disciplined claims management and timing of collections.
| Metric | Q1 2026 | Q1 2025 | Change |
|---|---|---|---|
| Revenue | $17.3M | $15.5M | +12% |
| Gross Margin | 59.0% | 58.9% | +0.1 pts |
| Adjusted EBITDA Loss | $2.2M | $2.5M | -14% |
| AVISE CTD ASP (TTM) | $444 | $419 | +6% |
| Cash & Equivalents | $21.5M | $11.2M | +92% |
Full-Year Outlook Remains Unchanged
Exagen reaffirmed its 2026 revenue guidance of $70 million to $73 million. The company continues to focus on three priorities: broadening product adoption, optimizing revenue cycle management, and advancing diagnostic innovations that address unmet clinical needs.
With the first quarter now complete, management expressed confidence that execution remains on track. The results position Exagen to build on recent momentum while maintaining a measured approach to spending and cash preservation.
