Exagen Inc. (XGN) Q1 2026 Earnings Call Transcript – Image for illustrative purposes only (Image credits: Pixabay)
Exagen Inc. reported record revenue of $17.3 million for the first quarter of 2026, marking a 12 percent increase from the same period a year earlier. The autoimmune diagnostics company achieved this result even after early-quarter weather disruptions affected operations. Executives pointed to higher test volumes and stronger reimbursement execution as the main drivers behind the performance.
Financial Performance at a Glance
The quarter showed steady progress on several key measures. Gross margin held at 59 percent, while the adjusted EBITDA loss narrowed to $2.2 million, a 14 percent improvement from the prior year. Net loss came in at approximately $4.0 million. Cash and cash equivalents stood at $21.5 million at quarter end. A comparison of the main metrics illustrates the year-over-year shift:
| Metric | Q1 2026 | Q1 2025 |
|---|---|---|
| Revenue | $17.3 million | $15.5 million |
| Gross Margin | 59% | 59% |
| Adjusted EBITDA Loss | $2.2 million | $2.5 million |
These figures reflect disciplined cost management alongside revenue growth.
Operational Drivers Behind the Results
Volume for the flagship AVISE CTD test rose 10 percent compared with the first quarter of 2025. The number of ordering clinicians expanded 15 percent to more than 2,700. Average selling price on a trailing twelve-month basis improved to $444 per test, up 6 percent from the prior year. Revenue cycle improvements and collection of older claims contributed more than $900,000 to the quarter. The gains occurred in a competitive market for autoimmune testing. Exagen continues to focus on expanding adoption among rheumatologists and health systems.
Full-Year Outlook Remains Unchanged
Management reaffirmed its 2026 revenue guidance of $70 million to $73 million. The company expects continued volume growth and further gains in average selling price to support that target. No changes were made to operating expense or cash-burn expectations. Stakeholders, including investors and clinicians, now have a clearer view of the pace of the turnaround that began under current leadership in late 2022.
Positioning for Continued Momentum
Exagen’s results demonstrate that operational improvements are translating into measurable financial progress. The company remains focused on its core AVISE portfolio for differential diagnosis and monitoring of rheumatic diseases. With cash reserves strengthened and guidance intact, the firm enters the remainder of 2026 with a solid foundation for execution.
