Exagen (XGN) Q1 2026 earnings summary

Executive summary

• Achieved record Q1 2026 revenue of $17.3 million, up 12% year-over-year, driven by higher ASP and test volume, with gross margin at 59%.

• AVISE CTD test volume grew 10% year-over-year, outpacing the estimated 5% market growth rate.

• Trailing twelve-month ASP for AVISE CTD increased 6% to $444 per test, marking 12 consecutive quarters of ASP growth.

• Adjusted EBITDA loss improved 14% year-over-year to $2.2 million.

• Ended Q1 with $21.5 million in cash and cash equivalents, ahead of expectations.

Financial highlights

• Revenue reached $17.3 million (+12% YoY), with gross margin stable at 59%.

• Operating expenses were $13.6 million, with SG&A at $12.1 million and R&D at $1.6 million, both up year-over-year.

• Net loss was $4.0 million, compared to $3.8 million in Q1 2025; net loss per share improved to $(0.17).

• Adjusted EBITDA loss narrowed to $2.2 million, a 14% improvement year-over-year.

• Pharma Services revenue was approximately $300,000, with a contract backlog exceeding $5 million.

Outlook and guidance

• Full-year 2026 revenue guidance reaffirmed at $70–$73 million, representing 5% to 10% year-over-year growth.

• Guidance assumes high single-digit percent volume growth and low single-digit percent ASP growth versus Q4 2025.

• Gross margin expected to progress to mid-60s over time as scale and ASP expand.

• Management expects continued improvement in adjusted EBITDA and ASP.

• Existing cash and anticipated revenue expected to fund operations for at least the next twelve months.