Exagen (XGN) Q4 2025 earnings summary

Executive summary

• Achieved record revenue of $66.6 million in 2025, up 20% year-over-year, driven by strong AVISE CTD test volume and higher ASP.

• Test volume grew over 11% in 2025, reaching 137,000 tests, with Q4 marking the highest quarterly volume.

• Strategic focus on innovation, operational discipline, and market access, including new biomarker launches and advocacy from the American College of Rheumatology.

• Expanded sales force to 45 territories, with new hires expected to reach full productivity by mid-2026.

• Enhanced leadership with new Chief Scientific Officer and Board appointments.

Financial highlights

• Full-year 2025 revenue reached $66.6 million, up from $55.6 million in 2024.

• Gross margin improved to 58.3% in 2025, up from 54% in 2024.

• Adjusted EBITDA loss improved to $9.79 million in 2025.

• Ended 2025 with $32.2 million in cash and equivalents, and $43 million including accounts receivable.

• Net loss for 2025 was $19.95 million, compared to $15.12 million in 2024.

Outlook and guidance

• 2026 revenue guidance is $70–$73 million, with high single-digit volume growth and low single-digit ASP growth expected.

• Breakeven Adjusted EBITDA and cash flow expected at ~$80 million revenue run rate, likely in 2027 depending on ASP and volume mix.

• Continued focus on expanding ASP, volume, and product innovation, with a goal to launch one new product annually.

• Structural initiatives and expanded reach across autoimmune disease expected to contribute more significantly in late 2026 and beyond.