Exagen (XGN) Q4 2025 earnings summary

Executive summary

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

• Test volume grew over 11% in 2025, with 137,000 AVISE CTD tests performed for the year.

• Strategic focus on expanding ASP, upgrading sales force, and launching new biomarkers, including T-cell and RA markers.

• Expanded sales force from 40 to 45 territories, with new hires expected to reach full productivity by mid-2026.

• Expanded leadership with new Chief Scientific Officer and Board member appointments.

Financial highlights

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

• Gross margin for 2025 was 58%–58.3%, up from 54%–55.4% in 2024.

• Adjusted EBITDA loss for 2025 was $9.8–$9.79 million, a moderate improvement over 2024.

• Ended 2025 with $32–$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 an $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 expected to contribute more significantly in late 2026 and beyond.

• Focus on expanding reach across autoimmune disease and addressing high-impact clinical dilemmas.