Recent developments include quarterly financial results showing revenue growth alongside net losses, ongoing enhancements to the AVISE® CTD test platform, and operational updates such as a new lease agreement.

• Exagen reported Q2 2026 results with a net loss but revenue growth and gross margin expansion, reflecting increased test volume and average selling price improvements [N1].
• The company held Q1 2026 earnings calls and released transcripts highlighting operational progress and financial results [N2][N3][N4].
• Exagen announced a new lease agreement for office space in Carlsbad, California, commencing May 1, 2027, with a term of 39 months and options to extend [S2].
• The company continues research and development efforts on new biomarker assays, including myositis and lupus nephritis, with clinical validation ongoing [S2].

Exagen's focused portfolio of AVISE® diagnostic tests addresses a growing need for accurate autoimmune disease diagnosis and monitoring, supported by extensive clinical validation. Recent enhancements to its flagship AVISE® CTD test, including new biomarker assays, have contributed to revenue growth and gross margin expansion. The company's specialized sales force and laboratory capabilities support market penetration and customer service. Ongoing research and development efforts targeting additional biomarkers and disease activity assays could expand the product portfolio and clinical utility. Collaborations with pharmaceutical and research organizations may provide additional revenue streams and validation opportunities. The company's liquidity position and secured term loan facility provide resources to support operations and growth initiatives.

Exagen has incurred net losses since inception and continues to operate at a loss, with an accumulated deficit exceeding $321 million as of June 30, 2026. The company's revenue depends heavily on reimbursement from third-party payors, which can be variable and subject to reductions or delays. Supply chain risks exist due to reliance on imported reagents, with potential cost increases that may not be fully passed on to customers, impacting gross margins. The company faces risks related to achieving sufficient market acceptance, reimbursement coverage, and profitability. Operating expenses, including selling, general and administrative costs, have increased, and cash flow from operations remains negative. Failure to raise additional capital or generate sufficient cash from operations could adversely affect the company's ability to execute its business plan and maintain operations.

Exagen's moat is anchored in its specialized focus on autoimmune disease diagnostics, particularly rheumatic and connective tissue diseases, supported by its proprietary AVISE® testing platform. The company's extensive peer-reviewed clinical validation and unique biomarker offerings differentiate its products from traditional screening methods, enabling more accurate and timely diagnosis. Its CLIA-certified and CAP-accredited laboratory infrastructure, combined with a specialized sales force trained to interpret complex test results, enhances customer engagement and clinical utility. Additionally, partnerships with pharmaceutical companies and contract research organizations for testing services and data utilization provide strategic collaboration advantages. The company's intellectual property, including licensed biomarkers and proprietary assays, further strengthens its competitive position in a niche market with significant unmet clinical needs.

• Reimbursement Risk: Exagen's revenue depends on obtaining and maintaining adequate coverage and reimbursement from commercial and government payors. Changes in reimbursement policies or rates could adversely affect revenue and profitability.
• Supply Chain and Cost Risk: The company relies on reagents and materials sourced internationally, including from Germany. Tariffs, trade restrictions, or price increases could raise costs, which may not be fully passed on to customers, impacting margins.
• Operating Losses and Capital Needs: Exagen has a history of net losses and an accumulated deficit. Continued operating losses and negative cash flow may require additional capital, and failure to secure funding could impair operations and growth plans.
• Market Acceptance and Competition: The company's ability to expand test volume and market penetration depends on acceptance by healthcare providers and payors. Competition from alternative diagnostic methods or products could limit growth.

• Exagen Inc. is a medical technology company focused on the design, development, and commercialization of innovative testing products under the AVISE® brand for differential diagnosis, prognosis, and monitoring of complex rheumatic, autoimmune, and autoimmune-related diseases including SLE and RA.
• The flagship product, AVISE® CTD, launched commercially in 2012, enables differential diagnosis for connective tissue diseases and related diseases with overlapping symptoms, addressing limitations of traditional screening methods.
• The company revitalized its senior leadership team in late 2022, adding executives with industry experience in diagnostics, medical devices, and medical technology.
• Exagen operates a CLIA-certified and CAP-accredited laboratory in Vista, California, performing all AVISE® tests with typical reporting within five business days.
• Revenue is primarily derived from sales of AVISE® CTD tests, which accounted for approximately 90% of revenue for the six months ended June 30, 2026.
• Reimbursement for testing services comes from commercial payors, government payors, client payors, and patients, with reimbursement rates varying by product and payor.
• The company has developed and launched enhancements to AVISE® CTD, including SLE and RA biomarker assays and PAD4 biomarker assays, which contribute to average selling price expansion and gross margin improvement.
• Exagen has ongoing research and development efforts targeting myositis biomarkers, lupus nephritis biomarkers, and disease activity assays for SLE and RA, with clinical validation and development in progress.
• The company markets its products through a specialized sales force covering 45 U.S. territories, with personnel trained to interpret test results and engage rheumatologists in tailored discussions.
• Exagen has partnerships with pharmaceutical companies and contract research organizations for use of its testing products and de-identified data.
• Financial snapshot as of June 30, 2026: cash and equivalents of $24.6 million, current assets of $42.9 million, current liabilities of $13.5 million, resulting in a current ratio of 3.18 and a cash ratio of 1.83.
• For the six months ended June 30, 2026, revenue was $37.2 million, net loss was $7.2 million, and basic and diluted EPS were -$0.13 per share.
• The company has incurred net losses since inception with an accumulated deficit of $321.4 million as of June 30, 2026.
• Exagen has a Perceptive Term Loan Facility secured by a first-priority lien on substantially all assets, with $40 million available subject to revenue and other conditions.
• Cash flow from operating activities was negative $6.4 million for the six months ended June 30, 2026, an improvement from prior periods.
• The company entered a new lease agreement in July 2026 for office space in Carlsbad, CA, commencing May 1, 2027, with a term of 39 months and options to extend.
• Revenue growth is driven by increased test volume and average selling price expansion due to new biomarkers and enhanced reimbursement.
• The company faces risks related to reimbursement coverage and rates, supply chain costs including reagents sourced internationally, and the ability to achieve profitability.
• Recent quarterly reports show consistent revenue growth and gross margin expansion alongside operating expense management.
• The company recognizes revenue on an accrual basis using estimates based on historical collections by test and payor, requiring significant management judgment.