8-K: Exagen Reports Record Q3 Revenue, Narrows Losses

Exagen Inc. announced record third-quarter 2025 revenue of $17.2 million, a 38% increase year-over-year, alongside improved operating and adjusted EBITDA losses.

Summary

• Reported record total revenue of $17.2 million for Q3 2025, representing a 38% increase compared to the third quarter of 2024, or a 26% increase before the impact of one-time adjustments recorded in 2024.
• AVISE CTD test volume grew 16% compared to the third quarter of 2024.
• Expanded AVISE CTD trailing twelve-month average selling price (ASP) to $441 per test, an increase of $37 per test over the third quarter of 2024.
• Operating loss improved to $(3.1) million in Q3 2025 from $(4.7) million in Q3 2024.
• Adjusted EBITDA improved to $(1.9) million in Q3 2025 from $(4.0) million in Q3 2024.
• Net loss worsened to $(7.1) million in Q3 2025 from $(5.0) million in Q3 2024.
• Cash and cash equivalents stood at $35.7 million as of September 30, 2025, up from $30.0 million in the second quarter of 2025.
• Commercially launched seronegative RA markers for anti-PAD4, the latest enhancement to the AVISE CTD panel.
• Reiterated full-year 2025 revenue guidance of between $65 million and $70 million.
• Expects to achieve positive adjusted EBITDA in the fourth quarter of 2025 at the high end of the revenue range.

Sentiment

Score: 7

Explanation: The company reported strong revenue growth, improved operating metrics (operating loss, adjusted EBITDA), and a healthy cash position. The launch of new diagnostic markers and positive outlook for Q4 2025 contribute to a positive sentiment, despite a worsening net loss which is common for growth-stage companies investing in R&D and expansion.

Positives

• Achieved record total revenue of $17.2 million in Q3 2025, a 38% increase year-over-year.
• AVISE CTD test volume increased by 16% compared to Q3 2024.
• Trailing twelve-month AVISE CTD average selling price (ASP) grew to $441, an increase of $37 per test from Q3 2024.
• Operating loss significantly improved to $(3.1) million in Q3 2025 from $(4.7) million in Q3 2024.
• Adjusted EBITDA improved to $(1.9) million in Q3 2025 from $(4.0) million in Q3 2024.
• Cash and cash equivalents increased to $35.7 million at September 30, 2025, up from $22.0 million at September 30, 2024, and $30.0 million in Q2 2025.
• Commercially launched seronegative RA markers for anti-PAD4, enhancing the AVISE CTD panel.
• Presented six abstracts at the American College of Rheumatology Conference, including progress on a lupus nephritis platform.

Negatives

• Net loss worsened to $(7.087) million in Q3 2025 compared to $(5.028) million in Q3 2024.
• Net loss for the nine months ended September 30, 2025, worsened to $(15.278) million compared to $(11.354) million for the same period in 2024.
• Operating expenses increased to $13.175 million in Q3 2025 from $11.644 million in Q3 2024.
• Interest expense increased to $1.319 million in Q3 2025 from $0.562 million in Q3 2024.
• Change in fair value of warrant liability resulted in a $(2.670) million loss in Q3 2025.

Risks

• Delays in reimbursement and coverage decisions from Medicare and third-party payors, and interactions with regulatory authorities.
• Delays in ongoing and planned clinical trials involving its tests.
• Potential effects of inflation and tariffs on margins.
• Changes in laws and regulations related to regulatory requirements.
• Commercial success depends upon attaining and maintaining significant market acceptance of testing products among rheumatologists, patients, third-party payors, and others in the medical community.
• Ability to successfully execute on business strategies.
• Ability to obtain additional funding.
• Third-party payors not providing coverage and adequate reimbursement for testing products, including the ability to collect on funds due.
• Ability to obtain and maintain intellectual property protection for testing products.
• Regulatory developments affecting the business.

Future Outlook

The company reiterates its full-year 2025 revenue guidance of between $65 million and $70 million. Management expects to achieve positive adjusted EBITDA in the fourth quarter of 2025, particularly if revenue reaches the high end of the guidance range.

Management Comments

• "Delivered record total revenue of $17.2 million, representing a 38% increase compared to the third quarter of 2024, or a 26% increase before the impact of one-time adjustments recorded in 2024."
• "Grew AVISE CTD test volume 16% compared to the third quarter of 2024."
• "Expanded AVISE CTD trailing twelve-month ASP to $441 per test, an increase of $37 per test over the third quarter of 2024."
• "Ended the third quarter of 2025 with $35.7 million in cash and cash equivalents, up from $30.0 million in the second quarter of 2025."
• "At the end of Q3, commercially launched seronegative RA markers for anti-PAD4, the latest enhancement to the AVISE CTD panel."
• "Presented six abstracts at the American College of Rheumatology Conference, including a plenary presentation related to the continued development of a lupus nephritis platform."

Industry Context

Exagen operates in the growing autoimmune diagnostics market, which is driven by increasing prevalence of autoimmune diseases and demand for earlier, more accurate diagnosis. The launch of new markers for seronegative RA and continued development of a lupus nephritis platform indicate a focus on expanding its diagnostic capabilities and market reach within this specialized sector. The company's growth in test volume and ASP suggests strong demand for its AVISE CTD product, positioning it favorably against competitors in the autoimmune testing space.

Comparison to Industry Standards

• NA

Stakeholder Impact

• Shareholders: Positive revenue growth, improved operating performance, and a strong cash position could lead to increased shareholder value. The worsening net loss might be a concern but is offset by adjusted EBITDA improvement and future outlook.
• Customers (Clinicians/Patients): Launch of seronegative RA markers and continued development of lupus nephritis platform offer enhanced diagnostic tools, potentially leading to better patient outcomes and increased utility for clinicians.
• Employees: Continued growth and product development suggest a stable and potentially expanding work environment.
• Creditors: Improved adjusted EBITDA and strong cash balance indicate a healthier financial position, potentially reducing credit risk.

Next Steps

• Continue development of the lupus nephritis platform.
• Achieve full-year 2025 revenue between $65 million and $70 million.
• Aim for positive adjusted EBITDA in Q4 2025, especially at the high end of revenue guidance.

Key Dates

Recommendation

The company demonstrated robust top-line growth with record revenue and significant increases in test volume and average selling price, indicating strong market adoption for its diagnostic solutions. While net loss widened, the substantial improvement in operating loss and adjusted EBITDA suggests a positive trend towards profitability, especially with the Q4 2025 positive adjusted EBITDA guidance. The strong cash position provides financial stability for continued innovation and market expansion, such as the recent launch of new RA markers. These factors, combined with a reiterated optimistic full-year guidance, present a compelling investment case for long-term growth.

Keywords

Autoimmune Diagnostics, Exagen, XGN, AVISE CTD, Rheumatology, Lupus, Rheumatoid Arthritis, Sjogren's Disease, Financial Results, Q3 2025 Earnings, Medical Diagnostics, Clinical Laboratory