Slide 1: Accelerating personalized medicine in autoimmune disease
Accelerating personalized medicine Patient Focused. Discovery Driven. in autoimmune disease Q1 2026 UPDATE | MAY 11, 2026
Slide 2: Disclaimer
Disclaimer This presentation and all oral statements made by Exagen Inc.'s ("Exagen" or the "Company") officers, directors or employees in connection with this presentation contains forward-Jooking statements within the meaning of the Private Securities Litigation Reform Act of 1995 that involve ris
Slide 3: Identifying autoimmune disease is a challenge…
Identifying autoimmune disease is a challenge… Ambiguous symptoms >41M 3 Manifestations overlap AMERICANS ANA+ Americans ~1M diagnosed with lupus1 Outdated tech, testing delays Tests lack specificity, sensitivity With ANA+: antinuclear antibody ~2M rheumatoid arthritis2 High rate of misdiagnosis pos
Slide 4: The patient challenge: diagnosis is prolonged
THE PATIENT CHALLENGE Diagnosis is Lupus diagnosis prolonged can take ~6 years 1 despite the need for INCLUDING: timely intervention… 15 Doctor visits1 58 Lab procedures1 Rheumatoid arthritis diagnosis can take ~2 years 2 4 Different physicians consulted3 4 1. Bruce IN, O’Keeffe AG, Farewell V, et a
Slide 5: Earlier intervention improves outcomes
THE PATIENT CHALLENGE Earlier intervention improves outcomes 25% Reduction in lupus-related hospitalization with earlier treatment1 LUPUS 1.5x Reduction in lupus mortality risk related to irreversible organ damage2 within RHEUMATOID Inflammation will lead to articular damage ARTHRITIS & bone erosion
Slide 6: Conventional biomarkers are not specific to one disease
THE CLINICAL CHALLENGE CONVENTIONAL AUTOIMMUNE BIOMARKERS Systemic sclerosis Rheumatoid arthritis Conventional centromere ACPA dsDNA biomarkers are DNA-topoisomerase I histone Sm not specific to RNA-topoisomerase III NOR90 nucleosome C1q Fc of IgG Th/To one disease Pm/Scl Ku SSa RNP ribosomal P Jo1
Slide 7: AVISE Testing: the simple, clear choice for rheumatologists
OUR PROPRIETARY SOLUTION 2 tubes of patient’s blood AVISE Testing: the simple, clear choice for Rheumatologist Exagen rheumatologists lab >1.2M AVISE CTD report Tests completed • Comprehensive panel aids autoimmune disease diagnosis Simple | Proven | Trusted • Proprietary markers • Algorithmic inter
Slide 8: AVISE testing outperforms conventional biomarkers
OUR PROPRIETARY SOLUTION AVISE testing ® 100% TEST SENSITIVITY FOR LUPUS outperforms 80% conventional 80% Conventional markers 66% biomarkers 60% 1 44% 40% 33% 20% 14% Better diagnostic accuracy for 0% the >41M Americans with ANA+ anti-Smith anti-dsDNA C3/C4 CB-CAPs MAP 8 1. Source: Putterman, et al
Slide 9: Demonstrated clinical benefit at scale
Demonstrated clinical benefit at scale Peer-reviewed Capstone Publication highlights improvements to patient care 6x Greater likelihood of lupus diagnosis ~22K ~23K AVISE® Lupus- tested patients vs Conventionally tested patients 3x Higher likelihood of starting treatment, which reduces risk of hospi
Slide 10: Experienced Leadership
Experienced Chief Executive Officer Chief Financial Officer Leadership John Aballi Jeff Black Track records of success in diagnostics Medical & Lab Director Chief Scientific Officer Prashanti Reddy, MD Michael Mahler, PhD Prashanti Reddy, MD Board adds deep industry expertise Tina S. Nova PhD Ana Ho
Slide 11: Prioritizing objectives to deliver long-term, profitable growth
FINANCIAL UPDATE Q1 2026 Prioritizing objectives to deliver long-term, profitable growth 1 ADVANCE ADOPTION 2 EXPAND ASP 3 INNOVATE • Upgrade & expand sales force • Improve RCM & market access • Invest in high-potential projects • Support science with evidence • Engage with payers • Create new produ
Slide 12: Volume growth has resumed
1 ADVANCE ADOPTION Volume growth has resumed VOLUME GROWTH DRIVERS 140 • Earning market share with demonstrated clinical differentiation 135 S TR ATE G I C in autoimmune disease testing* VOLUME (IN 000’S) E MP HAS I S O N AS P 130 • Emphasizing & generating clinical support 125 • Upgrading talent fo
Slide 13: Singular commitment to autoimmune diagnostic clarity is driving adoption
1 ADVANCE ADOPTION Singular commitment to autoimmune diagnostic clarity is driving adoption DIFFERENTIATED ADDRESSING A GROWING OPPORTUNITY Bringing better science, more timely results and unmatched service to the >$2B clinicians serving some of medicine’s * ~3% toughest-to-diagnose patients Estimat
Slide 14: Robust clinical validation for AVISE
1 ~50 ADVANCE ADOPTION Robust clinical validation for AVISE Peer-reviewed clinical publications & abstracts Drives Changes Improves Predictive Outperforms Single-Time Reduces Earlier Clinical Real-World Accuracy Standard Accuracy Costs Diagnosis & Decisions Outcomes Over Time Testing Treatment n 794
Slide 15: Execution is delivering ASP growth
2 EXPAND ASP Execution is delivering ASP growth TTM ASP REVENUE DRIVERS $80 $500 TTM $ASP • Improving RCM • Strategic exit of unprofitable $60 $425 business • Launching new biomarkers $40 $350 • Engaging medical directors REVENUE ($M) and payers with evidence $20 $275 • Expect LCD to contribute when
Slide 16: AVISE enhancements contribute to ASP
2 EXPAND ASP AVISE enhancements contribute to ASP + Enhanced AVISE CTD for lupus + Strengthened AVISE CTD with T-cell markers* with additional RA markers* • Improves sensitivity • Anti-RA33 and anti-PAD4 improve sensitivity for Rheumatoid Arthritis • T-cell autoantibodies rarely present in patients
Slide 17: Pipeline prioritizes innovation with impact
3 INNOVATE Pipeline prioritizes innovation with impact Discover Assay developed Algorithmic Clinical validity Reimbursement Commercialized markers to CLIA standards discovery* & utility AVISE CTD CTD expansion: RA33 & T-Cell CTD expansion: PAD4 Myositis RA disease activity Lupus Nephritis (urine) PR
Slide 18: Positioning to advance Myositis testing
3 INNOVATE Positioning to advance Myositis testing Launch of first new standalone product will address channel’s top request ARDUOUS, POORLY UNDERSTOOD DISEASE DIAGNOSTIC DILEMMA >100K 80% U.S. disease of clinicians rely on standard prevalence testing to treat patients but lack confidence in the res
Slide 19: Q1'26 Results Summary
FINANCIAL UPDATE Q1 2026 Q1’26 Results Summary KEY METRICS Q1’25 Q1’26 Change Revenue $15.5M $17.3M +12% Volume -- -- +10% TTM ASP $419 $444 +6% Adjusted EBITDA* ($2.5M) ($2.2M) +14% 19 *Numbers may not foot due to rounding. Reference appendix for non-GAAP and Adjusted EBITDA reconciliations
Slide 20: Balance Sheet Highlights
FINANCIAL UPDATE Q1 2026 Balance Sheet Highlights Runway to execute growth strategy and fund business to positive free cash flow $30M $77M Available debt capital for strategic opportunities * $37M Cash, cash equivalents & AR Cash, AR, and future credit capacity $10M Available debt capital for operat
Slide 21: FY 2026 Revenue Outlook
FINANCIAL UPDATE Q1 2026 FY 2026 Revenue Outlook Expect continued volume expansion while navigating transitory ASP headwind $70M to $73M • 5% to 10% revenue growth YoY • Volume: High-single digit % growth • ASP: Low-single digit % growth compared to Q4 2025 exit rate 21. | Guidance as of May 11, 202
Slide 22: Appendix
Appendix Patient Focused. Discovery Driven. 22
Slide 23: AVISE Lupus outperforms conventional biomarkers
OUR SCIENCE AVISE® lupus outperforms conventional biomarkers 1 Demonstrated 80% sensitivity | 98% specificity against healthy individuals TEST SENSITIVITY FOR LUPUS RECEIVER OPERATING CURVE (ROC) FOR SLE DIAGNOSIS1 80% 100% 80% Conventional markers 66% 60% AUC= SENSITIVITY SENSITIVITY overall test 4
Slide 24: AVISE CTD test result report
OUR SCIENCE AVISE CTD test result report Page 1 includes AVISE Lupus and additional SLE biomarkers Pages 2 and 3 contain a comprehensive antibody profile including novel including TC4d and autoantibodies to T Cells anti-RA33 and anti-PAD4 biomarkers Rheumatoid Arthritis Value Interpretation Systemic
Slide 25: Extensive, long-term I.P. protection
OUR SCIENCE Extensive, Patent Families long-term • AVISE: cell-bound complement activation product for diagnosing SLE - 2032 I.P. protection • AVISE : treating & diagnosing likelihood of SLE - 2034 • Lupus nephritis biomarkers - 2045 • Use of T-cell autoantibodies + CB-CAPs in diagnosis 17 Patents i
Slide 26: Financial impact of progress
Financial impact of progress Positioning organization for profitable long-term growth WHAT WE’VE DONE: 2022 to 2024 2025 AVERAGE • RCM: Expanding ASP Revenue growth 5% 20% • Sales force: Restructured, now expanding • Organization: Upgraded talent + culture Volume growth (1%) 11% • R&D: Refocused pip
Slide 27: Path to Breakeven AEBITDA & Cash Generation
Path to Breakeven AEBITDA & Cash Generation Expect inflection at FY revenue of ~$80M and ~63% gross margin $100 REVENUE $90 27 TOTAL COSTS $80M $80 $70 $60 OPEX ($M) $50 40% GROSS MARGIN 45% 50% 55% 63% 60% 65% 70% 75% 27 |. *Reference appendix for non-GAAP and Adjusted EBITDA reconciliations
Slide 28: Use of Non-GAAP Financial Measures
Use of Non-GAAP Financial Measures UNAUDITED 28
Slide 29: Cap Table
Cap Table AS OF MAY 2026 24.2M TOP 25 SHAREHOLDERS 1 JOREY CHERNETT 2,613,901 2 Tullis Health Investors, Inc. 1,789,287 3 H.I.G Capital LLC (Private Equity) 1,696,252 4 Parian Global Management LP 1,292,000 LOAN WARRANTS 5 Sun Mountain Capital Advisors, LLC 1,169,058 6 ABALLI JOHN, CEO 880,235 Princ
Slide 30: Reconciliation of Non-GAAP Financial Measures
Reconciliation of Non-GAAP Financial Measures UNAUDITED This table presents the reconciliation of adjusted EBITDA, which is a non- GAAP financial measure. See previous slide for further information regarding the Company’s use of non-GAAP financial measures. 30