Exagen Inc. · NASDAQ:XGN
Exagen — Q1 2025 Earnings Presentation
28 slides from Exagen's earnings presentation, May 5, 2025
Slide 1: Accelerating personalized medicine in autoimmune disease
Accelerating personalized medicine Patient Focused. Discovery Driven. in autoimmune disease MAY 2025
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-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995 that involve ris
Slide 3: Highlights
HIGHLIGHTS Proprietary solutions for diagnosis, prognosis & monitoring of autoimmune disease Improving care for an underserved patient Patient Focused. Discovery Driven. population with a clinically validated platform Highly regarded management team positioning the business for long-term success Str
Slide 4: Identifying autoimmune disease is a challenge…
Identifying autoimmune disease is a challenge… Ambiguous symptoms >41M AMERICANS ANA+ Manifestations overlap ~1M Americans diagnosed with lupus1 Outdated tech, testing delays With Tests lack specificity, sensitivity ~2M rheumatoid arthritis2 ANA+: antinuclear antibody High rate of misdiagnosis posit
Slide 5: The Patient Challenge
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 5 1. Bruce IN, O’Keeffe AG, Farewell V, et a
Slide 6: 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 Inflammation will lead to articular damages Rheumatoid & bone erosion without
Slide 7: Conventional Autoimmune Biomarkers
THE CLINICAL CHALLENGE Conventional Autoimmune Biomarkers Systemic sclerosis Rheumatoid Conventional arthritis centromere dsDNA ACPA 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 8: AVISE Testing: the simple, clear choice for rheumatologists
2 tubes of OUR PROPRIETARY SOLUTION patient’s blood AVISE Testing: the simple, clear choice for Rheumatologist Exagen rheumatologists lab 1M+ AVISE CTD report Tests completed • Comprehensive panel aids Simple | Proven | Trusted autoimmune disease diagnosis • Proprietary markers • Algorithmic interpr
Slide 9: AVISE Testing outperforms conventional biomarkers
OUR PROPRIETARY SOLUTION TEST SENSITIVITY FOR LUPUS AVISE Testing outperforms 100% 80% conventional 80% Conventional markers 66% biomarkers 1 60% 44% 40% 33% 20% 14% Better diagnostic accuracy for 0% the >41M Americans with ANA+ anti-Smith anti-dsDNA C3/C4 CB-CAPs MAP 1. Source: Putterman, et al., L
Slide 10: Demonstrated clinical benefit at scale
Demonstrated clinical benefit at scale Peer-reviewed capstone publication highlights impact to patient care ~22K AVISE® CTD-tested ~23K Conventionally 6x Greater likelihood of lupus diagnosis vs patients tested patients 3x Higher likelihood of starting treatment, which reduces risk of hospitalizatio
Slide 11: Innovation expands the AVISE platform
Innovation expands the AVISE platform Enhancing AVISE CTD for lupus Strengthening AVISE CTD with T-cell markers with additional RA markers • Improves sensitivity • Improves sensitivity for Rheumatoid Arthritis • T-cell autoantibodies rarely present in patients (RA) with other autoimmune rheumatic di
Slide 12: Financial Profile
Financial Profile 12
Slide 13: Positioning for profitable long-term growth
Positioning for profitable long-term growth 2-YEAR SCORECARD 2024 vs 2022 S T R A TEGIC I N I TIATI VES 22% Revenue growth 45% ASP growth 2x Improvement in • Maximize ASP by improving revenue-cycle sales productivity practices • Build on robust adoption • Right-size operations to reduce expenses & c
Slide 14: ASP expansion fueling revenue growth
ASP expansion fueling revenue growth REVENUE & TTM ASP $60 $420 $400 • Enhanced billing & collection processes $50 $380 $360 • Revamped appeal process REVENUE($M) $40 $340 ASP $320 $30 • Increased patient payment responsibility $300 $20 $280 • Discontinued programs that promoted $260 unprofitable bu
Slide 15: Path to Cash Flow Positive
Path to Cash Flow Positive Clear line of sight to inflection point at FY revenue of $75M + gross margin of 60% $110 $100 REVENUE $75M $90 TOTAL COSTS ($M) $80 $70 $60 OPEX $50 $40 $30 40% 45% 50% Gross Margin 55% 60% 60% 65% 70% 75% 15
Slide 16: Results Summary
Results Summary KEY METRICS FY’23 FY’24 Change Q1’24 Q1’25 Change Revenue $52.5M $55.6M 6% $14.5 $15.5M 7.5% TTM ASP $336 $411 $75 $377 $419 $42 Adjusted EBITDA ($17.1M) ($10.1M) 41% ($2.0M) ($2.5M) -26% Net loss ($23.7M) ($15.1M) 36% ($3.4M) ($3.8M) -12% 16 Reference appendix for non-GAAP and adjus
Slide 17: Experienced Leadership Team
Experienced CHIEF CHIEF EXECUTIVE FINANCIAL OFFICER OFFICER Leadership John Aballi Jeff Black Team brings track records of success in diagnostics CHIEF MEDICAL VP OF MEDICAL & LAB SALES OFFICER DIRECTOR Mike Prashanti Nerenberg, MD Reddy, MD J.R. Weed Tina S. Nova PhD Ana Hooker Bruce Robertson, PhD
Slide 18: Catalysts Ahead
Accelerating personalized medicine in autoimmune disease Patient Focused. Discovery Driven. CATALYSTS AHEAD New biomarkers ASP & gross Adjusted EBITDA Pipeline products earning awareness & margin expanding positive by year- targeting high advancing platform end 2025 customer needs
Slide 19: Appendix
Appendix
Slide 20: R&D Pipeline
R&D Pipeline 20
Slide 21: A Thoughtful Return to Product Development
A Thoughtful Return to Product Development Discover Assay developed Algorithmic Clinical validity Reimbursement Commercialized markers to CLIA standards discovery & utility AVISE CTD Enhanced CTD: RA33 & T-Cell CTD panel expansion: PAD4 Commercialized SLE disease activity Near term RA disease activi
Slide 22: Activity Indices for Autoimmune Disease
Activity Indices for Autoimmune Disease SLE Disease Activity RA Disease Activity Disease Systemic Lupus Erythematosus Rheumatoid Arthritis Patient Prevalence ~1 million patients in the U.S. ~2 million patients in the U.S. Disease managed by clinical Disease managed by clinical Clinical Challenge eva
Slide 23: Developing Enhanced Diagnostics for Seronegative RA Patients
Developing Enhanced Diagnostics for Seronegative RA Patients Biomarker Positivity Rates for • Conventional biomarkers for diagnosis of RA accurately Diagnosis of Rheumatoid Arthritis identify ~70% of patients PAD4 7% • Exagen is commercializing novel biomarkers to identify RA33 the conventionally se
Slide 24: Lupus Nephritis
Validation of proteomic signature to predict Lupus Nephritis histologically active Lupus Nephritis • Exagen is developing a urinary biomarker panel that is intended to diagnosis and aid in monitoring disease activity for LN • Validation work has been completed showing a high degree of correlation be
Slide 25: Novel Kidney Biomarkers Outperform Standard of Care for Early Disease Detection
Novel Kidney Biomarkers Outperform Standard of Care for Early Disease Detection Better than SOC for early diabetic kidney disease • Efforts to develop technology in Proteins A+ B+ C+ D | AUC = 0.91 Lupus Nephritis were broadened to discover biomarkers in chronic kidney disease Creatinine | AUC 0.78
Slide 26: Extensive, long-term I.P. protection
Patent Families Extensive, long- • AVISE: cell-bound complement activation product for diagnosing SLE - 2032 term I.P. • AVISE : treating & diagnosing likelihood of SLE - 2034 protection • Lupus nephritis biomarkers - 2045 • Kidney disease biomarkers - 2045 • Use of T-cell autoantibodies + CB-CAPs i
Slide 27: Use of Non-GAAP Financial Measures (Unaudited)
Use of Non-GAAP Financial Measures (Unaudited) 27
Slide 28: Reconciliation of Non-GAAP Financial Measures (Unaudited)
Reconciliation of Non-GAAP Financial Measures (Unaudited) The table below 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. 28 28