Exagen Inc. · NASDAQ:XGN
Exagen — Q4 2025 Earnings Presentation
27 slides from Exagen's earnings presentation, Mar 10, 2026
Slide 1: Accelerating personalized medicine in autoimmune disease
Accelerating personalized medicine Patient Focused. Discovery Driven. in autoimmune disease Q 4 & F Y 2 0 2 5 U P D AT E | M AR C H 1 0 , 2 0 2 6
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: Identifying autoimmune disease is a challenge…
Identifying autoimmune disease is a challenge… Ambiguous symptoms >41M ~1M 3 Manifestations overlap AMERICANS ANA+ Americans diagnosed with lupus1 Outdated tech, testing delays With Tests lack specificity, sensitivity ~2M rheumatoid arthritis2 ANA+: antinuclear antibody High rate of misdiagnosis pos
Slide 4: The patient challenge
TH E PAT IE NT CHA LLE NGE 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,
Slide 5: The patient challenge: earlier intervention improves outcomes
TH E PAT IE NT CHA LLE NGE 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 RH EU MA TO ID Inflammation will lead to articular damage ARTHRITIS & bon
Slide 6: Conventional autoimmune biomarkers
TH E CLINICAL CH ALL ENGE CONVENTIONAL AU TOIMMUNE 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
Slide 7: AVISE Testing: the simple, clear choice for rheumatologists
2 tubes of OUR PROPRIETA RY SOLUTION patient’s blood AVISE Testing: the simple, clear choice for Rheumatologist Exagen rheumatologists lab >1.1M AVISE CTD report Tests completed • Comprehensive panel aids autoimmune disease diagnosis Simple | Proven | Trusted • Proprietary markers • Algorithmic inte
Slide 8: AVISE testing outperforms conventional biomarkers
OUR PROPRIE TA RY SOLUTION TEST SENSITIVI TY FOR LUPU S AVISE testing ® 100% outperforms 80% 80% conventional 60% Conventional markers 66% biomarkers 1 40% 33% 44% 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, e
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® CTD-tested patients vs Conventionally tested patients 3x Higher likelihood of starting treatment, which reduces risk of hospital
Slide 10: AVISE platform expansion delivered in 2025
AVISE platform expansion delivered in 2025 + Enhanced AVISE CTD for lupus + Strengthened AVISE CTD with T-cell markers with additional RA markers • Improves sensitivity • RA33 and PAD4 improve sensitivity for Rheumatoid Arthritis • T-cell autoantibodies rarely present in patients with other autoimmu
Slide 11: Prioritizing objectives to deliver long-term, profitable growth
F IN AN CIA L UP D AT E Q4 2025 Prioritizing objectives to deliver long-term, profitable growth 1 ADVANCE ADOPTION • Upgrade & expand sales force 2 EXPAND ASP • Improve RCM & market access 3 INNOVATE • Invest in high-potential projects • Support science with evidence • Engage with payers • Create ne
Slide 12: Financial impact of progress
F IN AN CIA L UP D AT E Q4 2025 Financial impact of progress Positioning organization for profitable long-term growth WHAT WE’VE DONE: 2022 to 2024 2025 AVE RAGE • RCM: Expanding ASP Revenue growth 5% 20% • Sales force: Restructured, now expanding • Organization: Upgraded talent + culture Volume gro
Slide 13: ASP expansion & volume recovery in 2025
F IN AN CIA L UP D AT E Q4 2025 ASP expansion & volume recovery in 2025 Both levers now contributing to revenue growth TTM AS P REVE NUE DR IVE RS $80 $500 • Improving RCM RE V ENUE ($ M) $60 $425 T T M $ AS P • Strategic exit of unprofitable programs $40 $350 • Launching new biomarkers $20 $275 • E
Slide 14: FY’25 & Q4’25 Results Summary
F IN AN CIA L UP D AT E Q4 2025 FY’25 & Q4’25 Results Summary KE Y ME TR IC S FY’24 FY’25 Change Q4’24 Q4’25 Change Revenue $55.6M $66.6M +20% $13.7M $16.6M +22% Volume 122,883 137,004 +11% -- -- -- TTM ASP $411 $441 +$30 $411 $441 +$30 Adjusted EBITDA* ($10.1M) ($9.8M) +5% ($2.5M) ($3.7M) (38%) 14
Slide 15: Balance Sheet Highlights
F IN AN CIA L UP D AT E Q4 2025 Balance Sheet Highlights Runway to execute growth strategy and fund business to positive free cash flow $30M Available debt capital for strategic $83M opportunities * $43M Cash, AR, and future Cash, cash equivalents & AR credit capacity $10M Available debt capital for
Slide 16: FY 2026 Revenue Outlook
F IN AN CIA L UP D AT E Q4 2025 FY 2026 Revenue Outlook Expect continued volume expansion while navigating transitory ASP headwind • 5% to 10% revenue growth YoY $70M to $73M • Volume: High-single digit % growth • ASP: Low-single digit % growth compared to Q4 2025 exit rate Structural initiatives co
Slide 17: Path to Breakeven AEBITDA & Cash Generation
F IN AN CIA L UP D AT E Q4 2025 Path to Breakeven AEBITDA & Cash Generation Expect inflection at FY revenue of ~$80M and ~63% gross margin $100 RE VE NU E 17 $90 TOTAL COSTS $80M $80 $70 $60 OP EX ($M) $50 40% 45% GROSS MARGIN 50% 55% 63% 60% 65% 70% 75% 17 *Reference appendix for non-GAAP and Adjus
Slide 18: Refocused Pipeline
Refocused Pipeline Discover Assay developed Algorithmic Clinical validity Reimbursement Commercialized markers to CLIA standards discovery & utility AVISE CTD CTD expansion: RA33 & T-Cell CTD expansion: PAD4 Lupus Nephritis SLE disease activity Myositis RA disease activity 18 18
Slide 19: 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 20: Appendix
Appendix Patient Focused. Discovery Driven. 20
Slide 21: Capitalization
Capitalization $81M Market Cap $74M Enterprise Value Share Price (as of 3/9/2026) $3.38 Market Cap $81 million Average Daily Volume 475,000 Term Debt (as of 12/31/2025) $25 million 52Week Range $2.80 / $12.23 Cash (as of 12/31/2025) $32 million Market Cap1 $81 million Enterprise Value $74 million 21
Slide 22: Use of Non-GAAP Financial Measures
Use of Non-GAAP Financial Measures UNAUDITED 22
Slide 23: 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. 23
Slide 24: Extensive, long-term I.P. protection
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 • Kidney disease biomarkers - 2046 • Use of T-cell autoantibodies + CB-CAPs in
Slide 25: 2025: Enhanced Diagnostics for Seronegative RA Patients
2025: Enhanced Diagnostics for Seronegative RA Patients Biomarker Positivity Rates for Diagnosis of Rheumatoid Arthritis • Conventional biomarkers for diagnosis of RA accurately identify ~70% of patients PAD4 7% • Exagen is commercializing novel biomarkers to identify RA33 the conventionally seroneg
Slide 26: Pipeline: Activity Indices for Autoimmune Disease
Pipeline: 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 Cha
Slide 27: Pipeline: Lupus Nephritis
Pipeline: Validation of proteomic signature to predict Lupus Nephritis histologically active Lupus Nephritis • Developing a urinary biomarker panel that is intended to diagnosis and aid in monitoring disease activity for LN • Completed validation work shows high degree of correlation between our pro