Core Insights - Exagen Inc. reported a record revenue of $17.2 million for Q3 2025, marking a 38% increase compared to Q3 2024, or a 26% increase when excluding one-time adjustments from 2024 [8] - The company anticipates full-year revenue for 2025 to be between $65 million and $70 million, with expectations of achieving positive adjusted EBITDA in Q4 2025 [4] Financial Performance - Revenue for Q3 2025 was $17,244 thousand, compared to $12,507 thousand in Q3 2024, and for the nine months ended September 30, 2025, revenue was $49,944 thousand, up from $41,986 thousand in the same period of 2024 [2][18] - Gross margin improved to 58.4% in Q3 2025 from 55.8% in Q3 2024, and for the nine months, it was 59.3% compared to 58.7% [2] - Operating expenses increased to $13,175 thousand in Q3 2025 from $11,644 thousand in Q3 2024, and for the nine months, they rose to $38,688 thousand from $34,888 thousand [2][18] - The net loss for Q3 2025 was $7,087 thousand, compared to a net loss of $5,028 thousand in Q3 2024, with a nine-month net loss of $15,278 thousand versus $11,354 thousand in the prior year [2][18] Operational Highlights - The volume of AVISE CTD tests grew by 16% compared to Q3 2024, and the average selling price (ASP) for AVISE CTD tests increased to $441, up by $37 from Q3 2024 [8] - The company ended Q3 2025 with cash and cash equivalents of $35,652 thousand, an increase from $22,035 thousand at the end of Q3 2024 [2][18] - Exagen launched seronegative RA markers for anti-PAD4, enhancing the AVISE CTD panel, and presented six abstracts at the American College of Rheumatology Conference [8] Company Overview - Exagen Inc. is a leading provider of autoimmune diagnostics, focusing on improving clinical outcomes for patients with chronic autoimmune conditions through innovative testing solutions [13] - The company's flagship product, AVISE CTD, aids in the diagnosis of complex autoimmune diseases such as lupus and rheumatoid arthritis [13]

Core Insights - Exagen Inc. announced the acceptance of six abstracts at the 2025 American College of Rheumatology's annual meeting, highlighting advancements in autoimmune testing [1][2][3] Group 1: Research and Presentations - A plenary presentation in collaboration with Johns Hopkins University will focus on a urinary biomarker panel for guiding precision management of Lupus Nephritis [2][3] - Additional abstracts will cover innovative research on anti-RA33, anti-PAD4, and traditional biomarkers to improve rheumatoid arthritis diagnostic accuracy, as well as T Cell biomarkers to differentiate systemic lupus erythematosus from other conditions [2][3] - Exagen will present preliminary data on a novel kidney damage biomarker panel aimed at transforming early kidney disease management [3] Group 2: Abstract Details - The accepted abstracts include a plenary talk on "Urinary Tenascin C Predicts Kidney Function Loss in Lupus Nephritis" scheduled for October 27, 2025 [4] - Other presentations will feature a machine learning classifier for rheumatoid arthritis and a kidney-specific biomarker panel that differentiates Lupus Nephritis from diabetic kidney disease [4][5] - A poster presentation will discuss the clinical utility of a multianalyte lupus risk score incorporating cell-bound complement activation products [6] Group 3: Company Overview - Exagen Inc. is a leading provider of autoimmune diagnostics, focused on improving patient care for chronic autoimmune conditions [7] - The company's flagship product, AVISE CTD, enhances the diagnosis of complex autoimmune diseases such as lupus and rheumatoid arthritis [7] - Exagen operates a CLIA-certified, CAP-accredited laboratory specializing in rheumatic disease testing, emphasizing research, innovation, and patient-centered care [7]

Core Insights - Exagen Inc. will release its financial results for Q3 2025 on November 4, 2025, before market opening [1] - The conference call to discuss the results will be hosted by the President and CEO, John Aballi, along with CFO Jeff Black at 8:30 a.m. ET [1] Company Overview - Exagen Inc. is a leading provider of autoimmune diagnostics, focused on transforming care for patients with chronic autoimmune conditions [2] - The company's flagship product, AVISE CTD, aids in the early and accurate diagnosis of complex autoimmune diseases such as lupus and rheumatoid arthritis [2] - Exagen operates a CLIA-certified, CAP-accredited laboratory specializing in rheumatic disease testing, providing precise and timely results [2] - The company emphasizes research, innovation, education, and patient-centered care to address challenges in autoimmune disease management [2]

Core Insights - Exagen Inc. (NASDAQ: XGN) stock is performing well, currently trading at its 52-week highs, levels last seen in January 2022 [1] - The stock experienced a challenging period from October 2022 before its recent recovery [1] Company Performance - XGN stock has reached its highest trading levels in over a year, indicating strong market performance [1] - The stock's recovery follows a slow patch, suggesting potential for future growth [1] Analyst Background - Gamu Dave Innocent Pasi is a financial professional with extensive experience in investment research and analysis [1] - He has a strong track record in providing actionable trading ideas and investment recommendations, with contributions to reputable financial publications [1] - Pasi holds advanced qualifications in investments and portfolio management, emphasizing his expertise in the field [1]

Company Overview - Exagen Inc. is a leading provider of autoimmune diagnostics, focused on transforming care for patients with chronic autoimmune conditions [2] - The company's flagship product, AVISE CTD, aids in the early and accurate diagnosis of complex autoimmune diseases such as lupus, rheumatoid arthritis, and Sjögren's disease [2] - Exagen specializes in testing for rheumatic diseases, offering a comprehensive suite of AVISE-branded tests for diagnosis, prognosis, and monitoring [2] Upcoming Events - Exagen management will participate in the Canaccord Genuity 45 Annual Growth Conference on August 12, 2025, in Boston, MA, featuring a fireside chat and 1X1 meetings [1] - The company will also attend the Cantor Global Healthcare Conference 2025 on September 3, 2025, in New York, NY, with similar participation formats [1]

Core Viewpoint - Exagen reported strong revenue growth driven by its AVISE CTD test, but continued to face widening net losses due to increased operating expenses and ongoing investments in sales and research efforts [1][5][7]. Financial Performance - Q2 2025 GAAP revenue reached $17.2 million, exceeding analyst expectations of $16.31 million, and representing a 14.2% increase from $15.1 million in Q2 2024 [2][5]. - GAAP EPS was $(0.21), worse than the expected $(0.15) and a decline from $(0.16) in Q2 2024, marking a 31.3% year-over-year deterioration [2][5]. - Gross margin improved slightly to 60.4%, up from 60.1% in the previous year, with management targeting mid-60% range in the long term [2][6]. - Cash and cash equivalents increased to $30.0 million, a 22.6% rise from $24.5 million in Q2 2024, bolstered by a recent equity offering [2][9]. Product and Market Dynamics - The AVISE CTD test, which accounts for approximately 90% of revenue, saw a 14% sequential increase in test volumes and a 7% year-over-year rise, reflecting growing clinical adoption [3][5]. - The average selling price (ASP) for AVISE CTD improved to $428, a $27 increase from the previous year, attributed to reimbursement progress and higher pricing on new biomarkers [5][6]. Operational Insights - Operating expenses rose due to increased hiring for sales and R&D, with R&D costs climbing to $1.5 million from $1.2 million in Q2 2024 [7]. - The net loss widened to $4.4 million from $3.0 million in Q2 2024, driven by higher spending and the need to scale revenue [7]. Reimbursement and Legal Developments - Exagen achieved a significant legal victory regarding a denied Medicare Advantage claim, which may set a precedent for future appeals [8]. - Positive policy decisions for AVISE CTD with TRICARE were secured, expanding coverage for military families after a two-year review [8]. Future Outlook - For fiscal 2025, management projects GAAP revenue between $65 million and $70 million, relying on continued momentum from AVISE CTD and reimbursement efforts [11]. - The company aims to reach break-even on adjusted EBITDA by Q4 2025, contingent on sales acceleration and expense management [11].

分组1 - Exagen Inc. reported a quarterly loss of $0.18 per share, consistent with the Zacks Consensus Estimate, compared to a loss of $0.16 per share a year ago [1] - The company posted revenues of $17.2 million for the quarter ended June 2025, exceeding the Zacks Consensus Estimate by 7.51%, and up from $15.06 million year-over-year [2] - Exagen shares have increased approximately 80.2% since the beginning of the year, significantly outperforming the S&P 500's gain of 8.6% [3] 分组2 - The earnings outlook for Exagen is crucial for investors, as it includes current consensus earnings expectations for upcoming quarters and any recent changes to these expectations [4] - The estimate revisions trend for Exagen was mixed ahead of the earnings release, resulting in a Zacks Rank 3 (Hold) for the stock, indicating expected performance in line with the market [6] - The current consensus EPS estimate for the upcoming quarter is -$0.14 on revenues of $16.5 million, and -$0.61 on revenues of $65.8 million for the current fiscal year [7] 分组3 - The Medical - Products industry, to which Exagen belongs, is currently ranked in the bottom 28% of over 250 Zacks industries, which may impact stock performance [8] - Cresco Labs Inc., another company in the same industry, is expected to report a quarterly loss of $0.04 per share, reflecting a year-over-year change of +75%, with revenues projected at $163.86 million, down 11.1% from the previous year [9]

Financial Data and Key Metrics Changes - Exagen reported record revenue of $17.2 million for Q2 2025, representing a 14% year-over-year growth, marking the highest quarterly revenue in the company's history [5][23] - The average revenue per territory reached over $430,000 for the quarter, up from $285,000 two years ago, indicating significant commercial leverage [6] - Gross margin improved to just over 60%, up from about 59% in Q1 and 60% in Q2 2024, reflecting higher average selling prices (ASP) and normalization of lab operations [24] Business Line Data and Key Metrics Changes - The Advise CTD test volume growth was substantial, with the best quarterly volume since strategic adjustments were made in 2023 [6] - ASP for the trailing twelve months grew by $27 year-over-year to $428, driven primarily by new biomarkers [23] Market Data and Key Metrics Changes - The company is currently around 10% penetrated in its market, indicating significant room for growth [35] - The expansion of the physician base and consistent ordering patterns from high-value clinicians contributed to revenue growth [7][9] Company Strategy and Development Direction - Exagen is focused on building leadership in autoimmune diagnostics through disciplined execution, physician engagement, and innovation [5] - The company plans to launch additional biomarkers, including anti-PAD antibodies, to strengthen its value proposition in rheumatoid arthritis [54] - Strategic investments in R&D and commercial expansion are ongoing, with a focus on achieving profitability and improving patient outcomes [28] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the sustainability of volume growth, attributing it to a strong team and the introduction of new biomarkers [35] - The company expects to achieve positive adjusted EBITDA by Q4 2025 and maintain it throughout 2026 [28] Other Important Information - Exagen ended the quarter with over $30 million in cash and equivalents, positioning itself for near free cash flow positive status [27] - The addition of key personnel, including a new Chief Scientific Officer, is expected to enhance the company's R&D capabilities [14] Q&A Session Summary Question: Sustainability of Volume Growth - Management believes the recent volume growth is sustainable due to a strong team and the introduction of new biomarkers, with a market penetration of just under 10% [35] Question: ASP Progress - Management remains optimistic about achieving a $90 increase in ASP by the end of 2025, despite some adjustments made to align accrual rates with cash collections [41] Question: Market Access Initiatives - The company is enhancing marketing campaigns and training for the sales team to drive awareness and adoption of its products, focusing on building trust within the clinical community [92] Question: Expansion of Territories - Exagen started Q2 with 40 territories and expanded to 42, with plans to reach 44 by year-end, emphasizing the importance of field-based representatives for growth [72][75]

Financial Data and Key Metrics Changes - Exagen reported record revenue of $17.2 million for Q2 2025, representing a 14% year-over-year growth and the highest quarterly revenue in company history [4][22]. - The average revenue per territory reached over $430,000 for the quarter, up from $285,000 a couple of years ago, indicating significant commercial leverage [5][6]. - Gross margin improved to just over 60%, up from about 59% in Q1 and 60% in Q2 2024, reflecting higher average selling prices (ASP) and normalization of lab operations [23]. Business Line Data and Key Metrics Changes - The Advise CTD test volume growth was substantial, with the best quarterly volume since strategic adjustments were made in 2023 [5]. - The ASP for the trailing twelve months grew by $27 year-over-year to $428, driven primarily by new biomarkers [22]. Market Data and Key Metrics Changes - The company is currently around 10% penetrated in its market, indicating significant room for growth [35]. - The revenue growth was driven by increased ordering within the physician base and expansion of the physician base [6][19]. Company Strategy and Development Direction - Exagen is focused on building leadership in autoimmune diagnostics through disciplined execution, physician engagement, and innovation [4]. - The company plans to launch additional biomarkers, including anti PAD antibodies, to strengthen its value proposition in the rheumatoid arthritis space [52]. - Strategic investments are being made in R&D and commercial expansion while maintaining a path to profitability [28]. Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the sustainability of volume growth, attributing it to a strong team and the introduction of new biomarkers [35]. - The company expects to achieve positive adjusted EBITDA by Q4 2025 and maintain it throughout 2026 [28]. - Management highlighted the importance of building trust and value in clinical practice to drive adoption of new biomarkers [90]. Other Important Information - The company ended the quarter with over $30 million in cash and equivalents, positioning itself for near free cash flow positive status [26]. - Exagen made key leadership hires, including a new Chief Scientific Officer, to enhance its R&D capabilities [13][14]. Q&A Session Summary Question: Sustainability of Volume Growth - Management believes the recent volume growth is sustainable due to a strong team and the introduction of new biomarkers, with a market penetration of just under 10% [35]. Question: ASP Progress - Management remains optimistic about achieving a $90 increase in ASP by the end of 2025, despite some adjustments made to accrual rates [38][41]. Question: Seasonal Trends in Volume - Management does not provide quarterly volume guidance but expects continued improvement in the second half of the year, aided by sales expansion [48]. Question: Expansion of Territories - The company started Q2 with 40 territories and expanded to 42, with plans to reach 44 by year-end [71][72]. Question: Market Access Initiatives - Exagen is enhancing its marketing campaigns and focusing on building trust with clinicians to drive volume growth [90].

Part I. Financial Information This section provides the company's unaudited condensed financial statements and related management discussion and analysis [Item 1. Unaudited Condensed Financial Statements](index=3&type=section&id=Item%201.%20Unaudited%20Condensed%20Financial%20Statements) This section presents Exagen Inc.'s unaudited condensed financial statements, including balance sheets, statements of operations, stockholders' equity, and cash flows, along with detailed explanatory notes [Unaudited Condensed Balance Sheets](index=3&type=section&id=Unaudited%20Condensed%20Balance%20Sheets) Presents Exagen Inc.'s financial position, detailing assets, liabilities, and stockholders' equity at specific reporting dates Unaudited Condensed Balance Sheets (in thousands) | Metric | June 30, 2025 (in thousands) | December 31, 2024 (in thousands) | | :-------------------------------- | :----------------------------- | :------------------------------- | | Cash and cash equivalents | $30,033 | $22,036 | | Accounts receivable, net | $14,272 | $7,835 | | Total current assets | $50,986 | $36,455 | | Total assets | $58,760 | $44,689 | | Total current liabilities | $10,295 | $13,506 | | Total liabilities | $37,726 | $35,149 | | Total stockholders' equity | $21,034 | $9,540 | - Total assets increased by **$14.1 million (31.5%)** from December 31, 2024, to June 30, 2025, primarily driven by an increase in cash and cash equivalents and accounts receivable[9](index=9&type=chunk) - Total stockholders' equity more than doubled, increasing by **$11.5 million (120.9%)** from December 31, 2024, to June 30, 2025, largely due to a public offering[9](index=9&type=chunk) [Unaudited Condensed Statements of Operations](index=4&type=section&id=Unaudited%20Condensed%20Statements%20of%20Operations) Details Exagen Inc.'s revenues, expenses, and net loss over specific reporting periods Unaudited Condensed Statements of Operations (in thousands) | Metric (in thousands) | Three Months Ended June 30, 2025 | Three Months Ended June 30, 2024 | Six Months Ended June 30, 2025 | Six Months Ended June 30, 2024 | | :-------------------- | :------------------------------- | :------------------------------- | :----------------------------- | :----------------------------- | | Revenue | $17,202 | $15,064 | $32,700 | $29,479 | | Cost of revenue | $6,807 | $6,008 | $13,182 | $11,825 | | Gross margin | $10,395 | $9,056 | $19,518 | $17,654 | | Total operating expenses | $13,025 | $11,643 | $25,513 | $23,244 | | Loss from operations | $(2,630) | $(2,587) | $(5,995) | $(5,590) | | Net loss | $(4,439) | $(2,966) | $(8,191) | $(6,326) | | Net loss per share | $(0.21) | $(0.16) | $(0.41) | $(0.35) | - Revenue increased by **14.2%** for the three months ended June 30, 2025, and by **10.9%** for the six months ended June 30, 2025, compared to the respective prior-year periods[11](index=11&type=chunk) - Net loss widened to **$4.4 million** for the three months and **$8.2 million** for the six months ended June 30, 2025, from **$3.0 million** and **$6.3 million** in the prior-year periods, respectively, partly due to increased interest expense, loss on debt extinguishment, and change in fair value of warrant liability[11](index=11&type=chunk) [Unaudited Condensed Statements of Stockholders' Equity](index=5&type=section&id=Unaudited%20Condensed%20Statements%20of%20Stockholders'%20Equity) Outlines changes in Exagen Inc.'s equity accounts, including common stock, additional paid-in capital, and accumulated deficit Unaudited Condensed Statements of Stockholders' Equity (in thousands) | Metric (in thousands) | December 31, 2024 | March 31, 2025 | June 30, 2025 | | :-------------------- | :---------------- | :------------- | :------------ | | Total Stockholders' Equity | $9,540 | $6,403 | $21,034 | | Common Stock Shares Outstanding | 17,640,328 | 17,950,033 | 21,998,739 | | Additional Paid-In Capital | $303,853 | $304,468 | $323,534 | | Accumulated Deficit | $(294,331) | $(298,083) | $(302,522) | - Total stockholders' equity significantly increased from **$9.5 million** at December 31, 2024, to **$21.0 million** at June 30, 2025, primarily driven by a public offering that generated **$18.6 million** in net proceeds[14](index=14&type=chunk)[26](index=26&type=chunk) - The company issued **3,852,500 shares** of common stock from a public offering and **107,969 shares** from warrant exercises during the six months ended June 30, 2025[14](index=14&type=chunk) [Unaudited Condensed Statements of Cash Flows](index=7&type=section&id=Unaudited%20Condensed%20Statements%20of%20Cash%20Flows) Summarizes Exagen Inc.'s cash inflows and outflows from operating, investing, and financing activities Unaudited Condensed Statements of Cash Flows (in thousands) | Cash Flow Activity (in thousands) | Six Months Ended June 30, 2025 | Six Months Ended June 30, 2024 | | :-------------------------------- | :----------------------------- | :----------------------------- | | Net cash used in operating activities | $(13,556) | $(11,466) | | Net cash used in investing activities | $(316) | $(222) | | Net cash provided by (used in) financing activities | $21,869 | $(326) | | Net increase (decrease) in cash, cash equivalents and restricted cash | $7,997 | $(12,014) | | Cash, cash equivalents and restricted cash, end of period | $30,233 | $24,679 | - Net cash used in operating activities increased to **$13.6 million** for the six months ended June 30, 2025, from **$11.5 million** in the prior-year period, primarily due to a higher net loss and changes in working capital[20](index=20&type=chunk)[174](index=174&type=chunk)[175](index=175&type=chunk) - Financing activities provided **$21.9 million** in cash for the six months ended June 30, 2025, a significant increase from a net use of **$0.3 million** in the prior-year period, driven by proceeds from debt and warrant issuance (**$23.7 million**) and common stock issuance (**$18.8 million**)[20](index=20&type=chunk)[178](index=178&type=chunk)[179](index=179&type=chunk) [Notes to Unaudited Condensed Financial Statements](index=8&type=section&id=Notes%20to%20Unaudited%20Condensed%20Financial%20Statements) Provides detailed explanations and additional information supporting the unaudited condensed financial statements [Note 1. Organization](index=8&type=section&id=Note%201.%20Organization) Describes Exagen Inc.'s business, operational focus, and financial viability considerations - Exagen Inc. is a medical technology company focused on diagnostic testing products under the AVISE® brand for rheumatic, autoimmune, and autoimmune-related diseases[23](index=23&type=chunk) - The company has incurred recurring losses and negative cash flows from operations since inception, with an accumulated deficit of **$302.5 million** as of June 30, 2025[24](index=24&type=chunk) - Management believes existing capital resources are sufficient for at least twelve months, supported by a new **$75.0 million** Perceptive Term Loan Facility (initial **$25.0 million** funded) and **$18.6 million** net proceeds from a public stock offering in May 2025[24](index=24&type=chunk)[25](index=25&type=chunk)[26](index=26&type=chunk) [Note 2. Summary of Significant Accounting Policies](index=8&type=section&id=Note%202.%20Summary%20of%20Significant%20Accounting%20Policies) Outlines the key accounting principles and methods used in preparing the financial statements, including revenue recognition and fair value measurements - The financial statements are prepared in accordance with GAAP for interim financial statements, requiring management estimates and assumptions, particularly for revenue recognition and fair value of warrant liability[28](index=28&type=chunk)[29](index=29&type=chunk)[30](index=30&type=chunk)[31](index=31&type=chunk) Significant Payors and Customers (Revenue % of Total) | Customer | Three Months Ended June 30, 2025 | Three Months Ended June 30, 2024 | Six Months Ended June 30, 2025 | Six Months Ended June 30, 2024 | | :--------- | :------------------------------- | :------------------------------- | :----------------------------- | :----------------------------- | | Customer A | 23% | 23% | 23% | 25% | | Customer B | 16% | 25% | 17% | 21% | | Customer C | <10% | 11% | 10% | <10% | | Customer D | 10% | <10% | <10% | <10% | - Approximately **91%** of the Company's revenue for the three and six months ended June 30, 2025, was derived from the AVISE® CTD test[34](index=34&type=chunk) Revenue Disaggregation by Payor (in thousands) | Payor Category | Three Months Ended June 30, 2025 | Three Months Ended June 30, 2024 | Six Months Ended June 30, 2025 | Six Months Ended June 30, 2024 | | :------------- | :------------------------------- | :------------------------------- | :----------------------------- | :----------------------------- | | Commercial | $8,811 | $8,672 | $17,571 | $15,535 | | Government | $3,926 | $3,457 | $7,633 | $7,643 | | Client direct bill | $4,371 | $2,910 | $7,367 | $6,194 | | Other | $94 | $25 | $129 | $107 | | Total revenue | $17,202 | $15,064 | $32,700 | $29,479 | - The company recognized a net revenue increase of **$0.1 million** and **$1.0 million** for the three and six months ended June 30, 2025, respectively, from changes in estimated variable consideration related to prior periods[44](index=44&type=chunk) - The allowance for credit losses was **$0.5 million** as of June 30, 2025, compared to zero as of June 30, 2024[48](index=48&type=chunk) - Total potentially dilutive securities not included in diluted EPS calculation due to anti-dilution were **2,878,858 shares** as of June 30, 2025[55](index=55&type=chunk) [Note 3. Other Financial Information](index=14&type=section&id=Note%203.%20Other%20Financial%20Information) Presents details on prepaid expenses, property and equipment, and accrued liabilities Prepaid Expenses and Other Current Assets (in thousands) | Category | June 30, 2025 | December 31, 2024 | | :-------------------------------- | :------------ | :---------------- | | Diagnostic testing supplies | $3,744 | $5,725 | | Prepaid maintenance and insurance contracts | $1,707 | $829 | | Loan commitment fees | $1,132 | — | | Total | $6,681 | $6,584 | Property and Equipment, net (in thousands) | Category | June 30, 2025 | December 31, 2024 | | :-------------------------------- | :------------ | :---------------- | | Total property and equipment | $10,945 | $11,295 | | Less: accumulated depreciation and amortization | $(6,363) | $(6,012) | | Property and equipment, net | $4,582 | $5,283 | - Depreciation and amortization expense was approximately **$0.5 million** for the three months and **$0.9 million** for the six months ended June 30, 2025[60](index=60&type=chunk) Accrued and Other Current Liabilities (in thousands) | Category | June 30, 2025 | December 31, 2024 | | :-------------------------------- | :------------ | :---------------- | | Accrued payroll and related expenses | $3,455 | $5,046 | | Other accrued liabilities | $1,487 | $2,071 | | Total | $4,942 | $7,117 | [Note 4. Borrowings](index=14&type=section&id=Note%204.%20Borrowings) Details the company's debt arrangements, including the new Perceptive Term Loan Facility and related terms - On April 25, 2025, the Company entered into a **$75.0 million** senior secured delayed draw term loan facility with Perceptive, with an initial **$25.0 million** tranche funded, of which **$19.7 million** was used to repay the 2017 Term Loan[62](index=62&type=chunk)[25](index=25&type=chunk) - The Perceptive Term Loan Facility matures on April 25, 2030, accrues interest at Term SOFR (or **4.75%**) plus **7.0%**, and includes an interest-only period through maturity[63](index=63&type=chunk)[64](index=64&type=chunk) - In connection with the Perceptive Term Loan, the Company issued a warrant certificate to purchase up to **1,150,000 shares** of common stock, with **400,000 shares** vesting upon issuance[25](index=25&type=chunk)[66](index=66&type=chunk) - The Company recognized **$0.8 million** in interest expense for the three months ended June 30, 2025, related to the Perceptive Term Loan, with an effective interest rate of **16.2%**[68](index=68&type=chunk) - A **$0.3 million** loss on extinguishment of debt was recognized for the six months ended June 30, 2025, due to the early repayment of the 2017 Term Loan[70](index=70&type=chunk) Future Minimum Payments on Outstanding Borrowings (in thousands) | Year | Amount | | :--- | :----- | | 2025 (remaining) | $1,888 | | 2026 | $3,700 | | 2027 | $3,450 | | 2028 | $3,117 | | 2029 | $2,978 | | 2030 | $25,930 | | Total | $41,063 | [Note 5. Commitments and Contingencies](index=17&type=section&id=Note%205.%20Commitments%20and%20Contingencies) Outlines the company's contractual obligations, including licensing agreements, supply commitments, and legal matters - The Company has licensing agreements requiring ongoing royalty payments of less than **1%** on net sales of products incorporating licensed technology[74](index=74&type=chunk) - A supply agreement with a key supplier includes a minimum annual purchase commitment of **$10.4 million** for diagnostic testing consumables for the year ending December 31, 2025[75](index=75&type=chunk) - A qui tam case related to a DOJ settlement was dismissed with prejudice on July 15, 2025, following an appeal by the relator[78](index=78&type=chunk) [Note 6. Fair Value Measurements](index=18&type=section&id=Note%206.%20Fair%20Value%20Measurements) Explains the methodologies and assumptions used to determine the fair value of financial instruments, including debt and warrant liabilities - The Perceptive Term Loan Facility had a carrying value of **$21.4 million** and a fair value of **$22.0 million** as of June 30, 2025, determined using Level 2 inputs (discounted cash flow approach)[79](index=79&type=chunk) - The warrant liability, recorded at **$3.963 million** as of June 30, 2025, is classified as a Level 3 fair value measurement, utilizing a probability-weighted Black-Scholes-Merton model with significant unobservable inputs[83](index=83&type=chunk)[85](index=85&type=chunk) Warrant Liability Fair Value Assumptions | Assumption | April 25, 2025 (Issuance Date) | June 30, 2025 | | :-------------------------- | :----------------------------- | :------------ | | Fair value of underlying common stock | $6.21 | $6.98 | | Exercise price | $4.96 - $6.99 | $4.96 - $7.85 | | Risk-free interest rate | 4.3% | 4.2% - 4.3% | | Expected volatility | 88.8% | 88.1% - 88.3% | | Expected term (in years) | 10.0 | 9.8 - 10.0 | | Expected dividend yield | 0% | 0% | [Note 7. Stockholders' Equity](index=20&type=section&id=Note%207.%20Stockholders'%20Equity) Details changes in the company's equity structure, including public offerings and outstanding warrants - The Company has a shelf registration statement (Form S-3) effective November 29, 2023, with **$129.8 million** remaining available for sale as of June 30, 2025[86](index=86&type=chunk) - A public offering closed on May 9, 2025, resulting in the issuance of **3,852,500 shares** of common stock at **$5.25 per share**, generating net proceeds of approximately **$18.6 million**[88](index=88&type=chunk) Outstanding Warrants as of June 30, 2025 | Shares | Weighted-Average Exercise Price | Issuance date | Expiration date | | :----- | :------------------------------ | :------------ | :-------------- | | 124,848 | $1.84 | Jan 19, 2016 | Jan 19, 2026 | | 34,416 | $1.84 | Mar 31, 2016 | Mar 31, 2026 | | 131 | $1.84 | Apr 1, 2016 | Apr 1, 2026 | | 20,944 | $14.32 | Dec 7, 2018 | Dec 7, 2025 | | 804,951 | $0.001 | Jun 22, 2021 | None | | 400,000 | $5.27 | Apr 25, 2025 | Apr 25, 2035 | | **1,385,290** | | | | [Note 8. Stock Option Plan](index=21&type=section&id=Note%208.%20Stock%20Option%20Plan) Provides information on the company's incentive award plan, including available shares, unrecognized compensation costs, and stock-based compensation expense - As of June 30, 2025, **2,533,057 shares** remained available for future awards under the 2019 Incentive Award Plan[91](index=91&type=chunk) - Total unrecognized compensation cost related to RSUs was **$4.1 million**, expected to be recognized over a weighted-average vesting period of **2.8 years**[92](index=92&type=chunk) - Total unrecognized compensation cost related to stock options was **$0.6 million**, expected to be recognized over a weighted-average vesting period of **2.7 years**[93](index=93&type=chunk) Stock-Based Compensation Expense (in thousands) | Category | Three Months Ended June 30, 2025 | Three Months Ended June 30, 2024 | Six Months Ended June 30, 2025 | Six Months Ended June 30, 2024 | | :-------------------------- | :------------------------------- | :------------------------------- | :----------------------------- | :----------------------------- | | Cost of revenue | $60 | $39 | $115 | $56 | | Selling, general and administrative | $324 | $465 | $670 | $944 | | Research and development | $59 | $56 | $75 | $113 | | Total | $443 | $560 | $860 | $1,113 | [Note 9. Segment Reporting](index=22&type=section&id=Note%209.%20Segment%20Reporting) Confirms the company operates as a single segment focused on diagnostic testing products for rheumatic and autoimmune diseases - The Company operates as a single segment focused on diagnostic testing products for rheumatic, autoimmune, and autoimmune-related diseases, primarily the AVISE® CTD test[96](index=96&type=chunk) Segment Revenue and Net Loss (in thousands) | Metric | Three Months Ended June 30, 2025 | Three Months Ended June 30, 2024 | Six Months Ended June 30, 2025 | Six Months Ended June 30, 2024 | | :-------------------------- | :------------------------------- | :------------------------------- | :----------------------------- | :----------------------------- | | Revenue | $17,202 | $15,064 | $32,700 | $29,479 | | Gross margin | $10,395 | $9,056 | $19,518 | $17,654 | | Total segment operating expenses | $13,025 | $11,643 | $25,513 | $23,244 | | Segment net loss | $(4,439) | $(2,966) | $(8,191) | $(6,326) | [Item 2. Management's Discussion and Analysis of Financial Condition and Results of Operations](index=24&type=section&id=Item%202.%20Management's%20Discussion%20and%20Analysis%20of%20Financial%20Condition%20and%20Results%20of%20Operations) Management discusses the company's financial condition, operational results, key business developments, and factors influencing performance for the reported periods [Overview](index=24&type=section&id=Overview) Provides a high-level introduction to Exagen Inc.'s business, strategic focus, and flagship product - Exagen Inc. is a medical technology company focused on innovative AVISE® brand testing products for differential diagnosis, prognosis, and monitoring of complex rheumatic, autoimmune, and autoimmune-related diseases[102](index=102&type=chunk) - Under new leadership since late 2022, the company is executing an operational turnaround, achieving revenue growth, gross margin expansion, and reduced operating expenses and cash burn[103](index=103&type=chunk)[104](index=104&type=chunk) - The flagship product, AVISE® CTD, launched in 2012, comprised **91%** of revenue for the six months ended June 30, 2025, and is supported by extensive peer-reviewed literature[103](index=103&type=chunk)[107](index=107&type=chunk) [Recent Developments](index=25&type=section&id=Recent%20Developments) Highlights significant recent corporate events, including public offerings and new debt facilities - The 2025 Public Offering, closed on May 9, 2025, generated approximately **$18.6 million** in net proceeds from the sale of **3,852,500 common shares** at **$5.25 per share**[110](index=110&type=chunk) - The Perceptive Term Loan Facility, entered on April 25, 2025, provides up to **$75.0 million**, with an initial **$25.0 million** tranche funded, maturing on April 25, 2030, and includes interest-only payments until maturity[111](index=111&type=chunk) - The Credit Agreement is secured by a first-priority lien on substantially all company assets and includes financial covenants, such as maintaining a minimum unrestricted cash balance of **$3.0 million** and achieving specified net revenue levels[113](index=113&type=chunk)[114](index=114&type=chunk) [Research and Development](index=26&type=section&id=Research%20and%20Development) Discusses the company's ongoing investment in developing and enhancing diagnostic testing products - The company continues to invest in R&D to enhance existing and develop new testing products, either independently or through collaborations[115](index=115&type=chunk) [Factors Affecting Our Performance](index=26&type=section&id=Factors%20Affecting%20Our%20Performance) Identifies key internal and external elements influencing the company's financial and operational outcomes - Key performance drivers include the commercial launch of AVISE® CTD enhancements, with new SLE and RA biomarker assays expected to improve clinical utility, ASP, gross margin, and demand[116](index=116&type=chunk)[119](index=119&type=chunk) - Upcoming biomarker launches include PAD4 (expected end of 2025 for RA sensitivity), Lupus Nephritis (LN) biomarkers (results Q3 2025, initially for Pharma collaborations), SLE Disease Activity, RA Disease Activity, and Kidney Damage Biomarkers (provisional patent filed Nov 2024, initially for Pharma collaborations)[117](index=117&type=chunk) - Reimbursement for testing products is critical, with challenges from commercial payors regarding coverage and rates, and ongoing efforts to secure favorable Local Coverage Determinations (LCDs) for AVISE® Lupus[119](index=119&type=chunk)[128](index=128&type=chunk)[130](index=130&type=chunk) - AVISE® CTD test volume increased by approximately **7%** for the three months ended June 30, 2025, compared to the same period in 2024, and the trailing-twelve-month ASP increased by approximately **7%**[119](index=119&type=chunk)[131](index=131&type=chunk) - The company expects some seasonal variations in financial results due to holidays, vacation patterns, and patient benefit changes[122](index=122&type=chunk) - The current inflationary environment has impacted costs for laboratory testing services, personnel, and other operating expenses[123](index=123&type=chunk)[124](index=124&type=chunk) [Financial Overview](index=29&type=section&id=Financial%20Overview) Summarizes the company's revenue recognition policies, cost of revenue components, and expense expectations - Revenue recognition follows ASC Topic 606, with estimates based on historical collection analysis by test and payor, requiring significant management judgment[125](index=125&type=chunk) - Cost of revenue includes materials, direct labor, equipment, infrastructure, shipping, blood specimen collection fees, royalties, depreciation, and allocated overhead, with variations influenced by payor mix[132](index=132&type=chunk) - Selling, general and administrative expenses are expected to increase moderately in absolute dollars in the near-term due to sales force expansion and infrastructure investment, but decrease as a percentage of revenue[134](index=134&type=chunk)[144](index=144&type=chunk) - Research and development expenses are expected to increase moderately in absolute dollars in the near-term for pipeline initiatives, but decrease year-over-year as a percentage of revenue[135](index=135&type=chunk)[146](index=146&type=chunk) - Interest expense is projected to increase by approximately **$1.7 million** annually, including **$0.9 million** in non-cash interest, due to the Perceptive Term Loan Facility[136](index=136&type=chunk) [Results of Operations](index=31&type=section&id=Results%20of%20Operations) Compares the company's financial performance for the three and six months ended June 30, 2025, against the prior-year periods Three Months Ended June 30, 2025 vs. 2024 (in thousands) | Metric | 2025 | 2024 | Change | | :-------------------------------- | :----- | :----- | :----- | | Revenue | $17,202 | $15,064 | $2,138 | | Cost of revenue | $6,807 | $6,008 | $799 | | Gross margin | $10,395 | $9,056 | $1,339 | | Selling, general and administrative expenses | $11,542 | $10,464 | $1,078 | | Research and development expenses | $1,483 | $1,179 | $304 | | Loss from operations | $(2,630) | $(2,587) | $(43) | | Net loss | $(4,439) | $(2,966) | $(1,473) | - Revenue increased by **14.2%** for the three months ended June 30, 2025, driven by ASP expansion from new biomarkers and a **7%** increase in AVISE® CTD test volume[141](index=141&type=chunk) - Gross margin percentage slightly increased to **60.4%** for the three months ended June 30, 2025, from **60.1%** in the prior year, due to ASP expansion and improved overhead absorption[142](index=142&type=chunk) Six Months Ended June 30, 2025 vs. 2024 (in thousands) | Metric | 2025 | 2024 | Change | | :-------------------------------- | :----- | :----- | :----- | | Revenue | $32,700 | $29,479 | $3,221 | | Cost of revenue | $13,182 | $11,825 | $1,357 | | Gross margin | $19,518 | $17,654 | $1,864 | | Selling, general and administrative expenses | $22,746 | $21,006 | $1,740 | | Research and development expenses | $2,767 | $2,238 | $529 | | Loss from operations | $(5,995) | $(5,590) | $(405) | | Net loss | $(8,191) | $(6,326) | $(1,865) | - Revenue increased by **10.9%** for the six months ended June 30, 2025, primarily due to ASP expansion from new biomarkers and a **5%** increase in AVISE® CTD test volume[152](index=152&type=chunk) - Gross margin percentage slightly decreased to **59.7%** for the six months ended June 30, 2025, from **59.9%** in the prior year, attributed to investments in lab operations for new biomarker launch and temporary headwinds from contract amendments[153](index=153&type=chunk) [Liquidity and Capital Resources](index=34&type=section&id=Liquidity%20and%20Capital%20Resources) Assesses the company's ability to meet its short-term and long-term financial obligations and fund operations - The company has incurred net losses since inception, with a net loss of **$8.2 million** for the six months ended June 30, 2025, and an accumulated deficit of **$302.5 million**[162](index=162&type=chunk) - As of June 30, 2025, cash and cash equivalents were **$30.0 million**, with an additional **$50.0 million** available under the Perceptive Term Loan Facility, subject to revenue levels and other conditions[162](index=162&type=chunk) - Primary capital sources include product sales, common stock sales (e.g., **$18.6 million** net proceeds from May 2025 public offering), and term loan facilities[163](index=163&type=chunk)[166](index=166&type=chunk) - The company expects near- and longer-term liquidity requirements for working capital, general corporate expenses, milestone payments, purchase obligations, and debt/lease payments[169](index=169&type=chunk)[170](index=170&type=chunk) - Management believes existing cash and anticipated revenue will be sufficient for at least the next 12 months, but future funding may be required through equity offerings, debt financings, or collaborations[170](index=170&type=chunk)[172](index=172&type=chunk) Cash Flows Summary (in thousands) | Cash Flow Activity | Six Months Ended June 30, 2025 | Six Months Ended June 30, 2024 | | :----------------- | :----------------------------- | :----------------------------- | | Operating activities | $(13,556) | $(11,466) | | Investing activities | $(316) | $(222) | | Financing activities | $21,869 | $(326) | | Net change | $7,997 | $(12,014) | [Item 3. Quantitative and Qualitative Disclosures About Market Risk](index=37&type=section&id=Item%203.%20Quantitative%20and%20Qualitative%20Disclosures%20About%20Market%20Risk) States that the company has no applicable quantitative and qualitative disclosures regarding market risk - The company has no applicable quantitative and qualitative disclosures about market risk[184](index=184&type=chunk) [Item 4. Controls and Procedures](index=38&type=section&id=Item%204.%20Controls%20and%20Procedures) Details the evaluation of the company's disclosure controls and procedures, confirming their effectiveness and noting no material changes in internal control - Management, including the principal executive and financial officers, concluded that disclosure controls and procedures were effective at a reasonable level of assurance as of June 30, 2025[187](index=187&type=chunk) - There have been no material changes in internal control over financial reporting during the three months ended June 30, 2025[188](index=188&type=chunk) - The company acknowledges the inherent limitations of any cost-effective control system, which can only provide reasonable, not absolute, assurance[186](index=186&type=chunk)[189](index=189&type=chunk) Part II. Other Information This section provides additional non-financial information, including legal proceedings, risk factors, and exhibit listings [Item 1. Legal Proceedings](index=39&type=section&id=Item%201.%20Legal%20Proceedings) Addresses potential legal claims and highlights the dismissal of a specific qui tam case related to a prior DOJ settlement - The company may be subject to legal proceedings in the ordinary course of business, which can impact operations regardless of outcome[191](index=191&type=chunk) - A previously disclosed qui tam case, related to a **$0.7 million** settlement with the Department of Justice in October 2023, was dismissed with prejudice by the presiding judge on July 15, 2025[192](index=192&type=chunk) [Item 1A. Risk Factors](index=39&type=section&id=Item%201A.%20Risk%20Factors) Confirms no material changes to the risk factors previously disclosed in the 2024 Annual Report and Q1 2025 Quarterly Report - No material changes to the risk factors previously disclosed in the 2024 Annual Report and the Q1 2025 10-Q[194](index=194&type=chunk) [Item 5. Other Information](index=40&type=section&id=Item%205.%20Other%20Information) Reports no adoption, modification, or termination of Rule 10b5-1 or non-Rule 10b5-1 trading arrangements by directors or officers - No directors or officers adopted, modified, or terminated Rule 10b5-1 or non-Rule 10b5-1 trading arrangements during the six months ended June 30, 2025[197](index=197&type=chunk) [Item 6. Exhibits](index=41&type=section&id=Item%206.%20Exhibits) Lists all exhibits filed with the Form 10-Q, including corporate documents, agreements, and certifications - The exhibits include corporate governance documents (Amended and Restated Certificate of Incorporation, Bylaws), various warrant forms, the Credit Agreement and Guaranty with Perceptive Credit Holdings IV, LP, and the Underwriting Agreement for the May 2025 public offering[199](index=199&type=chunk) - Certifications from the Principal Executive Officer and Principal Financial Officer (pursuant to Rule 13a-14(a)/15d-14(a) and U.S.C. Section 1350) are furnished with the report[199](index=199&type=chunk) [Signatures](index=43&type=section&id=Signatures) Contains the duly authorized signatures of Exagen Inc.'s President, CEO, and CFO, affirming the report filing - The report is signed by John Aballi, President and Chief Executive Officer, and Jeffrey G. Black, Chief Financial Officer, on July 29, 2025[205](index=205&type=chunk)