Exagen Q3 2026: Revenue Beats, But EPS Misses by 47%

Exagen reported third-quarter 2026 revenue of $18.42 million, a 6.8% gain year over year and a narrow beat of the $18.34 million Wall Street consensus. The top-line result was driven by growth in both test volume and average selling price for its flagship AVISE CTD test, marking the 14th consecutive quarter of pricing gains. Gross margin edged up to 58.8% from 58.4% a year earlier.

The earnings picture was considerably messier. GAAP EPS came in at -$0.25, missing the -$0.17 analyst estimate by 47%, dragged down in part by a $587,000 in-process research and development charge tied to the July 16 acquisition of an AI-enabled rheumatology workflow software platform, as well as a $909,000 non-cash loss from the change in fair value of warrant liability. Operating expenses climbed to $15.24 million from $13.18 million in the prior-year period, widening the operating loss to $4.41 million.

The EPS miss looks worse in the context of recent history. Exagen has now missed earnings estimates in four of the last eight quarters, including a significant shortfall in Q3 2025, when the reported loss of -$0.31 per share ran well past the -$0.16 estimate. The two beats in between, Q1 2026 and Q2 2026, had raised expectations that the bottom line was finally stabilizing.

Management held its full-year 2026 revenue guidance of $72 million to $75 million, signaling confidence in the trajectory of the core diagnostics business. Cash ended the quarter at $28.1 million, down from $32.2 million at year-end 2025, a decline of roughly 21% year over year that investors will be watching closely as the company funds its pipeline.

The clearest near-term catalyst is the planned early-2027 launch of a myositis testing offering, which CEO John Aballi described as addressing an area of significant unmet clinical need. An educational webcast on the myositis solution and additional pipeline development is scheduled for December 15, 2026, giving investors a formal checkpoint before year-end.