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XBiotech was founded in 2005 in Vancouver, Canada by John Simard. The company moved its headquarters to Austin, Texas in 2008.
In September 2016, XBiotech was listed on Nasdaq, raising $70.9 million through its initial public offering (IPO). The company allocated about $42 million of the proceeds to complete later-stage trials for one of its key cancer drugs and to construct a new manufacturing and research facility in southeast Austin. The remaining funds were used for earlier-stage trials of other products and general corporate purposes. In March 2017, XBiotech announced a registered direct offering in which it sold over $30 million of its common shares at a price of $13 per share. In the same year, XBiotech opened a 40,000-square-foot production facility in Southeast Austin.
In October 2017, XBiotech enrolled its first patient in a clinical study to evaluate the effectiveness of its antibody MABp1 in combination with ONIVYDE and 5-fluorouracil/folinic acid for treating pancreatic cancer.
In December 2019, XBiotech's drug for dermatological conditions, bermekimab, was acquired by Janssen Pharmaceutical, a subsidiary of Johnson & Johnson, for $750 million. XBiotech is eligible for up to $600 million in milestone payments, potentially increasing the total value of the deal to $1.35 billion. In February 2022, Johnson & Johnson discontinued development of bermekimab for eczema taking a $610 million pretax impairment charge. As of January 2023, bermekimab is no longer being developed for hidradenitis suppurativa.
During the COVID-19 pandemic, XBiotech worked with BioBridge Global to offer its antibody screening technology to the South Texas Blood & Tissue Center. The technology identified patients with natural antibodies effective against the virus. XBiotech also developed a COVID-19 therapy candidate by isolating specific antibodies and their genes from convalescent plasma, aiming to create a mass-producible, purified antibody product.