Real-World Prevalent Cardiovascular Comorbidity Burden and Treatment Prescribing Patterns in Psoriasis: A Regional French Outpatient Claims Analysis

Background/Objectives: The relative contributions of treatment modality and traditional cardiovascular risk factors (CVRFs) to identified cardiovascular disease (CVD) burden remain poorly quantified in population-level outpatient administrative data. Methods: We conducted a cross-sectional study using CPAM Loire outpatient reimbursement claims (August 2023–August 2025). Treated psoriasis and prevalent CVD were identified via validated medication- and procedure-based proxy algorithms. Multivariable logistic regression identified factors associated with prevalent CVD. Inverse probability of treatment weighting (IPTW) assessed systemic treatment channelling bias, and E-values quantified robustness to unmeasured confounding. Results: The cohort comprised 10,331 adults (mean age 54.1 years; 50.9% male); overall CVD prevalence was 14.4%. After multivariable adjustment, treatment modality showed no independent association with prevalent CVD for non-biologic systemic therapy (adjusted OR [aOR] 1.07; 95% CI 0.78–1.45) or biologic therapy (aOR 1.08; 95% CI 0.93–1.27). Restricted IPTW sensitivity analysis confirmed no biologic-versus-non-biologic systemic difference (weighted OR 0.98; 95% CI 0.69–1.38). The dominant independent determinants were dyslipidaemia (aOR 3.75; 95% CI 3.27–4.30), hypertension (aOR 3.20; 95% CI 2.71–3.77), and diabetes mellitus (aOR 1.95; 95% CI 1.68–2.27). E-values exceeded 5.8 for dyslipidaemia and hypertension. Conclusions: Prevalent CVD burden in this regional French psoriasis cohort was primarily associated with traditional CVRFs rather than treatment category. These findings support systematic cardiovascular risk management in psoriasis care pathways. However, this outpatient claims analysis is structurally unable to establish temporal precedence or long-term causal modification of cardiovascular risk.