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At present the effect of monoclonal antibodies on rheumatoid nodules remains poorly understood. Several cases of development or enlargement of rheumatoid nodules in association with TNF-α inhibitors have been described in the medical literature. Recently three cases of regression of rheumatoid nodules following tocilizumab have been published. We describe a 55-year-old female patient with long-standing rheumatoid arthritis, who developed an olecranon nodule during tocilizumab-induced rheumatoid arthritis remission.