Atlizumab [Actemra, MRA] is a humanised anti-interleukin-6 receptor monoclonal antibody. It was originated by the Japanese company Chugai Pharmaceutical and is being developed for the treatment of rheumatoid arthritis, Crohn's disease, multiple myeloma and the lymphoproliferative disorder giant lymph node hyperplasia (Castleman's disease). In October 2002, a majority share (50.1%) in Chugai Pharmaceutical was acquired by Roche. Nippon Roche was merged into Chugai Pharmaceutical, which is now Roche's exclusive pharma representative in Japan. The relationship between Chugai Pharmaceutical and Roche has been defined through a jointly agreed governance agreement, by which Chugai Pharmaceutical will be an autonomously managed company. Chugai Pharmaceutical is now Roche's exclusive pharma representative in Japan and will have rights to develop and market Roche products in Japan. As part of the transaction, Roche gained rights of first refusal for licencing, marketing or co-developing any Chugai Pharmaceutical products which are available for partnering. In the first quarter of 2003, Chugai Pharmaceutical and Roche formed an agreement to co-develop and co-promote atlizumab. The companies will co-promote the drug in the UK, France and Germany. Roche will co-develop and promote atlizumab worldwide, except in Japan, South Korea and Taiwan. Chugai Pharmaceutical has retained co-promotion rights in the US, Italy and Spain. Atlizumab completed phase II development for giant lymph node hyperplasia in Japan in 2002, where it has been granted orphan drug status. In April 2003, a regulatory filing was submitted in Japan for use of atlizumab in the treatment of giant lymph node hyperplasia. In May 2000, Chugai Pharmaceutical and the US company Protein Design Labs reached an agreement whereby Chugai Pharmaceutical will receive nonexclusive, worldwide licences for an undisclosed number of its antibody targets under Protein Design Labs' antibody humanisation patents. One of the targets included is the human interleukin-6 receptor. Chugai Pharmaceutical will pay Protein Design Labs 6.04 million US dollars in signing and licencing fees. Chugai Pharmaceutical will also pay annual maintenance fees and royalties on any future product sales.