Exhibit 4.9

English summary of Principal Terms of an Addendum to the Lease Agreement (dated March 22, 2015), entered on February 27, 2017, by and between Mintz K. Construction Company Ltd. (the “Landlord”), as landlord, and Galmed Research and Development Ltd. (the “GRD”), as tenant (the “Addendum”).

The Addendum

· Premises covered by the Addendum: Approximately 90 square meters for a space adjacent to the original premises covered under the Lease Agreement (the “Additional Premises”). The Additional Premises together with the original premises shall add up to a total of 446 square meters (the “Total Premises”).

· Term of Lease: Notwithstanding the Lease period under the Lease Agreement, the term of the Total Premises shall be for a period of 25 months from February 20, 2017 until March 21, 2019 (the “New Lease Term”), provided however that GRD shall have an option to extend the New Lease Term in accordance with the terms of the Lease Agreement (the “Option”).

· Fees: In addition to the fees paid under the Lease Agreement, the Company shall pay additional monthly rental fees in the amount of NIS 5,900 plus VAT for the Additional Premises (the “Additional Rental Fee)”, which shall increase to NIS 6,600 during the Option period, if exercised. The Additional Rental Fee is linked to the Israeli consumer price index of March 2015 and shall be paid on a quarterly basis together with the original premises rental fees.

· Expenses: GRD shall bear all customary expenses associated with the use of the Total Premises, including, but not limited to, Total Premises’ management fees and municipal tax.

· Security: GRD shall provide the Landlord with (i) an autonomous bank guarantee of NIS 26,000; provided however that during the Option Period, if exercised, the autonomous bank guarantee shall increase to NIS 29,000.

· Sublease: GRD shall have the right to transfer or assign its rights in the Premises to a third party, provided that in such event the Landlord's rights under the Lease and the Addendum thereof shall remain.